Minicase - Wt Loss and Gain Flashcards Preview

USMLE Step 2 CS > Minicase - Wt Loss and Gain > Flashcards

Flashcards in Minicase - Wt Loss and Gain Deck (10)
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1

Ddx for weight loss (6)

1. hyperthyroidism
2. cancer
3. HIV
4. dieting/diet drugs
5. anorexia nervosa
6. malabsorption

2

Ddx for wt gain (7)

1. smoking cessation
2. drug SFX
3. hypothyroidism
4. Cushing syndrome
5. PCOS
6. insulinoma
7. pregnancy
(also reactive postprandial hypoglycemia that you would test with a GTT)

3

W/u for wt loss (6)

1. TSH, free T4
2. CBC
3. BMP
4. HIV antibody
5. Utox
6. Age-appropriate cancer screenings

4

W/u for wt gain (7)

1. CBC
2. BMP, glucose
3. TSH
4. 24-hour urine free cortisol
5. dexamethasone suppression text
6. urine B-hCG
7. plasma insulin after induced hypoglycemia

5

44yo F presents with wt gain of >25lbs within past 2 months. Quit smoking 3 months ago and is on amitriptyline for depression. Also reports cold intolerance and constipation. (3)

1. smoking cessation
2. drug SFX (TCA)
3. hypothyroidism

6

30 yo F presents with wt gain over past 3 months. Tremor, palpitations, anxiety and hunger that is relieved by eating. Proximal muscle weakness and easy bruising. (3)

1. insulinoma
2. reactive postprandial hypoglycemia
3. Cushing syndrome

7

Wt gain exam (3)

1. complete exam (ALL of them, which is impossible)
2. so look for Cushing syndrome (moon facies, central obesity, purple abdominal striae)
3. LE edema from water retention in renal disease

8

Wt loss exam (3)

1. all of them
2. skin
3. MSK

9

Wt loss history (9)

1. amount
2. duration
3. intention
4. body image
5. anxiety, depression
6. constitutional symptom, hx of cancer
7. hyperthyroid symptoms
8. HIV risk factors
9. medication and drug use

10

Wt gain history (8)

1. amount
2. duration
3. timing (when did it start: meds, smoking cessation, depression)
4. diet history
5. hypothyroid symptoms
6. menstrual irregularity
7. hirsutism
8. sexual history