3_4EatingDisorders Flashcards
What are the risk factors for developing an eating disorder?
female, middle class, sports, college-aged
What hormones may be involved in eating disorder pathogenesis?
dopamine, serotonin, dopamine
What are the screening tools for eating disorders?
SCOFF and ESP
Define AN.
psychiatric disorder with severe physiologic consequences characterized by inability or refusal to maintain a minimally normal body weight
What are the types of AN?
restricting; binge-eating and purging and/or purging
What is the usual onset for AN?
13-18 yo
What is the mortality rate for AN?
10%
Describe restricting AN.
300-700 cal/day with intense exercise; no binging or purging
Describe binge-eating and purging and/or purging
regular engagement of these activities
What are the DSM-5 criteria for AN?
1) restriction of energy intake resulting in less than minimally normal weight 2) intense fear of becoming fat or gaining weight, 3) distorted body image
What components are no longer included in DSM-5 for AN?
amenorrhea and weight
What are the 3 components of treatment for eating disorders?
1) weight restoration, 2) psychotherapy, 3) nutrition
What drug classes are used in the treatment of AN?
1) SSRIs, 2) atypical antipsychotics, 3) prokinetics, 4) PPIs
What is refeeding syndrome?
occurs with AN and most common with < 70 % IBW. Acute decrease in PO4, K, and MG causes confusion, coma, seizures, death
What is the prognosis for AN patients?
.5 good, .3 intermediate, .2 poor, .1 dead
What is hospitalization criteria for AN?
> 25% weight loss, medical complications, suicidal ideas and poor motivation, nonresponsive to OP therapy, if continuous supervision needed
What substance is used to induce vomiting?
ipecac
What is bad about ipecac?
cardiotoxic
What are complications of AN?
1) pubertal delay, 2) growth retardation, 3) electrolyte abnormalities, 4) EKG abnormalities, 5) constipation, delayed emptying
What does bulimia nervosa mean in its original language?
Greek for excessive hunger
What is the prevalence and mean onset of BN?
1% w/ onset @ 20 years lasting 8 years
What are the DSM-5 for BN?
1) recurrent (>1/wk for 3 mos) binging, 2) purging/compensatory methods, 3) lack of self control during eating, 4) self-eval dependent on weight, 5) does not occur exclusively during episodes of AN
What are the symptoms and complications of BN?
1) metabolic alkalosis, 2) electrolyte imbalance/dehydration causing palpitations, 3) GI/esophagitis, 4) dental issues (caries, erosion), 5) amenorrhea, 6) russels’ sign
What is russel’s sign
calluses from the knuckles, diagnostic for BN
Pharmacotherapy is more successful for?
BN compared to AN
What new therapies are seeking indication for BED?
lisdexamfetamine (Vyvanse) and opiod antagonists (nasal naloxone)
What is BED?
binge eating disorder
Describe BED?
recurring binge-eating episodes but no compensatory measures. Associated with marked distress.
What is OSFED?
other specified feeding or eating disorder
What are 4 types of eating disorders?
1) BN 2) AN 3) BED 4) OSFED
What was the former name for OSFED?
ED-NOS (eating disorder not otherwise specified)
Describe OSFED.
eating/weight disorder that doesn’t meet any DSM-5
What are examples of OSFEDs?
night eating syndrome, purging without binge eating
