Weight Loss

Question 1

Endocrinologic weight loss:

Answer 1

DM type 1
Hyperthyroidism (thyrotoxicosis)
Addison’s disease

Question 2

Signs and symptoms of type 1 diabetes

Answer 2

Polyuria
Polydipsia
Polyphagia
Weight loss, fatigue, increased frequency of infections, rapid onset, insulin dependent, familial tendency, peak incidence 10-15 years.
Initial weight loss d/t osmotic diuresis.
Late weight loss = tissue loss despite increased appetite (hormonal abnormalities and loss of glucose through urine)

Question 3

Hyperthyroid signs and symptoms

Answer 3

(D/t Graves disease, hot adenoma, secondary)
Strong, rapid pulse, lid lag, sweating, neurotic anxiety, wide pulse pressure, brisk reflexes, low LDL
Diarrhea
Weight loss despite increased appetite
Osteoporosis
Atrial fibrillation
Depression? Dementia? Rule out apothetic hyperthyroidism!
WEIGHT LOSS D/T INCREASED METABOLIC RATE AND INCREASED MOTOR ACTIVITY

Question 4

Signs and symptoms addisons disease

Answer 4

Weight loss d.t DECREASED appetite = decreased cortisol secretion
(D/t norma adrenal, autoimmune, iron overload, TB)
Hypotension
HYPERkalemia, sudden death, weakness, hyperpigmentation, mental illness, nausea, weight loss.

Question 5

GI weight loss

Answer 5

Fat malabsorption (sprue, chronic pancreatitis, cystic fibrosis) + IBD

Question 6

Infection associated weight loss

Answer 6

Occult infections (TB, systemic mycoses, parasitic infestations = tape worms) + HIV disease

Question 7

Renal disease associated weight loss

Answer 7

Early manifestation of uremia = anorexia (end stage renal disease!)

Question 8

Malignancy associated weight loss

Answer 8

MC cause of weight loss in absence of major signs and symtoms
Any time of malignancy = eventual weight loss (anorexia, increased metabolic demand of the cancer, side-effects of cancer therapy)

Question 9

Psycholgoical assocaited weight loss

Answer 9

Anorexia nervosa (karen carpenter!)
Conversion disorders
Schizophrenia
Depression

Question 10

Diagnostic tests for weight loss

Answer 10

The big 4 (CBC, UA, chem prfile, ESR0
Fasting plasma glucose
Thyroid function tests
Amylase and lipase (pancreas)
Stool analysis