Questions and Answers
What is defined as unexplained or unintentional weight loss?
Weight loss of at least 5% of the patient’s usual body weight that occurs within the preceding 6 to 12 months, not expected from treatment of a known illness.
What is the prevalence of unexplained weight loss in individuals over 65?
Chronic alcohol abuse is a potential cause of unexplained weight loss.
True
What are some associated symptoms of unexplained weight loss?
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Match the following terms with their definitions:
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The common drugs implicated in unexplained weight loss include _____ and _____ medications.
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What is emphasized in the approach to weight loss assessment?
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Which of the following are considered functional factors contributing to unexplained weight loss? (Select all that apply)
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Eating in company is not useful for patients dealing with unexplained weight loss.
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What should be monitored during follow-up for unexplained weight loss?
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Study Notes
Unexplained Weight Loss Overview
- Defined as a loss of at least 5% of usual body weight occurring within 6 to 12 months, unrelated to treatment for known illnesses.
Related Terms
- Cachexia: Weight loss characterized by loss of muscle mass due to underlying illness, with or without fat loss.
- Sarcopenia: Geriatric syndrome involving loss of muscle mass, strength, and performance, distinct from unintentional weight loss.
- Malnutrition: Imbalance in energy and nutrient intake, which may result in deficiency or excess.
Epidemiology
- Prevalence ranges from 7% to 13% in the general population, 15-20% in those over 65.
- Effects in elderly: 27% in community dwellers, 50-60% in nursing home residents.
Etiology
- Decreased Intake: Psychological conditions like depression or eating disorders, dementia, and side effects of medications.
- Malabsorption: Conditions such as Crohn’s disease, pancreatic insufficiency, cholestatic liver disease, and inflammatory bowel disease.
- Increased Energy Expenditure: Hyperthyroidism, chronic infections, heart failure, and adrenal insufficiency.
Evaluation and Assessment
- Initial evaluation includes detailed history, comprehensive clinical examination, and baseline investigations.
- Documentation of weight loss patterns, including duration, appetite changes, and physical activity.
- Screening for malnutrition using validated tools like MUST and ESPEN.
Associated Symptoms
- Gastrointestinal: Nausea, vomiting, abdominal pain, diarrhea.
- Malignancy: Recurrent infections, fatigue, loss of appetite.
- Psychological: Insomnia, guilt, concentration issues, suicidal thoughts.
Functional and Social Factors
- Assess poor dentition, cognitive abilities, and social support systems affecting food intake.
- Consider travel history and sexual history to evaluate risks for infectious causes.
Physical Examination
- Features to note include abnormal general appearance, neurological deficits, signs of malnutrition, and signs related to chronic conditions.
Investigations
- Blood tests: Complete blood count, glucose, liver and renal function tests, thyroid function tests, inflammatory markers, and viral screens.
- Urine/stool tests: Dipstick analysis, culture, and fecal occult blood test.
- Imaging: Chest X-ray, abdominal ultrasound, upper and lower gastrointestinal endoscopy.
Management
- Non-Pharmacological: Optimize food intake with dietician guidance, encourage balanced diets, ensure social eating scenarios, and promote physical activity.
- Pharmacological: Treat underlying causes with appropriate medications ensuring safety and monitoring for risks.
Complications
- Possible complications include increased mortality risk from certain pharmacological agents and deterioration due to unresolved underlying conditions.
Conclusion
- Rising incidence of unexplained weight loss necessitates proactive identification of causes and timely management interventions.
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Description
A group project on unexplained weight loss, presented by Group D2, covering various aspects of the topic.
