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Symptoms » Poor appetite » Book Sections
 

Loss of Appetite

Differential Overview

❑ Depression

❑ Drugs

❑ Anorexia nervosa

❑ Congestive heart failure

❑ Hepatitis

❑ Cancer

❑ HIV infection

❑ Uremia

❑ Addison disease

❑ Mesenteric ischemia

❑ Hypothalamic lesion

Diagnostic Approach

This differential refers to protracted loss of appetite. Acute anorexia may occur as a migraine prodrome or in early appendicitis.

Anorexia must be differentiated from early satiety or odynophagia (aversion to swallowing due to pain).

Clinical Findings

Depression  Depressed mood, anhedonia, sleep disturbance, and inertia are key symptoms.

Drugs  Digoxin, narcotics, diuretics, amphetamines, antidepressants (SSRIs), and antihypertensives (especially ACE inhibitors) are common causes.

Anorexia nervosa  Loss of appetite is less common than an avoidance of food due to an abnormal body perception. Suspect anorexia nervosa in very thin young women. Hypothermia, constipation, and downy lanugo hair are additional findings.

Congestive heart failure  Because anorexia only occurs in advanced heart failure, signs such as edema, dependant rales, and S3 gallop are readily evident.

Hepatitis  Anorexia may precede the appearance of clinical jaundice, but right upper quadrant discomfort and tenderness are present.

Cancer  Anorexia is prominent in gastric and pancreatic cancer and in cancer with liver metastases. A humoral substance such as tumor necrosis factor may play a role. Weight loss that is out of proportion to the anorexia is common.

HIV infection  Anorexia can occur as a primary phenomenon in the wasting syndrome, due to opportunistic infection or to medication side effects.

Uremia  Waxy edema, sallow color, and oliguria are frequent findings.

Addison disease  Associated signs include fatigue, hypotension, and hyperpigmentation, especially of the palmar creases and buccal mucosa.

Mesenteric ischemia  The patient will avoid eating because of resulting abdominal discomfort. Systemic vascular disease and an abdominal bruit usually coincide.

Hypothalamic lesion  Lesions such as sarcoidosis or tumor also cause visual field defects and metabolic/thermoregulatory disorders.

Book Source Details

  • Book Title: Field Guide to Bedside Diagnosis
  • Author(s): David S. Smith
  • Year of Publication: 2007
  • Copyright Details: Field Guide to Bedside Diagnosis, Copyright © 2007 Lippincott Williams & Wilkins.

Other Book Chapters Related to Poor appetite

Read excerpts from these other book chapters related to Poor appetite:

Medical Books Excerpts
  • ANOREXIA
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • DEPRESSION
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • WEIGHT LOSS
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • Anorexia
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • ANOREXIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • Anorexia
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Depression
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Nausea
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Anorexia
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Depression
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Nausea
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Anorexia
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Depression
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Weight Loss
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Nausea and Vomiting
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Anorexia
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Nausea
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Anorexia
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Nausea
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • ANOREXIA
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
 

Copyright Details: Field Guide to Bedside Diagnosis, Copyright © 2008 Williams & Wilkins.

More About Causes of Poor appetite



More About This Book:
Title: Field Guide to Bedside Diagnosis
Authors: David S. Smith
Publisher: Lippincott Williams & Wilkins
Copyright: 2007
ISBN: 0-78178-165-5

 » Next page: Involuntary Weight Loss (Field Guide to Bedside Diagnosis)

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