Weight loss resident survival guide: Difference between revisions
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*[[Malignancy|Malignancies]] (specifically digestive and non-hematologic), [[dementia]], [[stroke]], [[parkinson's disease]], [[polymyalgia rheumatica]], and [[oral]] disorders are more [[prevalent]] among individuals >65 years [[old]].<ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref> | *[[Malignancy|Malignancies]] (specifically digestive and non-hematologic), [[dementia]], [[stroke]], [[parkinson's disease]], [[polymyalgia rheumatica]], and [[oral]] disorders are more [[prevalent]] among individuals >65 years [[old]].<ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref> | ||
*[[Endocrine]] disorders, [[infections]] such as [[TB]] and [[HIV]], [[psychiatric disorders]] such as [[depression]], [[anxiety]], [[OCD]], and [[malignancy|malignancies]] such as [[hematology|hematologic]] ones are more prevalent among [[patients]], <65 years of age.<ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref> | *[[Endocrine]] disorders, [[infections]] such as [[TB]] and [[HIV]], [[psychiatric disorders]] such as [[depression]], [[anxiety]], [[OCD]], and [[malignancy|malignancies]] such as [[hematology|hematologic]] ones are more prevalent among [[patients]], <65 years of age.<ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref> | ||
*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.<ref name="Alibhai2005">{{cite journal|last1=Alibhai|first1=S. M.H.|title=An approach to the management of unintentional weight loss in elderly people|journal=Canadian Medical Association Journal|volume=172|issue=6|year=2005|pages=773–780|issn=0820-3946|doi=10.1503/cmaj.1031527}}</ref><ref name="WuBosch2017">{{cite journal|last1=Wu|first1=Wen-Chih Hank|last2=Bosch|first2=Xavier|last3=Monclús|first3=Esther|last4=Escoda|first4=Ona|last5=Guerra-García|first5=Mar|last6=Moreno|first6=Pedro|last7=Guasch|first7=Neus|last8=López-Soto|first8=Alfons|title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients|journal=PLOS ONE|volume=12|issue=4|year=2017|pages=e0175125|issn=1932-6203|doi=10.1371/journal.pone.0175125}}</ref><ref name="pmid24784334">{{cite journal |vauthors=Gaddey HL, Holder K |title=Unintentional weight loss in older adults |journal=Am Fam Physician |volume=89 |issue=9 |pages=718–22 |date=May 2014 |pmid=24784334 |doi= |url=}}</ref><ref name="pmid11168783">{{cite journal |vauthors=Lankisch P, Gerzmann M, Gerzmann JF, Lehnick D |title=Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre |journal=J. Intern. Med. |volume=249 |issue=1 |pages=41–6 |date=January 2001 |pmid=11168783 |doi=10.1046/j.1365-2796.2001.00771.x |url=}}</ref><ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref><ref name="pmid23633816">{{cite journal |vauthors=Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S |title=Addison's disease |journal=Contemp Clin Dent |volume=3 |issue=4 |pages=484–6 |date=October 2012 |pmid=23633816 |pmc=3636818 |doi=10.4103/0976-237X.107450 |url=}}</ref><ref name="pmid1512386">{{cite journal |vauthors=Brymer C, Winograd CH |title=Fluoxetine in elderly patients: is there cause for concern? |journal=J Am Geriatr Soc |volume=40 |issue=9 |pages=902–5 |date=September 1992 |pmid=1512386 |doi=10.1111/j.1532-5415.1992.tb01987.x |url=}}</ref><ref name="pmid8919685">{{cite journal |vauthors=Guigoz Y, Vellas B, Garry PJ |title=Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation |journal=Nutr. Rev. |volume=54 |issue=1 Pt 2 |pages=S59–65 |date=January 1996 |pmid=8919685 |doi=10.1111/j.1753-4887.1996.tb03793.x |url=}}</ref><ref name="pmid8201141">{{cite journal |vauthors=Morley JE, Kraenzle D |title=Causes of weight loss in a community nursing home |journal=J Am Geriatr Soc |volume=42 |issue=6 |pages=583–5 |date=June 1994 |pmid=8201141 |doi=10.1111/j.1532-5415.1994.tb06853.x |url=}}</ref> | |||
