Sandbox:Javaria

Labs Expand ❑ CBC with differential and peripheral smear ❑ ESR, CRP, LDH ❑ HbA1c ❑ CMP ❑ Lipid profile ❑ TSH, free T4 ❑ Urinalysis ❑ FOBT ❑ Chest X-ray ❑ Abdominal ultrasound ❑ Echocardiography ❑ Rheumatoid factor

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Progressive oropharyngeal or esophageal dysphagia

Stomach/ duodenal ulcer celiac sprue, whipple disease

Potential depression or Cognitive dysfunction

Suspected malignancy

Nutritional deficiency is suspected

Infection is suspected

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❑ Videofluoroscopy ❑ Dysphagia barium swallow

Specific tests: Expand ❑ Upper or lower GI endoscopy with biopsy ❑ Stool fat, anti-transglutaminase antibodies, elastase, lactoferrin ❑ Upper GI and small bowl series

❑ Geriatric Depression Scale ❑ MoCA

Specific tests: Expand ❑ CT (chest, abdomen, pelvis, head, etc) ❑PET scan ❑ Colonoscopy ❑ Mammogram ❑ Protein electrophoresis

Specific tests Expand ❑ Serum ferritin ❑ Vitamins: Beta carotene, vitamin D, tocopherol, vitamin B12, and folic acid ❑ Minerals: Serum copper and zinc, manganese, and magnesium

Specific tests: Expand ❑ Chronic diarrhea: Stool osmotic gap, culture, ova and parasite, electrolytes, leukocytes, lactoferrin, and C. difficile test. For a detailed information on differentials click here ❑ Tuberculosis: AFB and sputum culture sputum ❑ HIV:ELISA or Latex Agglutination Test for screening and viral RNA (P24) for confirmation ❑ Endocarditis: Modified Duke Criteria and at least two blood cultures ❑ Gastroenteritis and colitis: Stool exam as in chronic diarrhea.

Expand ❑ Chronic diarrhea treatment ❑ Tb treatment ❑ HIV treatment ❑ Infective endocarditis treatment ❑ Gastroenteritis treatment and colitis treatment

Follow-up in 1, 3, and 6 months depending upon the cause. Reevaluate should be continued among cases of unknown etiology.