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2: NMSP Exam 3 > 49: Eating Disorders > Flashcards

49: Eating Disorders Flashcards

1
Q

bulimia / anorexia and suicide***

A

bulimia = suicide rates 7x higher than general population, anorexia 5x higher

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2
Q

3 DSM5 diagnostic criteria for anorexia nervosa

A
  1. restriction of food -> significantly low BMI
  2. intense fear of gaining weight / becoming fat
  3. distorted perception of body weight and shape linked to decreased self-worth
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3
Q

two types of anorexia nervosa

A
  1. restricting type: 3 months excess exercise, fasting, dieting (no binging or purging)
  2. binge-eating purging type: 3 months binging/purging behaviors
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4
Q

what condition does anorexia share features with?

A

OCD

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5
Q

medical complications that can occur with anorexia

A
  1. cardiac: bradycardia, hypotension, cardiac atrophy
  2. gyn: amenorrhea, decreased libido
  3. endocrine: osteoporosis, hypothermia, euthyroid, hypoglycemia
  4. GI: gastroparesis, constipation
  5. electrolytes: dehydration, hypoK, hypoPh, hypoMg
  6. resp muscle atrophy, dypsnea
  7. heme: anemia, leukopenia, thrombocytopenia
  8. neuro: brain atrophy
  9. derm: xerosis, seb dermatitis
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6
Q

refeeding syndrome

A

complications that occur as a result of fluid/electrolyte shifts during aggressive nutritional rehab -> potentially fatal

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7
Q

s/s of refeeding syndrome

A
  1. hypoPh, hypoK
  2. CHF, peripheral edema
  3. rhabdomyolysis, hemolysis
  4. seizures
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8
Q

how to avoid refeeding syndrome

A

slowly increase amount of calories given to patients, closely monitor labs in the first few weeks

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9
Q

common co-morbidities with anorexia

A
  1. depression, anxiety, OCD**
  2. impulse control disorders
  3. personality disoders: OCPD, avoidant, dependent, narcissistic, paranoid, borderline
  4. perfectionism, compulsivity, narcissism (traits)
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10
Q

treatment for anorexia nervosa

A

nutritional rehab, psychotherapy, hospitalization until at a healthy weight (pharm doesnt really work)

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11
Q

four drugs to avoid with anorexia and why**

A
  1. buproprion: seizure risk with binging/purging
  2. TCAs: cardiotoxicity
  3. antipsychotics: QT prolongation(electrolytes)
  4. Olanzapine: causes weight gain, pts will refuse it
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12
Q

first line drug to treat anxiety associated with mealsin anorexia pt

A

lorazepam

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13
Q

DSM5 6 Dx criteria for bulimia nervosa

A
  1. recurrent episodes of binge eating large amounts
  2. pts cannot control eating
  3. purging behavior
  4. at least 1x/week for 3 months
  5. pts sense of self-worth is majorly influenced by body
  6. not exclusively during an episode of anorexia nervosa
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14
Q

how to distinguish between anorexia and bulemia***

A

anorexia: underweight
bulemia: nl weight, slightly underweight, or overweight

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15
Q

medical complications with bulemia

A
  1. electrolytes: dehydration, hypoK, hypoCl, met alkalosis
  2. cardiac: hypotension, orthostasis, tachy, arrhythmias
  3. GI: mallory-weiss tears, salivary gland hypertrophy, abd pain/bloating, constipation
  4. mouth: tooth enamel erosions, dental caries, scars on dorsum of hand, xerosis
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16
Q

treatment for bulemia

A

psychotherapy**, nutrtional rehab, CBT

17
Q

goals of psychotherapy for bulemia

A

improve self esteem, decrease emphasis on thinness, eliminate dietary restraints, create pattern of regular eating, eliminate binging/purging habits

18
Q

what drug to avoid in bulemia and why

A

buproprion (increased risk of SZRS with binging and purging)

19
Q

first, second, third line pharmacotherapy for bulemia

A
  1. first line: fluoxetine
  2. other SSRIs (sertraline, fluvoxamine)
  3. third line: TCAs, topiramate, trazodone, MAOIs
20
Q

binge eating disorder: DSM5 5 Dx criteria

A
  1. episodes of binge eating
  2. pt lacks control over eating
  3. episodes marked by 3+: eating large amounts when not hungry, eating rapidly, feels uncomfortably full after, eating alone, feeling guilty, depression, disgust after binging
  4. episodes 1x/week for 3+ months
  5. no purging, fasting, excess exercise
21
Q

first line tx for binge eating DO

A

psyhotherapy, esp CBT and interpersonal therapy

22
Q

one drug approved to treat binge eating disorder**

A

vyvanse

2: NMSP Exam 3 (20 decks)

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