Anorexia Nervosa Flashcards
1
Q
What is AN?
A
Characterised by weight loss or failure to gain weight in children
2
Q
Diagnostic criteria for AN?
A
- Body weight >15% below standard weight for BMI <17.5
- Self-induced weight loss
- Distortion of body image
- Morbid fear of fatness
- Amenorrhoea
3
Q
Clinical features of AN?
A
- Patients generally eat little but food obsessed
- Sensitivity to cold
- Hypotension
- Bradycardia
- May have electrolyte abnormalities
- Dental problems maybe
- Renal and hepatic damage?
- Loss of fat= amenorrhoea, abnormal thyroid
- Dry skin, caroyanaemia, lanugo hair, hair loss
Bloods:
-Low WBC, iron, B12, bone marrow suppression, thrombocytopenia
4
Q
Subtypes of AN?
A
- Restricting
- Binge-purge
5
Q
Management of AN for CAMHS community?
A
=Weight, height, % weight for height, physical exam, bloods, ECG
-Junior MARSIPAN risk assessment
6
Q
Treating AN as CAMHS outpatient?
A
Family based therapy
Dietician
Monitor refeeding risk
Medications: olanzapine, SSRI
7
Q
Adult outpatient treatment?
A
-Dietician
Medical monitoring
Psychological therapy: CT-ED, MANTRA, SSCM, psychodynamic therapy
8
Q
What is refeeding syndrome?
A
Potentially fatal metabolic response to too rapid refeeding after period of starvation
9
Q
Management of refeeding syndrome?
A
- Start low with energy replacement, + high phosphate content and build it up
- Supplement with multivitamin
- Correct electrolyte and fluid imbalances
