Differential diagnosis of severe emaciation with skinny appearance;
1. body wasting type: body wasting type refers to the weight loss caused by diseases or some factors, and it is emaciation when it is lower than standard weight 10% (some authors think that it is emaciation when it is lower than standard weight 10%, and it is emaciation when it is lower than 20%).
2. Palpitation with emaciation and diarrhea: The onset of hyperthyroidism in the elderly is hidden, which is different from the typical symptoms of hyperthyroidism in young people. Most of them are cardiovascular and gastrointestinal symptoms such as arrhythmia, hypertension, anorexia, diarrhea and emaciation. Therefore, if people over 60 years old have palpitations, diarrhea, weight loss but good mental state, they should be alert to hyperthyroidism.
3. Progressive emaciation: Progressive emaciation refers to short-term progressive weight loss. Compared with the weight value measured before and after weight loss, there are obvious circumstantial evidences such as widening clothes, loosening belts, enlarging shoes, reducing subcutaneous fat, muscle emaciation, flabby skin and protruding bones.
Due to the different clinical types of protein-energy malnutrition, it is difficult to diagnose mild, moderate and chronic malnutrition, and comprehensive diagnosis is needed.
1. Medical record
According to the diet, understand the history of insufficient food intake and the history of diseases that affect the digestion and absorption of the body.
2. Clinical manifestations
(1) Symptoms: There are no obvious symptoms in the early stage, only poor appetite, and the height and weight of children are slightly lower than normal. The disease continues to develop, the digestive function may decline, and it is easy to suffer from respiratory infection. Severe malnutrition is characterized by emaciation in appearance, refusal to eat, apathy and slow response, often accompanied by multivitamin deficiency and various complications such as keratitis, keratomalacia and purpura. And finally enter a state of generalized edema and inhibition.
(2) Signs:
① Weight: Protein-energy malnutrition will affect children's growth and weight loss. Gomez et al. proposed that the body weight of degree I malnutrition is 75%~90% of the standard body weight, degree II malnutrition is 60%~75% of the standard body weight, and degree III malnutrition is
② Height: In childhood, the height rises linearly, and the rise of patients with protein-energy malnutrition continues to slow down. Generally, compared with the average height in this area, it is low or low, which has diagnostic value. The height of middle and lower finger is x 2s ~ X2s, and the height of lower finger is below X2s. But we should pay attention to comprehensive analysis, because protein-energy malnutrition can also occur in normal height; Conversely, short people are not all malnourished.