Unexplained weight loss
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A 27-year-old female presented with 6 months of upper abdominal pain and occasional nausea and vomiting. On examination, she was found to be severely malnourished with a body mass index of 14.06. Laboratory tests found iron deficiency anemia. The cause of her weight loss and anemia was unclear, though inflammatory bowel disease such as Crohn's disease or ulcerative colitis were suspected given her abdominal pain and elevated inflammatory markers. Further diagnostic testing was needed to determine the underlying cause.
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Evaluation of weight loss
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
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Evaluation of weight loss
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
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This document summarizes the medical examination and diagnosis of a 36-year-old pregnant woman named Khadija. She presented with nausea, morning sickness, and a 4-week history of amenorrhea and was found to be 4 weeks pregnant. She also reported a history of diabetes for 1.5 years. On examination, she appeared ill and anxious with normal vital signs and mild anemia. Laboratory tests confirmed diabetes in pregnancy with elevated blood sugar levels. She was diagnosed with diabetes in pregnancy and a treatment plan was outlined involving insulin, antiemetics, antiulcer medication, and folic acid, with advice on diet, rest, and follow up in 14 days.
ari ramadhan.pptx
- 34-year-old male presented with increased stomach pain, nausea, and vomiting for the past day. He has a history of abdominal tuberculosis diagnosed 6 months ago and has been undergoing tuberculosis treatment for 5 months.
- Physical examination found epigastric pain and normal bowel sounds. Laboratory tests showed elevated white blood cell count.
- The diagnosis is cholitis tuberculosis (tuberculosis of the bile ducts) and dyspepsia. The treatment plan includes rest, soft high calorie/protein diet, IV fluids, medications to reduce stomach acid and treat tuberculosis, and diagnostic tests of stool and urine.
Surgery-Hernia case profoma
A 48-year-old construction worker presented with a 2-month history of a swelling in his left groin that increased in size with lifting weights. On examination, a 5x5 cm reducible swelling was found in the left inguinal region with cough impulse. Investigations confirmed a diagnosis of left indirect inguinal hernia. The patient underwent a Lichtenstein tension free open mesh repair surgery to correct the hernia.
DY 17,08.2023-1.pptx
1) A 35-year-old woman at 37 weeks and 3 days with twin pregnancy presented in late labor and was admitted. She delivered via c-section twins A and B weighing 4kg and 2.8kg respectively.
2) A 57-year-old woman with a history of 6 pregnancies and 5 live births presented with abdominal pain, distension and weight loss. Imaging found abdominal masses. She was admitted for hydration and further investigation including CT scan and ultrasound.
3) A 29-year-old primigravida at 41 weeks gestation by dates was admitted for induction of labor by cervical ripening with cytotec. She had not achieved active labor after her fifth dose.
Adrenocortical carcinoma
This document provides details about a case of a 28-year-old male patient presenting with left upper abdominal pain, loss of appetite, nausea, and weight loss over the past year. A physical exam revealed a large irregular mass in the left hypochondriac region. Investigations including CT scan and left radical nephrectomy were performed. The final diagnosis was adrenocortical carcinoma stage III. Post-operative follow-ups over 8 days are documented, with the patient recovering well with no new complaints.
Nephrotic syndrome.pptx
This document summarizes a clinical meeting presentation about a 5-year-old female patient named Jannat. She presented with generalized swelling, scanty urination, and white urine precipitate. Her history revealed previous similar illnesses treated with steroids. On examination, she had puffy face and edema. Tests showed nephrotic syndrome with urine infection. She was diagnosed with infrequent relapse nephrotic syndrome and urine infection. She was treated with antibiotics, steroids, diet restrictions, and monitoring.
Nephrotic Syndrome Case Presentation
Mahmuda, a 2.5 year old girl, presented with swelling of the body for 15 days, decreased urine output, and red urine for 9 days. On examination, she had puffy face and swelling of the body. Tests found protein in the urine and low albumin levels. She was diagnosed with initial nephrotic syndrome and a urine infection. She received antibiotics, albumin infusion, diuretics to reduce swelling, and prednisolone for 6 weeks followed by a gradual taper, with calcium and vitamin supplements. Her parents were counseled and she will follow up every 2 weeks then monthly to monitor her response and for any side effects or infections.
Emphysematous pyelonephritis- case discussion
A 59-year-old diabetic male presented to the emergency department with left-sided abdominal pain, abdominal distension, and decreased urine output over two days. Imaging revealed gas in the left renal calyces and retroperitoneal spaces, consistent with emphysematous pyelonephritis. The patient was admitted to the ICU for IV fluids, antibiotics, and glycemic control. A nephrostomy tube was placed and aspirated pus and air. Antibiotics were adjusted based on culture results identifying E. coli. The patient's condition improved with treatment and he was later discharged.
