Are you concerned about malnutrition in this patient? Would you do additional workup?
No; She has had no weight loss and has a normal appetite
Incorrect! This patient is underweight, since her BMI is < 18.5. In addition, what the patient perceives as a ” normal appetite” does not seem to be providing enough calories and micronutrients to meet her nutritional needs in this situation.
Yes; She has a low BMI (16.8).
Incorrect, choose again! While a BMI of < 18.5 is a risk factor for malnutrition, this is not the only factor in the history and physical exam which place this patient at risk for malnutrition.
Yes; Based on low BMI, ongoing enteric loss (diarrhea) and physical exam findings
Good Choice! Although this patient reports that she has had no weight loss, her BMI is less than 18.5 which is one factor associated with malnutrition risk based on the MUST tool (Malnutrition Universal Screening Tool). In addition, she has signs on her physical exam ( angular cheilitis) that could be secondary to a micronutrient deficiency.
Finally, some of the GI specific malnutrition screening tools include symptom-based criteria, such as diarrhea or vomiting as contributing to malnutrition risk.
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