- Full List
- Blood Gas Analyser
- Critical Care
Sign up to start your free trial of MedSchool Premium!Get Started
The patient's body habitus provides insight into a patient's diet and metabolic status as well as their overall risk of cardiovascular and non-cardiovascular complications in the future. While static measures such as body habitus and waist-hip ratio can estimate future risk, unexpected change in weight may suggest active disease.
- The patient's body habitus provides insight into a patient's diet and metabolic status as well as their overall risk of cardiovascular and non-cardiovascular complications in the future. While static measures such as body habitus and waist-hip ratio can estimate future risk, unexpected change in weight may suggest active disease.
- The patient’s current weight
- Change in weight - compare to past weights
- Time course - sudden / gradual
Causes of Weight Gain
- ↑ Dietary intake
- ↓ Physical exercise
- Endocrine - hypothyroidism, Cushing’s, PCOS
- Medications - steroids, antidepressants, antipsychotics, OCP
- Fluid overload - excessive IV fluids, renal disease, heart failure
Causes of Weight Loss
- ↓ Dietary intake - anorexia, low access to food
- ↑ Physical activity
- Malabsorption - obstruction, IBD, pancreatitis, coeliac disease
- Endocrine - hyperthyroidism, diabetes, phaeochromocytoma, addison’s
- Neurological - stroke, Parkinson’s, dementia
- Drugs - diuretics, chemotherapy, amphetamines, opioids
- Organ failure - renal, hepatic, cardiac, respiratory, gut
- Chronic infection - TB, HIV
- Psychiatric - eating disorders, depression, alcoholism, schizophrenia
Body Mass Index
- BMI =WeightHeight²
- Underweight - <18.5
- Normal - 18.5 - 24.9
- Overweight - 25 - 29.9
- Obese - 30 - 34.9
- Severely obese - 35 - 39.9
- Morbidly obese - 40+
Associated with Obesity
- Metabolic syndrome - type 2 diabetes mellitus, hypertension, dyslipidaemia
- Ischaemic heart disease
- Respiratory - obstructive sleep apnoea, asthma
- Gastrointestinal - reflux, cholelithiasis, non-alcoholic steatohepatitis (NASH)
- Polycystic ovarian syndrome
- Varicose veins
Associated with Being Underweight
- Vitamin deficiency - scurvy, rickets
- Bone marrow suppression - anaemia, thrombocytopaenia, immunosuppression
- Cardiac - arrhythmia, MI
- Neurological - cognitive impairment, peripheral neuropathy, Wernicke-Korsakoff syndrome
- Muscle wasting
- Endocrine - osteoporosis, amenorrhoea
How to Assess
- Measure the waist circumference at the midpoint between the lowest palpable rib and the top of the iliac crest. Measure the hip circumference around the widest part of the buttocks. Divide the first measurement by the second.
- Males <0.9
- Females <0.85
- An estimate of central obesity. Waist circumference and WH ratio are used to estimate cardiovascular risk.
Last updated on January 1st, 2017
Almansa C, Wang B, Achem SR. Noncardiac chest pain and fibromyalgia. Med Clin North Am 2010; 94:275.Altiner A, Wilm S, Däubener W, et al. Sputum colour for diagnosis of a bacterial infection in patients with acute cough. Scandinavian Journal of Primary Health Care. 2009;27:70-73.Ayalon I, Glatstein MM, Zaidenberg-Israeli G, Scolnik D, Ben Tov A, Ben Sira L, Reif S. The role of physical examination in establishing the diagnosis of pneumonia. Pediatr Emerg Care. 2013 Aug; 29(8): 893-6.Chalmers JD, Finch S. Sputum colour in non?CF bronchiectasis: The original neutrophil biomarker.Respirology. 2014;19:153-154.Chojnowska S, Kepka A, Waszkiewicz N, et al. Etiopathogenesis of nasal polyps. Progress in Health Sciences. 2013;3:151.Delaunois LM. Lung auscultation: back to basic medecine. Swiss Med Wkly. 2005 Sep 3; 135(35-36): 511-2.Ferrer R. Lymphadenopathy: differential diagnosis and evaluation. American family physician. 1998;58:1313.Gillam GL, McNicol KN, Williams HE. Chest deformity, residual airways obstruction and hyperinflation, and growth in children with asthma. II. Significance of chronic chest deformity. Archives of Disease in Childhood. 1970;45:789-799.Godfrey S, Edwards RH, Campbell EJ, Armitage P, Oppenheimer EA. Repeatability of physical signs in airways obstruction. Thorax. 1969;24:4-9.Herbert T. Marx, Paul N. Yu, Clinical examination of the arterial pulse, Progress in Cardiovascular Diseases, Volume 10, Issue 3, November 1967, Pages 207-235
Huntzinger A. Guidelines for the Diagnosis and Management of Hoarseness. Am Fam Physician. 2010;81:1292.John G, Pasche S, Rothen N, Charmoy A, Delhumeau-Cartier C, Genne D. Tobacco-stained fingers: a clue for smoking-related disease or harmful alcohol use? A case-control study. BMJ OPEN. 2013;3:e003304.
