20. Clinical Approach to Eating disorderds and refeeding

Question 1

Eating disorders are usually more common in women and include anorexia nervosa, bulimia nervosa, and binge?

Answer 1

eating disorder

Question 2

bulimia and anorexia nervosa are accompanied by suicide which is an indication for hospitalization, rates are higher in bulimia than anorexia…

Answer 2

MEOW

Question 3

What is restriction of energy intake relative to requirements leading to low body weight for age sex and development, intense fear of gaining weight or becoming fat despite being underweight with a distorted perception of body weight and shape?

Answer 3

Anorexia Nervosa

Question 4

There are two types of Anorexia; restricting type - 3 months of no binging or purging - no vomiting, and what type which is 3 months of binging and purging behaviors w laxatives diuretics and enemas?

Answer 4

Binge-eating/purging type

Question 5

With anorexia, patients are usually underweight, excessive exercise fasting binging and purging with dietary restriction are common, wt loss viewed as self control, patients look at self excessively and weight self is?

Answer 5

common behavior

Question 6

Medical complications associated with Anorexia include bradycardia, hypotension, QT dispersion, cardiac atrophy and Mitral valve prolapse, dehydration, hypokalemia, hyponatremia, hypomagnesemia, and what gynecologic sx?

Answer 6

Amenorrhea

*NOTE refeed slowly!

Question 7

Anorexia is associated with depression and dysthymic disorder, personality disorders (cluster B), disordered personality traits and anxiety disorders such as?

Answer 7

Obsessive Compulsive Disorder

Question 8

Tx of anorexia involves a team approach with a mental health clinician, registered dietitian, and general medical clinician, first line- nutritional rehabilitation and psychotherapy*** with options that include cognitive behavioral therapy and?

Answer 8

family therapy (because intial problem is probably due to family calling kid fat)

avoid buprpion/ziprasidone/haldol

Question 9

may give anorexic patient olanzapine to help with weight gain or lorazepam to reduce anxiety with confronting meals, if anxiety or depression is severe, give?

Answer 9

SSRIs

Question 10

What eating disorder is recurrent episodes of binge eating, defined as eating an unusually large amount of food in a discrete period of time, patients feel they cannot control their eating during the episode with recurrent inappropriate compensatory behavior to prevent weight gain?

Answer 10

Bulimia Nervosa

Question 11

Bulimia Nervosa patients usually have normal body weight or slightly overweight or even obese, pts have euphoric feeling after binging and PURGING behaviors are used to counteract the weight gain, they dont want to become thin but instead they want?

Answer 11

to not become fat

Question 12

Bulimia Nervosa is associated with GI issues from excessive vomiting, including mallory weiss tears, or esophageal ruptures, parotid/submandibular gland hypertrophy, abdominal pain, bloating and?

Answer 12

constipation/ teeth issues/ metabolic alkalosis

Question 13

Tx for Bulimia Nervosa includes nutritional rehabilitation, CBT therapy and pharmacotherapy, **CBT is the treatment of choice, rx- avoid bupropion, second line tx are other SSRI such as sertraline/fluvoxamine and first line tx rx is?

Answer 13

Fluoxetine 60mg

Question 14

What disorder is episodes of binge eating, defined sa consuming a large amount of food in a discrete period of time (2hrs), patient feels they lack control over eating during the episode, occur once a week for 3 months, with NO USE of purging/fasting/exercise as seen in Bulimia Nervosa?

Answer 14

Binge Eating Disorder BED

Question 15

Binge Eating Disorder BED tx is psychotheraphy CBT is first line treatment and interpersonal therapy IPT, along with what medication, which is the only FDA approved med for BED?

Answer 15

Vyvanse