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5. Psychiatry > 2- Eating Disorders > Flashcards

2- Eating Disorders Flashcards

1
Q

What are the defining features of Anorexia Nervosa?

A

Low body weight, fears gaining weight/ becoming fat, self-esteem/ mood significantly influenced by weight

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2
Q

What are the defining features of Bulimia Nervosa?

A

Binge eating followed by compensatory behaviors, self-esteem/ mood significantly influenced by weight

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3
Q

What is the difference between purging and non-purging compensatory behaviors?

A

Purging- any way to get food out of body

Non-purging- keep food in but get rid of calories (exercise)

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4
Q

What is the most common type of ED?

A

Binge eating disorder

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5
Q

How is binge eating disorder defined?

A

Binge eating not followed by compensatory behaviors

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6
Q

What are common types of feeding disorders?

A

Pica, rumination disorder, ARFID (avoidant/ restrictive food intake disorder)

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7
Q

The following are signs/ sxs of what eating disorder?

Consistent drop in weight (BMI < 18.5), fainting/ dizzy, HAs, anemia, osteoporosis/ osteopenia, irregular/ absent menses, bloating/ IBS, anxiety/ OCD

A

Anorexia

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8
Q

The following are signs/ sxs of what eating disorder?

Heart irregularies/ electrolyte imbalance, low bone density, persistent sore throat, acid reflux, unexplained GI problems, swollen parotid glands

A

Bulimia

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9
Q

The following are signs/ sxs of what ED?

Excessive weight, T2DM, fatty liver disease, heart disease, high BP, high cholesterol, decades of failed dieting

A

Binge eating disorder

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10
Q

What general signs/ sxs may be a/w any ED? (3)

A
  • Fear/ anxiety around food
  • Body dissatisfaction, negative body image
  • Unresolved trauma, esp. abuse
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11
Q

For a pt that has an ED, it is imperative to understand that eating disorders are NOT about food, but instead that eating behaviors are what?

A

Sxs of something deeper (emotionally and psychologically)

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12
Q

You should avoid lecturing pts with an ED about weight, food, or exercise because they are not under- or over eating because they don’t know how else to eat. Instead there use food for what?

A

Psychological compulsion to use food to cope with emotions, anxiety, depression

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13
Q

If a pt with an ED shows signs of depression, anxiety, body hatred, or hx of struggling with eating disorders, it is important to discuss what?

A

Meeting with/ provide referrals to an eating disorder specialist or treatment program

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14
Q

What should you recommend in order to show a pt with an ED that you care and that you expect them to reach out to referrals?

A

Follow up appt

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15
Q

90% of people with EDs will not seek tx. What is the prevalence of dying from an ED if a pt seeks vs does not seek tx?

A

20% of those who do not seek tx will die vs

~2-3% of those who do seek tx will die

(of those who do seek tx- 60% full recovery, 20% partial recovery, 20% do not improve)

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16
Q

What are the therapeutic levels of care for an ED from most to least acute? (6)

A

Hospitalization (3-5 days) → inpt (30-60 days) → partial hospitalization/ residental (45-60 days) → intensive outpt (1-3 months) → outpt (2-5 yrs) → support groups

17
Q

What are the indications for in-patient tx of an ED?

A
  • Medically unstable
  • Refuses/ unable to follow outpt tx
  • Break from day-to-day stressors
18
Q

What are the indications for out-patient tx of an ED?

A
  • Medically stable
  • Able to care for self
  • Not too dependent on tx for day-to-day well-being
19
Q

What are the present-focued foals of outpatient therapy for an ED?

A
  • Manage mood/ anxiety
  • Communicate feelings/ needs
  • Creating meaningful life (“real self”)
20
Q

What are the past-focused goals of outpatient therapy for an ED?

A

Identify function of ED and heal related trauma

21
Q

CBT, DBT, exposure response prevention, and experiential/ psychodrama are all examples of present or past-focued models of outpatient therapy for an ED?

A

Present

22
Q

Psychodynamic/ object relations/ attachment and EMDR are all examples of present or past-focued models of outpatient therapy for an ED?

A

Past

23
Q

What type of present-focused outpatient therapy for an ED challenges negative thinking and activates healthy behaviors?

A

CBT

24
Q

What type of present-focused outpatient therapy for an ED places an emphasis on skills to effectively manage self w/o destructive coping mechanisms?

A

DBT- finds balance between rational mind and emotional mind

(coping skills = mindfulness, distress tolerance, emotion regulation, interpersonal)

25
Q

What type of present-focused outpatient therapy for an ED aims to identify fears and develop hierarchy of approaching fears, allows anxiety to increase and not escape for relief, and teaches the pt to learn that anxiety is tolerable?

A

Exposure response prevention

26
Q

Mindfulness, psychodrama, art therapy, play/ sand tray/ puppets, equine/ assisted psychotherapy, music therapy, and movement therapy are all examples of what type of ED therapy?

A

Experiential

27
Q

What are the goals of psychodynamic/ object relations/ attachment? (past-focused ED therapy)

A
  • Explore early experiences with attachment figures in which needs were not met
  • Explore defense mechanisms/ coping strategies
  • ID origins of shame
28
Q

What type of past-focused ED therapy reprocesses traumatic experiences and crippling negative beliefs about self?

A

EMDR

29
Q

What are the only 2 meds indicated for tx of EDs as most meds are used to treat underlying anxiety, depression, and compulsive behaviors?

A

Prozac for bulimia, Vyvanse for binge eating disorder

30
Q

What classes of psychotropic meds can be used in the treatment of an ED?

A

SSRI/ SNRI antidepressants, atypical antipsychotics, benzodiazepines, ADHD meds, anti-convulsants

31
Q

What are the SEs of atypical antipsychotics (helpful in impulsivity, cutting)? (can be used in therapy of ED)

A

Weight gain

32
Q

What are the SEs of benzodiazepines (useful before meals)? (can be used in therapy of ED)

A

Numb emotions, habit forming

33
Q

What are the SEs of ADHD meds (decrease urge to use substances)? (can be used in therapy of ED)

A

Decreased appetite, weight loss, heart problems

34
Q

What are the contraindications to anti-convulsants? (can be used in therapy of ED)

A

Underweight, purging

35
Q

Medical treatment/ monitoring is often requirement during the treatment of an ED. What specific things might be included in this?

A

Vitals, bloodwork, weight (caution w/ water loading), HR/ heartbeat, bone density

36
Q

Full recovery from an ED is possible. In addition to healthy relationships, life skills, and strong identity and sense of “real self”, what are the goals of recovery?

A
  • Optimal weight + tolerate imperfect body
  • Eating has a balance, variety, moderation
  • No irrational food fears

5. Psychiatry (19 decks)

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