Kanagalingam S, Miller NR. Horner syndrome: clinical perspectives. Eye and Brain. 2015;2015:35-46.Kaufmann P, Smolle KH, Fleck S, Lueger A. Ketoacidotic diabetic metabolic dysregulation: pathophysiology, clinical aspects, diagnosis and therapy. Wiener klinische Wochenschrift. 1994;106:119.Khadilkar SV, Khade SS. Brachial plexopathy. Ann Indian Acad Neurol. 2013 Jan; 16(1): 12-8.Mabedi C, Kendig C, Liomba G, et al. Causes of cervical lymphadenopathy at Kamuzu Central Hospital. Malawi medical journal : the journal of Medical Association of Malawi. 2014;26:16.Maitre B, Similowski T, Derenne J. Physical examination of the adult patient with respiratory diseases: inspection and palpation. European Respiratory Journal. 1995;8:1584.McGee S. Cheyne-stokes breathing and reduced ejection fraction. American Journal of Medicine. 2013;126:536-540.Metzinger SE, Guerra AB. Diagnosing and treating nasal septal perforations. Aesthetic surgery journal. 2005 Sep 1;25(5):524-9.Moll HH, Rome MD, Leeds MB. Chest Deformities in asthma. Lancet. 1937 Jan; 229(5914): 12-13.Peros-Golubici? T. Lijec Vjesn. Lung auscultation: an old skill with new interpretation and terminology. 1994; 116(11-12): 308-14.Pierce JA, Ebert RV. The barrel deformity of the chest, the senile lung and obstructive pulmonary emphysema. The American Journal of Medicine. 1958;25:13-22.Ross S, Godden D, Douglas G, Legge J, Friend J. Asthma trends. Causes of wheeze and asthma may differ. BMJ (Clinical research ed.). 1994;309:603-603.Rutherford JD. Digital Clubbing. Circulation. 2013 May; 127(19): 1997-1999.Sarkar M, Madabhavi I, Niranjan N, Dogra M. Auscultation of the respiratory system. Annals of thoracic medicine. 2015 Jul;10(3):158.Sarkar M, Mahesh D, Madabhavi I. Digital Clubbing. Lung India. 2012 Oct; 29(4): 354-362.
Sewall H. Some conditions other than aortic aneurism which determine the occurrence of the tracheal tug. The American Journal of the Medical Sciences. 1901;122:150-155.Sharma J, Senjyu H, Williams L, White C. Intra-tester and inter-tester reliability of chest expansion measurement in clients with ankylosing spondylitis and healthy individuals. Journal of the Japanese Physical Therapy Association = Rigaku ry?h?. 2004;7:23-28.Smith JA, Ashurst HL, Jack S, Woodcock AA, Earis JE. The description of cough sounds by healthcare professionals. Cough (London, England). 2006;2:1-1.
Stockley RA. Sputum colour: A marker of bacterial infection. European Respiratory Monograph. 2013;60:27-33.Sulica L. Hoarseness. Arch Otolaryngol Head Neck Surg. 2011; 137(6): 616-619.Vincent MT, Celestin N, Hussain AN. Pharyngitis. American family physician. 2004;69:1465.
Weber R. Pharyngitis. Primary care. 2014;2013;41:91.Williams AM, Crabbe DC. Pectus Deformities of the Anterior Chest Wall. Paediatric Respiratory Reviews. 2003 Sept; 4(3): 237-242.Williams N. What are the causes of a perforated nasal septum. OCCUPATIONAL MEDICINE. 2000 Feb 1;50(2):135-6.Winzenberg T, Jones G, Callisaya M. Musculoskeletal chest wall pain. Australian Family Physician. 2015;44:540.Wipf JE et al. Diagnosing pneumonia by physical examination: Relevant or relic? Arch Intern Med. 1999; 159: 1082Wise CM, Semble EL, Dalton CB. Musculoskeletal chest wall syndromes in patients with noncardiac chest pain: a study of 100 patients. Arch Phys Med Rehabil 1992; 73:147.