*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.<ref name="Alibhai2005">{{cite journal|last1=Alibhai|first1=S. M.H.|title=An approach to the management of unintentional weight loss in elderly people|journal=Canadian Medical Association Journal|volume=172|issue=6|year=2005|pages=773–780|issn=0820-3946|doi=10.1503/cmaj.1031527}}</ref><ref name="WuBosch2017">{{cite journal|last1=Wu|first1=Wen-Chih Hank|last2=Bosch|first2=Xavier|last3=Monclús|first3=Esther|last4=Escoda|first4=Ona|last5=Guerra-García|first5=Mar|last6=Moreno|first6=Pedro|last7=Guasch|first7=Neus|last8=López-Soto|first8=Alfons|title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients|journal=PLOS ONE|volume=12|issue=4|year=2017|pages=e0175125|issn=1932-6203|doi=10.1371/journal.pone.0175125}}</ref><ref name="pmid24784334">{{cite journal |vauthors=Gaddey HL, Holder K |title=Unintentional weight loss in older adults |journal=Am Fam Physician |volume=89 |issue=9 |pages=718–22 |date=May 2014 |pmid=24784334 |doi= |url=}}</ref><ref name="pmid11168783">{{cite journal |vauthors=Lankisch P, Gerzmann M, Gerzmann JF, Lehnick D |title=Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre |journal=J. Intern. Med. |volume=249 |issue=1 |pages=41–6 |date=January 2001 |pmid=11168783 |doi=10.1046/j.1365-2796.2001.00771.x |url=}}</ref><ref name="pmid28388637">{{cite journal |vauthors=Bosch X, Monclús E, Escoda O, Guerra-García M, Moreno P, Guasch N, López-Soto A |title=Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients |journal=PLoS ONE |volume=12 |issue=4 |pages=e0175125 |date=2017 |pmid=28388637 |pmc=5384681 |doi=10.1371/journal.pone.0175125 |url=}}</ref><ref name="pmid23633816">{{cite journal |vauthors=Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S |title=Addison's disease |journal=Contemp Clin Dent |volume=3 |issue=4 |pages=484–6 |date=October 2012 |pmid=23633816 |pmc=3636818 |doi=10.4103/0976-237X.107450 |url=}}</ref><ref name="pmid1512386">{{cite journal |vauthors=Brymer C, Winograd CH |title=Fluoxetine in elderly patients: is there cause for concern? |journal=J Am Geriatr Soc |volume=40 |issue=9 |pages=902–5 |date=September 1992 |pmid=1512386 |doi=10.1111/j.1532-5415.1992.tb01987.x |url=}}</ref> | |||
{{familytree/start |summary=Weight loss causes Algorithm.}} | {{familytree/start |summary=Weight loss causes Algorithm.}} | ||
{{familytree | | | | | | | | A01 |A01=Causes of weight loss }} | {{familytree | | | | | | | | A01 |A01=Causes of weight loss }} | ||
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❑ '''Endocrine''' (4 - 11%):<br>[[Type I diabetes]], [[type 2 diabetes]], [[hyperthyroidism]], [[primary hyperparathyroidism]], [[Addison's disease]], and [[subacute thyroiditis]]. | ❑ '''Endocrine''' (4 - 11%):<br>[[Type I diabetes]], [[type 2 diabetes]], [[hyperthyroidism]], [[primary hyperparathyroidism]], [[Addison's disease]], and [[subacute thyroiditis]]. | ||
|E05=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''Drug-induced''' (6 - 8%)<div class="mw-collapsible mw-collapsed"> | |E05=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''Drug-induced''' (6 - 8%)<div class="mw-collapsible mw-collapsed"> | ||
❑ [[Narcotic analgesic]]s (such as [[opioids]]) interfere with [[cognition]] and ability to eat<br> | |||
❑ [[Sedatives]] also interfere with [[cognition]]<br> | |||
❑ [[Psychedelic drug]]s<br> | |||
❑ [[Cocaine]]<br> | ❑ [[Cocaine]]<br> | ||
❑ [[Alcohol]] (4 - 8%)<br> | ❑ [[Alcohol]] (4 - 8%)<br> | ||
❑ [[ | ❑ [[SSRI]]s<br> | ||
❑ [[ | ❑ [[Psychotropic drug]] dose reduction <br> | ||
❑ | ❑ Other drugs that cause [[vomiting]], [[anorexia]], [[dysphagia]], and [[dysgeusia]]|E06='''Unexplained '''/ '''Unknown''' (6 - 36%)}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | | | | | | | | | }} |
Revision as of 13:43, 5 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][7][8][9]
- 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
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Physical exam Appearance of the patient Cachexia or surgical scar marks demonstrating previous malignancy treatment
❑ HEENT
❑ Extremities exam | |||||||||||||||||||||||||||||||||||||
Labs ❑ CBC with differential
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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.
- ↑ Brymer C, Winograd CH (September 1992). "Fluoxetine in elderly patients: is there cause for concern?". J Am Geriatr Soc. 40 (9): 902–5. doi:10.1111/j.1532-5415.1992.tb01987.x. PMID 1512386.
- ↑ Guigoz Y, Vellas B, Garry PJ (January 1996). "Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation". Nutr. Rev. 54 (1 Pt 2): S59–65. doi:10.1111/j.1753-4887.1996.tb03793.x. PMID 8919685.
- ↑ Morley JE, Kraenzle D (June 1994). "Causes of weight loss in a community nursing home". J Am Geriatr Soc. 42 (6): 583–5. doi:10.1111/j.1532-5415.1994.tb06853.x. PMID 8201141.