Weight Loss

Question 1

Clinically important wl defined as

unintentional may also result in

Answer 1

> 5% loss of body weight over 6 to 12 mnths

cachexia

Question 2

Pathophys includes

Result of

Answer 2

loss of appetite (anorexia), inadequate intake, inc metabolism due to inflamm

many different processes

Question 3

WL particularly present in

Possible etiologies

Malignancy

Psych do

GI do

metabolic do

Chronic dz

Answer 3

elderly, inc w severity of underlying illness/institutionalization

Lung, esophageal, gastric cancer, lumphoma, RCC, prostate ca

Depression, eating/bipolar do, schizo

PUD, celiac, IBD, const, dysmot, panc

DM, hyperthyroid, adrenal ins, pheochromocytoma

HF, COPD, CKD

Question 4

MCC overall

w/out sx of disorder or cachexia, MCC is

cachexia almost always caused by

other causes of cachexia

Answer 4

malignancy (rarely presenting sx)

psych (depression)

serious inflam dz (ie malignancy)

rheum, HIV, infections

Question 5

Eval

must obtain

important to get

assess

PE

Answer 5

hx and PE

accurate wl measures, intentional or not, additional sx

medication/substance hx

functional and social factors

differentiating unintenional wl/cachexia/dz

Question 6

Important lab studies

CBC

Serum elec

Renal fxn

Hepatic fxn

TSH

ESR

HIV ELISA

Answer 6

hematologic malig, anemia, leukocytosis (Chronic infec/inflamm disease)

hypoNa/K

CKD

CLD, hep C

hyperthyroid

chronic infec, inflamm

HIV infection

Question 7

Complications

unintentional wl always results in

Answer 7

hip fracture, pressure ulcers, impaired immune/functional status

dec life expectancy