An 88-year-old woman complains of fatigue and loss of weight over the past 6 months. She lives alone and she has no children. She has a long history of controlled hypertension with atenolol. Vital signs are within normal limits. Her weight is 5Ib less than it was in her last medical visit . Physical examination is unremarkable. Laboratory tests including CBC, thyroid panel and creatinine are normal. Her health screening tests are up-to-date and are unremarkable.
What is the appropriate next step?
A-MRI of the brain
B-Further investigations including liver function test
C-Begin anti-depressive medication
E-Arrange nursing and supportive assistance
This patient lives alone and most probably, she is too old to take care of herself. Her examination and laboratory tests are normal. She does not need extra tests. The best approach to this patient is to help her to arrange nurse visits and support with a social worker for counseling as she might need help with shopping and cooking healthy meals and performing other daily activities.
The correct answer is E
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Thank you Dr Akram