Weight loss history

Question 1

What are the main differentials for weight loss history?

Answer 1

1. Haematological system: Lymphoma, Leukaemia, Myeloma
2. Respiratory system: Lung cancer, Tuberculosis
3. Gastrointestinal system: Bowel cancer, Coeliac disease, Inflammatory bowel disease
4. Endocrine system: Hyperthyroidism, Diabetes, Addison’s disease
5. Renal system: Chronic kidney disease
6. Psychiatric: Depression, eating disorders
7. Others: Exercise, Human Immunodeficiency Virus, other cancers e.g. prostate cancer, breast cancer.

Question 2

How would you structure questions to ask about the weight loss?

Answer 2

1. When did you start losing weight? Did something happen?
2. How much weight have you lost? Was the weight loss intentional? Has your appetite changed at all? What would you say you eat in a day?
3. Ask about psychiatric/cardio/haem/endocrine/renal symptoms/other symptoms (establish mood)

Question 3

How would you ask about endocrine symptoms?

Answer 3

Tan/hyperpigmentation for Addisons
Asks about polydipsia
Asks about tremors (checking for further symptoms of hyperthyroidism)