Sandbox:Javaria

History ❑ Source of history: Patient or well-informed caregiver (elderly may be unaware or deny weight loss). ❑ Patient age: Helps determine age-specific causes, such as malignancy among the elderly. ❑ Duration of symptoms: (weeks in acute/severe versus years in chronic conditions). ❑ Associated symptoms: Assess if the patient is nauseated or vomiting/ anorexia/ dysphagia/ odynophagia/ social reasons hindering food supply. ❑ Nutritional status: ❑ Dietary history: Food availability, diet adequacy in the quantity (daily caloric intake), and quality (balance of nutrition), and nutritional supplements. ❑ Weight measurement records or best estimate of weight loss accessed by clothing size. ❑ Mini Nutritional Assessment: To assess the nutritional risk among the elderly. ❑ Assess the mental and functional status of the patient. ❑ Psychiatric illness screening. Geriatric Depression Scale may be utilized to assess for depression among elderly. ❑ Systemic review: Assess for cardiovascular, respiratory, renal, hepatic, and rheumatologic system. ❑ Past medical history: Helps assess the nutritional status. May suggest of immunodeficiency (recurrent infections), diagnosed malignancy, malabsorption (chronic diarrhea), HF, dyspepsia. ❑ Past surgical history: Helps assess nutritional status. ❑ Medication history: Assess the use of medications known to cause weight loss. Polypharmacy may cause anorexia or altered taste. ❑ Family history: Certain malignant disorders (breast cancer, ovarian cancer, colon cancer, or stomach cancer)) ❑ Social history: Tobacco, alcohol use, opioid, cocaine use ❑ Sexual history: Suggestive of HIV AIDS ❑ Exposure: Communicable infectious diseases/ travel to high-risk areas

Physical exam Appearance of the patient Cachexia or surgical scar marks demonstrating previous malignancy treatment ❑ Vital signs ❑ Temperature: High-grade / low-grade fever may demonstrate infection. ❑ Heart rate: Tachycardia with regular pulse may demonstrate infection. ❑ Respiratory rate: Tachypnea may demonstrate respiratory system involvement (infection\ metastasis). ❑ Blood pressure: Chronic hypertension or hypotension (may indicate sepsis as a complication). ❑ Oxygen saturation: may be low if the respiratory system is affected. ❑ HEENT ❑ Cardiovascular examination ❑ Respiratory examination ❑ Gastrointestinal system exam includes oral examination, abdominal examination, and digital rectal exam. ❑ Splenomegaly) may demonstrate IM, hodgkin's/ non-Hodgkin's lymphoma, and sarcoidosis ❑ Extremities exam ❑ Skin exam: Evaluate for the lesions that indicate malignancy such as melanoma/ potential inoculation sites for germ such as traumatic lesions.

Labs ❑ CBC with differential ❑ ESR ❑ CMP ❑ Peripheral smaer ❑ LFTs Labs may be required at a later stage pf diagnosis