A case report of acute pancrititis
The document describes a case report of an 80-year-old male who presented with abdominal pain for 4 days. On examination, he had tenderness in the epigastric and right upper quadrant regions. Laboratory tests showed elevated lipase, amylase and CRP, consistent with acute pancreatitis. CT imaging revealed a relatively enlarged pancreas. He was admitted and treated supportively with IV fluids, antibiotics and pain medications. His condition gradually improved and he was discharged. Common scoring systems for evaluating severity of acute pancreatitis like Ranson's criteria and BISAP score are discussed.
Cushing's syndrome
This document presents the case of a 36-year-old Saudi female who presented with lower back pain, headaches, and inability to walk for 3 months. She had a history of hypertension, diabetes, and dyslipidemia. Examination revealed signs of Cushing's syndrome including obesity, hirsutism, and bruising. Laboratory results found hypokalemia and elevated cortisol levels. Brain imaging detected a cystic mass compressing the pituitary gland. She was diagnosed with Cushing's disease caused by an ACTH-secreting pituitary adenoma, which was the underlying cause of her hypercortisolism and associated symptoms.
Splenic epidermoid cyst
A 9-year-old male presented with abdominal pain and fever. Imaging showed a large cyst in the spleen. CT and ultrasound findings were consistent with an epidermoid cyst based on the solitary, well-defined mass with thin walls and septations, fluid density, and lack of enhancement or calcification. Differential diagnoses included splenic cyst from prior trauma, lymphangioma, or abscess, but features were most consistent with a congenital epidermoid cyst.
A 10 year old boy with back pain
This document describes the case of a 10-year-old boy who presented with back pain and swelling for 1.5 years. Initial x-rays led to a diagnosis of spinal tuberculosis, but anti-tuberculosis treatment did not improve his condition. He then developed a cough. Further investigations including CT scans and biopsies revealed non-Hodgkin lymphoma with lymph node and lung involvement. Non-Hodgkin lymphoma can mimic other conditions at presentation and this case illustrates the importance of thorough investigation and follow-up given lack of response to initial treatment.
Hepatic adenoma case presentation.dr quiyum
Liver SOL with long history may confuse with adenoma and FNH as both may have hypodense center. we approach such a case and solve what is it actually?
alcoholic liver disease.pptx
A 45-year-old male chronic alcohol consumer presented with abdominal distension and swelling of the lower limbs for 15 and 12 days respectively. On examination, he was found to have icterus, edema up to the knees, and an enlarged liver. Based on his history of alcohol use and current symptoms and signs, the provisional diagnosis was decompensated liver disease with ascites likely due to chronic alcohol consumption. Further investigations and management with diet, diuretics, and potential liver transplant were planned.
Similar to Unexplained weight loss (20)
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Factor xii deficiency
A 51-year-old female presented with a history of kidney stones and recurrent sinus infections. Laboratory tests incidentally found a prolonged activated partial thromboplastin time (aPTT). Further testing found severely low levels of coagulation Factor XII. Factor XII deficiency is a rare condition that causes asymptomatic prolongation of aPTT but generally does not cause bleeding issues. The patient was diagnosed with Factor XII deficiency, kidney stones, and recurrent sinusitis. She received supportive treatment and monitoring due to the theoretical risk of thrombosis from the Factor XII deficiency.
Refractory itp
The document discusses refractory immune thrombocytopenic purpura (ITP). It states that for a patient to be considered refractory, they must have either failed splenectomy or relapsed after splenectomy, and they must exhibit severe ITP or be at risk of bleeding requiring treatment by their physician. Temporary responses to steroids or IVIG do not exclude a refractory diagnosis. Common treatments discussed include thrombopoietin receptor agonists like romiplostim and eltrombopag, as well as medications like danazol, azathioprine, and combined drug approaches.
All,neutropenia
A 39-year-old male presented with fever for 3 days and arthralgia and backache. Examination found an ill-looking, anemic patient with lymphadenopathy and splenomegaly. Laboratory findings included severe neutropenia, anemia, thrombocytopenia, and elevated inflammatory markers. A bone marrow examination showed acute lymphoblastic leukemia (ALL) of the L2 subtype. The patient was diagnosed with febrile neutropenia secondary to ALL.
