Weight Gain

1.  Document:  serial weights

2.  R/O Pedal Edema

3.  Draw TSH  (r/o Hypothyroidism)

4.  Consider Obscure Etiologies:

   a)  Cushings
  • striae, moon facies, buffalo hump, truncal obesity
  • Dx:  24-hr Urine Cortisol
   b)  Growth Hormone Deficiency
  • truncal obesity, mood Sx
  • very abnl. lipids (↑↑↑ LDL, ↑↑↑ TGs, ↓↓↓ HDL)
  • Only send to Endo if very suspicious
Distended Abdomen  —  “6 F’s”
  • Fat
  • Fluid (ascites)
  • Fetus (pregnant)
  • Feces (constipation, impaction)
  • Flatus (air, either functional or bowel obstruction)
  • Fatal Masses (abdominal tumors, malignant or benign)

.

Advertisements