OBESITY, PATHOLOGIC

Ask the Following Questions:

1. Is there associated hyperphagia? If the patient recognizes that he or she has a ravenous appetite or eats more than is necessary, the possibility of an insulinoma or Fröhlich's syndrome should be considered.
2. Is the obesity centripetal? The presence of centripetal obesity, especially with moon facies, should suggest Cushing's syndrome.
3. Is the obesity mainly of the lower extremities? This finding would suggest lipodystrophy.
4. Is there mental retardation? The presence of mental retardation should suggest Laurence-Moon-Bardet-Biedl syndrome.
5. What is the sex of the patient? In male patients one should consider Klinefelter's syndrome, and in female patients one should consider polycystic ovary.

DIAGNOSTIC WORKUP

Routine laboratory tests include a CBC, urinalysis, chemistry panel, 2-hr postprandial blood sugar, and thyroid profile. If an insulinoma is strongly suspected, a 24- to 36-hr fast, a 5-hr glucose tolerance test, and tolbutamide tolerance test may be done. If Cushing's syndrome is suspected, a serum cortisol and cortisol suppression test should be done. Pelvic ultrasound will help diagnose polycystic ovaries. Chromosomal analysis will help diagnose Klinefelter's syndrome. Perhaps a psychiatrist should be consulted.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Obesity

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Obesity

• Back to symptom: Obesity: Introduction (review 250 causes)
• Next Book Extract About Obesity: Obesity (In A Page: Pediatric Signs and Symptoms)
• All Book Extracts: All Online Book Extracts for Obesity

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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