Weightloss

Question 1

Name 3 questions to explore weightloss?

Answer 1

1. How much weight has been lost?
2. Over how long?
3. What other associated symptoms

Question 2

What relevant systems review questions can be asked regarding weight loss (5)

Answer 2

1. Has there been changes in appetite
2. Dysphagia
3. Abdominal pain which puts patient off eating
4. Any nausea / vomiting
5. Changes in bowel movements?

Question 3

Name 4 groupings of differential diagnosis?

Answer 3

1. Malignancy
2. Gastrointestinal
3. Endocrinological
4. Psychological

Question 4

Differential diagnosis of : Malignancy

Answer 4

1. Breast cancer - breast lump
2. Lung cancer - haemoptysis
3. Prostate cancer - urinary retention
4. Bowel cancer - changes in bowel movements
5. Post menopausal bleeding - uterine cancer

Question 5

Differential diagnosis : GI caused weightloss

Answer 5

1. Colon cancer
2. IBS
3. Coeliacs disease

Question 6

Differential diagnosis : Endocrinological cause weightloss

Answer 6

Thyrotoxicosis

Question 7

Differential diagnosis : Psychological cause of weight loss

Answer 7

1. Anorexia/Bulimia
2. Depression
3. Stress

Question 8

Other differentials

Answer 8

1. Diabetes mellitus

2. Chronic infection - TB / AIDS

Question 9

Colon cancer (3)

Answer 9

1. Elderly
2. Bloody stool / Malena
3. Changes in bowel habits

Question 10

IBS (3)

Answer 10

1. Diarrhea with blood/mucus

2. Abdominal pain

Question 11

Coeliac’s disease (3)

Answer 11

1. Diarrhea/ Steatorhhea
2. Anaemia - SOB/Tiredness
3. Abdominal discomfort

Question 12

Thyrotoxicosis

Answer 12

1. Diarrhea
2. Heat intolerance
3. Irritability
4. Restlessness
5. Tremor
6. Oligomenorrhea / Amenorrhea

Question 13

Anorexia / Bulimia symptoms

Answer 13

1. BMI < 17.5
2. Binge eating
3. Conscious effort to lose weight - gym/vomiting/laxative
4. Menstrual cycle disturbances

Question 14

Depression symptoms

Answer 14

1. Core : low mood, anhedonia
2. Biological : poor sleep / lack of energy
3. Hopelessness/ Suicidal thoughts