05-31-2008, 05:43 PM
66 yr old woman is evaluated because of 6 kg unexplained weight loss over 8 months. She has history of Graves' disease, mild osteoarthritis, and osteoporosis. Her meds are Alendronate and Calcium supplements. She states that she has had trouble concentrating at work and feels run down. She sleeps poorly, has poor appetite and has stopped walking for exercise. She doesn't use any alcohol or tobacco. Within the last 8 months, she has normal pelvic exam with pap smear, stimulating hormone concentration is 1.1 and serum electrolytes, creatinine and liver enzymes are normal.
Which of the following is the most appropriate next step in management of this patient?
1: Upper endoscopy
2: Abdominal computed tomography scan
3: Megestrol acetate therapy
4: Mirtazapine (antidepressant) therapy
5: Propylthiouracil therapy
Which of the following is the most appropriate next step in management of this patient?
1: Upper endoscopy
2: Abdominal computed tomography scan
3: Megestrol acetate therapy
4: Mirtazapine (antidepressant) therapy
5: Propylthiouracil therapy