EMQ: 28
Loss of Weight
a)
Achalasia of the cardia
b)
Carcinoma of the stomach
c)
Bowel cancer with liver metastases
d)
Crohn’s disease
e)
Ulcerative colitis
f)
Coeliac disease
g)
Short gut syndrome
h)
Oesophageal cancer
i)
Peptic stricture of the oesophagus
j)
Giardiasis
1) A 20-year-old Irish female presents with loose
motions, mouth ulcers and an itchy rash. The stools are bulky and difficult to
flush away.
On examination she appears to have lost weight and she
has a vesicular rash over her lower back. Most of vesicles have been scratched
away leaving crusts.
Investigations reveal a macrocytic anaemia.
2) A 24-year-old female presents with a rash over her
lower legs. She gives a long-standing history of diarrhoea and abdominal pain.
She has lost a considerable amount of weight.
On examination she appears to have lost weight, there are
tender erythematous nodules over her shins and there is a mass in the right
iliac fossa.
3) A 67-year-old male presents with progressive dysphagia
over several months duration. The dysphagia affects solid more than liquids.
He smokes 20 cigarettes a day and drinks 35 units of alcohol a week.
On examination he looks emaciated and has hepatomegaly.
4) A 70-year-old female presents with severe anorexia and
loss of weight. On examination she looks emaciated and has a palpable lymph
node in the right supraclavicular region.
5) A 35-year-old female presents with loss of weight and
diarrhoea. She has had multiple operations for Crohn’s disease of the small
and large bowel.
On examination she looks emaciated, there are multiple
scars on her abdominal wall.
There are no peripheral signs of chronic inflammatory
disease and investigations reveal that inflammatory markers are not raised
