Weight loss resident survival guide: Difference between revisions
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{{familytree/start |summary=Unintentional weight loss management Algorithm.}} | |||
{{familytree | | | | | | | | | | Z01 | | | | | | | |Z01=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''History'''<div class="mw-collapsible mw-collapsed"><br> | |||
:❑[[Patient]] [[age]] ([[age]] may help determine possibility of [[malignancy|malignancies]])<br> | |||
:❑ Duration of symptoms (weeks in acute/severe versus years in chronic conditions)<br> | |||
:❑ Past medical history suggestive of [[immunodeficiency]] (recurrent [[infections]]), diagnosed [[malignancy]], [[malabsorption]] (chronic [[diarrhea]]), [[HF]], [[dyspepsia]]<br> | |||
:❑ Sexual history suggestive of [[HIV AIDS history and symptoms|HIV AIDS]]<br> | |||
:❑ Family history of certain malignant disorders ([[breast cancer]], [[ovarian cancer]], [[colon cancer]], or [[stomach cancer]]))<br> | |||
:❑ Exposure to communicable [[infectious disease]]s/ travel to high-risk areas<br> | |||
:❑ Environmental exposure such as [[ultraviolet radiation|UV]] (skin cancer risk)/ animals/ occupational exposure <br> | |||
:❑ Social history such as [[tobacco]], alcohol use, [[opioid]], [[cocaine]] use<br> | |||
:❑ Associated symptoms such as [[pain]], [[fever]], [[weight loss]], [[anorexia]], [[cough]], or recurrent [[UTI]]s}} | |||
{{familytree | | | | | | | | | | |!| | | | | | | }} | |||
{{familytree | | | | | | | | | | M01 | | | | | | | M01=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''[[Physical exam]]'''<div class="mw-collapsible mw-collapsed"><br>'''Appearance of the [[patient]]'''<br>[[Cachexia]] or surgical scar marks demonstrating previous malignancy treatment<br> | |||
❑ [[Vital signs]]<br> | |||
:❑ [[Temperature]]: High-grade / low-grade fever may demonstrate [[infection]]. <br> | |||
:❑ [[Heart rate]]: [[Tachycardia]] with regular pulse may demonstrate [[infection]]. <br> | |||
:❑ [[Respiratory rate]]: [[Tachypnea]] may demonstrate [[respiratory system]] involvement ([[infection]]\ [[metastasis]]).<br> | |||
:❑ [[Blood pressure]]: [[Chronic hypertension]] or [[hypotension]] (may indicate [[sepsis]] as a complication).<br> | |||
:❑ [[Oxygen saturation]]: may be low if the [[respiratory system]] is affected.<br> | |||
❑ HEENT<br> | |||
❑ [[Cardiovascular examination]]<br> | |||
❑ [[Respiratory examination]]<br> | |||
❑ [[Gastrointestinal system]] exam includes [[oral examination]], [[abdominal examination]], and [[digital rectal exam]]. <br> | |||
:❑ [[Splenomegaly]]) may demonstrate [[infectious mononucleosis|IM]], [[Hodgkin's lymphoma|hodgkin's]]/ [[non-Hodgkin's lymphoma]], and [[sarcoidosis]]<br> | |||
❑ [[Limb (anatomy)|Extremities]] exam<br> | |||
❑ Skin exam: Evaluate for the lesions that indicate [[malignancy]] such as [[melanoma]]/ potential inoculation sites for germ such as traumatic lesions.}} | |||
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{{familytree | | | | | | | | | | U01 | | | | | | | U01='''Labs'''<div class="mw-collapsible mw-collapsed"><div style="float: left; text-align: left; width: 20em; padding:1em;"> | |||
❑ [[CBC]] with differential<br> | |||
❑ [[ESR]]<br> | |||
❑ [[CMP]]<br> | |||
❑ [[Peripheral smaer]]<br> | |||
❑ [[Liver function tests|LFTs]]<br> | |||
*''Labs may be required at a later stage pf diagnosis''}} | |||
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{{familytree | | | | | | | | | | | | | | | | | |}} | |||
{{familytree | | | | | | | | | | | | | | | | | |}} | |||
==Treatment== | ==Treatment== |
Revision as of 20:39, 2 September 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Javaria Anwer M.D.[2]
Synonyms and keywords: weight loss management guide, unintentional weight loss management guide, loss of weight resident survival guide, pathologic weight loss resident survival guide.
Lymphadenopathy resident survival guide microchapters |
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Overview |
Causes |
Management |
Do's |
Don'ts |
Overview
Weight loss may be intentional or unintentional.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Malignancies (specifically digestive and non-hematologic), dementia, stroke, parkinson's disease, polymyalgia rheumatica, and oral disorders are more prevalent among individuals >65 years old.[1]
- Endocrine disorders, infections such as TB and HIV, psychiatric disorders such as depression, anxiety, OCD, and malignancies such as hematologic ones are more prevalent among patients, <65 years of age.[1]
- The chart below demonstrates the cause of unintentional weight loss in adult population. The incidence describes the full range of occurrence described in five studies in older individuals.[2][3][4][5][1][6]
- To read about other causes of unintentional weight loss click here.
Diagnosis
Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
History
| |||||||||||||||||||||||||||||||||||||
Physical exam Appearance of the patient Cachexia or surgical scar marks demonstrating previous malignancy treatment
❑ HEENT
❑ Extremities exam | |||||||||||||||||||||||||||||||||||||
Labs ❑ CBC with differential
| |||||||||||||||||||||||||||||||||||||
Do's
- Perform a thorough physical exam to evaluate for cause of weight loss.
Don'ts
- The content in this section is in bullet points.
References
- ↑ 1.0 1.1 1.2 Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A (2017). "Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients". PLoS ONE. 12 (4): e0175125. doi:10.1371/journal.pone.0175125. PMC 5384681. PMID 28388637.
- ↑ Alibhai, S. M.H. (2005). "An approach to the management of unintentional weight loss in elderly people". Canadian Medical Association Journal. 172 (6): 773–780. doi:10.1503/cmaj.1031527. ISSN 0820-3946.
- ↑ Wu, Wen-Chih Hank; Bosch, Xavier; Monclús, Esther; Escoda, Ona; Guerra-García, Mar; Moreno, Pedro; Guasch, Neus; López-Soto, Alfons (2017). "Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients". PLOS ONE. 12 (4): e0175125. doi:10.1371/journal.pone.0175125. ISSN 1932-6203.
- ↑ Gaddey HL, Holder K (May 2014). "Unintentional weight loss in older adults". Am Fam Physician. 89 (9): 718–22. PMID 24784334.
- ↑ Lankisch P, Gerzmann M, Gerzmann JF, Lehnick D (January 2001). "Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre". J. Intern. Med. 249 (1): 41–6. doi:10.1046/j.1365-2796.2001.00771.x. PMID 11168783.
- ↑ Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S (October 2012). "Addison's disease". Contemp Clin Dent. 3 (4): 484–6. doi:10.4103/0976-237X.107450. PMC 3636818. PMID 23633816.