Hepatocellular carcinoma
Hepatocellular carcinoma is a primary cancer of the liver that is commonly associated with cirrhosis and hepatitis. Common causes include cirrhosis from various sources, chronic hepatitis B or C infection, and alcohol consumption. Symptoms can include abdominal pain, weight loss, jaundice, and nausea. Diagnosis involves imaging such as CT or MRI scans of the liver along with blood tests. Treatment options depend on factors like tumor size and liver function, and may include resection, transplantation, ablation, embolization, or chemotherapy. Prognosis can be assessed using scoring systems like the Child-Pugh score.
Splenomegaly
- The patient has a clinical history suggestive of non-Hodgkin's lymphoma (NHL) including splenomegaly and lymphadenopathy. However, other diseases need to be ruled out including myelofibrosis, Gaucher's disease, and cirrhosis.
- Laboratory tests found anemia and thrombocytopenia. Bone marrow biopsy did not find evidence of malignancy.
- CT scan showed a massively enlarged and calcified spleen but no evidence of cirrhosis.
- The diagnosis is mantle cell lymphoma stage IVB, an aggressive subtype of NHL. The patient will begin RCHOP chemotherapy regimen.
Rat poison
A 54-year-old female presented with dizziness, coughing up blood for 5 days, nosebleeds, vertigo, and facial swelling. She reported consuming rat poison. Examination found bruising on her chest, legs, and around her tonsils. Tests found prolonged clotting times and mild anemia. She was diagnosed with rat poisoning causing a coagulation disorder. She received transfusions of fresh frozen plasma and whole blood, vitamin K injections, and other supportive treatments. Rat poisons are commonly anticoagulant drugs that interfere with vitamin K and calcium homeostasis, leading to an inability to produce clotting factors and bleeding issues.
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Unexplained weight loss
- 2. 27 year old female presented with: C/O: Upper abdominal Pain(on/off) x 6 month Occasionally nausea,vomiting Shortness of Breath on exertion+ Menorrhagia+
- 3. ON EXAMINATION General Condition: Malnourished+, Body Mass Index(BMI)=14.06 Jaundice:Nil Anemic :Mild LN:Nil Cyanosis:Nil Clubbing:Nil Oedema:Nil Dehydration:Nil VITALS: P:80/min BP:80/40mmHg R/R:20/min T:afebrile
- 4. Chest: B/L clear air entry CVS:S1.S2.M0 P/A:Soft tenderness around Right Hypochondriac Region+ Hepatomegaly+
- 5. MEDICAL h/o: no h/o DM,HTN,PTB,Hepatitis SURGICAL h/o:Appendicectomy done last year, 2 C.S Performed ALLERGIC h/o:non significant PERSONAL h/o:Non Significant
- 7. COMPLETE BLOOD COUNT: WBC:14.28X10*9/L(N=72.9%),L(17.1%), RBC:3.34X10*12/L,HB:76g/L,HCT:25.6%,MCV:76.6fl,RET%:2.5% PLT:631X10*9/L Tumor Marker:CA 125,CA 19-9,AFP,CEA =all are Normal Renal Function Test: Within Normal Limits Biochemistry: Gluc=5.87mmol/L, Amylase:370U/L,Ca:2.12mmol/L Albumin:29.2g/L,ESR:100mm/hr,CRP:125.89mg/L Liver Function Test: Within Normal Limits
- 9. SEROLOGY
- 10. SEROLOGY
- 12. CT Scan Report
- 13. USG REPORT
- 14. DIAGNOSIS Iron Deficiency Anemia Abdominal Pain(?Cause) Weight Loss(?Cause)
- 15. TREATMENT
- 16. LITERATURE
- 17. Body Mass Index
- 18. Etiology Of Weight Loss Addison’s Disease Cancer HIV/AIDS Tuberculosis Celiac Disease Crohn's Disease DM Hyperthyroidism COPD Heart Failure Peptic Ulcer Parkinson’s Disease
- 19. DISCUSSION BMI is only 14.06 suggests passing is severely malnourished,albumin is also low so is transfusion of albumin and Nutrients rich diet is must for management? Addison’s Disease is the leading cause of wieght loss, did we evaluated it? Low Hb,elevated Platelets,raised ESR,CRP and WBC with abdominal pain is highly suggestive of Ulcerative Colitis & Crohn’s Disease? What may be the likely cause of Iron Deficiency Anemia in this patient?
- 20. Further Investigations Probably Needed Endoscopy,Colonoscopy to rule out Ulcerative Colitis ,Crohn’s Disease? Contrast Enhanced CT for more proper visualization? Laparascopic evaluation of abdomen
- 21. REFERENCE www.mayoclinic.org Harrison’s Principle of Internal Medicine wikipedia
- 22. THANK YOU