Loss of Appetite

HISTORY:

Loss of appetite for ‍ ‍hoursdays

Severity: ‍mildmoderatesevere

Occurs most frequently during ‍all mealsbreakfast

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective

‍unintentional weight loss, ‍ ‍lbskg over ‍ ‍weeksmonths

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍

‍diarrhea, ‍ episodes ‍per day, ‍

‍constipation

‍change in taste

‍bloating

‍heartburn

‍dyspepsia

‍fatigue

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍depressed mood

‍anxiety



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Neurologic: cranial nerves ‍normal, strength ‍5/5 throughout, sensation ‍normal, reflexes ‍2+ throughout, cerebellar function ‍normal, gait ‍stable



ASSESSMENT:

‍Appetite loss due to psychosocial factors ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍lytes, ‍creatinine, ‍glucose, ‍LFTs, ‍albumin, ‍TSH, ‍cortisol, ‍HIV, ‍PSA

- Upper GI endoscopy

- Colonoscopy

- CT scan of thorax, abdomen, and pelvis

- Dietary counseling

- High-calorie diet

- Nutritional supplements

- ‍Appetite stimulants

- Referral to dietitian

- Referral to gastroenterologist

- Referral to psychologist

- Follow-up in ‍ ‍weeksmonths

- Return if loss of appetite continues or if new symptoms develop such as weight loss, nausea, or vomiting