Anorexia Nervosa Flashcards
2 characteristics shared by anorexia and bulimia nervosa
Obsession about weight
Maladaptive behaviors eg restricting/vomiting
Management of Anorexia x5
Nutritional rehabilitation
Monitor for medical complications
CBT for eating disorders
Psychodynamic psychotherapy
Family psychotherapy
Medical complications of anorexia x6
Fatigue
Amenorrhea
Infertility
Osteoporosis
Electrolyte imbalance
Cardiac arrhythmias
Shared characteristics between anorexia and OCD x3
Obsessive thoughts
Compulsive behavior
No ‘feeling of knowing’
DSM 5 diagnostic criteria for AN x3
Restriction of energy intake resulting in low BMI
Fear of gaining weight or becoming fat
Disturbed perception of body weight and shape
Risk factors of AN x3
Genetic/family history
Female gender
Body dissatisfaction
Perpetuating factors of AN x4
Isolation
Initial positive reinforcement
Starvation related behavior changes
Pro-ana /thinspiration
Physical exam x3 and investigation findings in AN x4
Hypothermia
Bradycardia
Neutropenia
Postural hypotension
Hypo Mg, Pho, K
Indications for admission x5
Suicidal
Medical complications
Severe bingeing or purging
Severe psychiatric comorbidity
Failure to respond to outpatient treatment
Worrying signs of severe starvation x5
Pancreatitis
Autophonia
Hypoglycemia
Oropharyngeal dysphagia
Superior mesenteric artery syndrome
Psychiatric comorbidities of AN x4
OCD
Anxiety
Depression
Substance misuse
Electrolyte imbalance in refeeding syndrome x3
Hypo K, Mg, Pho
What causes refeeding syndrome
A switch from fasting gluconeogenesis to carbohydrate induced insulin release
Pharmacological management of BN
SSRIs - fluoxetine
Complications of BN x4
Injuries to mouth teeth and esophagus
Boerhaave syndrome
Electrolyte imbalance
Kidney injury
BOWL mnemonic for BN
Binge eating
Offsetting/purging
Weekly
Linked to self esteem
UNDER mnemonic for AN
Underweight
Nervous about weight gain
Distorted perception
Excessive exercise
Restriction
Difference between AN and BN in terms of self esteem
In BN the weight gain is linked to low self esteem, interpersonal rejection and fear of being alone
DSM 5 for BN x4
Objective binge eating episode
Sense of loss of control
Attempt to compensate for the episode
Over evaluation of the importance of weight and shape
Etiological factors of BN x5
Body commentary
Parental eating disorder
Thin idealization
Social pressures
Trauma
Aims of initial stage of treatment x4 in BN
Psychoeducation
Engage patient in treatment and change
To derive a personalized formulation with patient
To introduce and implement collaborative weekly weighing and regular eating
Treatment in mildly unwell patients x2 in BN
Dietary education
Counselling
Key elements of CBT- GSH guided self help x5
Monitor eating
Regular eating and meal planning
Eliminate dieting
Changing the mindset
Learning to intervene to prevent binge eating
Management of BN for adolescents x3
Family psychotherapy
CBT for BN
Adjunctive yoga
Difference between purging disease and BN x3
Postprandial fullness
GIT distress after meals
Elevated postprandial cholecystokinin ie hormone involved in satiety/ hunger suppression
Psychiatric comorbidities of purging disease x5
Anxiety
Depression
Suicidality
Personality disorders
Substance abuse disorders
Role of an ED experienced physician x4
Provide enough calories effective for re-nourishment
Provide supplementation and nutritional counseling
Make dietary adjustments
Address metabolic changes
