General appearance	Emaciated, sunken cheeks, sallow skin, flat affect; may be normal weight or overweight
Vital signs	Bradycardia, hypotension, hypothermia, orthostasis
Skin	Dry skin, lanugo, dull or brittle hair, nail changes, hypercarotenemic, subconjunctival hemorrhage
HEENT	Sunken eyes, dry lips, gingivitis, loss of tooth enamel on lingual and occlusal surfaces, dental caries, parotitis
Breasts	Atrophy
Cardiac	Mitral valve prolapse, click, or murmur; arrhythmias
Abdomen	Scaphoid, palpable loops of stool, tender epigastrium
Extremities	Edema, calluses on dorsum of hand (Russell's sign), acrocyanosis, Raynaud's phenomenon
Neuromuscular	Trousseau's sign,* diminished deep tendon reflexes