Anorexia Nervosa Flashcards
Anorexia Nervosa Criterion A:
Restriction of energy intake, leading to a low body weight
Anorexia Nervosa Criterion B:
Fear of gaining weight or becoming fat
Anorexia Nervosa Criterion C:
Disturbance in the way one’s body weight or shape is experienced
Describe the severity ranges for Anorexia
Mild BMI >17
Moderate BMI 16 - 16.99
Severe BMI 15 - 15.99
Extreme BMI <15
Are women or men more affected? How many men are affected?
women mainly, but about 25% of men
What is known about the aetiology?
AN has a strong genetic component, but unless you starve yourself these genes will not be expressed.
What is AN comorbid with?
Anxiety disorders, depression
AN is a ________ illness, describing an illness with _________ and ________ symptoms. Those with AN have a good ______ and enjoy food, but deliberately _______ themselves
psychosomatic
psychological and physical
appetite
starve
Those with the genetic component of AN can be divided into 3 categories. 1/3 have ________/_________ or obsessional, another 1/3 are ____ _______ (fear of failure, pass is 95%), and the final 1/3 are schizophrenic (madness, lack of insight)
anxiety/depression
high achievers
schizophrenic
What are some of the PHYSIOLOGICAL symptoms of AN?
hypothermis bradycardia <60bpm prolonged Qt interval hypotension <90/50 heart failure arrhythmia Electrolyte abnormalities (decr. Mg and K)
What are the changes to HAIR/SKIN and BONES
dry, scaly skin
burns from taking hot showers as they’re cold
lanugo - soft hairs on the body to protect from the cold
bones
- loss of bone marrow, so decr. in WBC and decr. immunity, can result in death due to infection or stomach ulcers
- osteoporosis
- decr. in RBC (from low bone marrow), leads to low energy and anemia
AN can also lead to severe ______ failure, and ______ deficiencies. Further, _____ may be present, where the woman’s menstrual cycle stops, or never starts
kidney, vitamin, amenorrhea
What are some of the changes in the BRAIN due to AN?
pseudoatrophy
confusion/reduced cognition
death
ataxia - lack of voluntary coordination of muscle movements that includes gait abnormality. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum.
What happens to the stomach during AN?
empties very slowly due to starvation
constipation
Describe re-feeding syndrome
Potentially fatal shift in electrolytes when re-feeding a malnourished patient
Phosphate, magnesium and potassium needed for digestion and to keep the heart functioning. These electrolytes, when food comes in after a period of starvation, become dangerously low in the serum and can lead to
- cardiac/respiratory failure
- gastrointestinal problems
- delirium
- death
In research studies, patients could ______ their body size on a computer. It was found they could _____ portray their _____ _____ (knew they were thin) but still felt fat. Further, fMRI studies found that they process their ____ ______ differently than the images of others. There is ___ ______ of the visual areas when looking at themselves. They have ______ assessing how they look. Self-images engaged _____ details and self _______ systems, but suppressed ________ processing. But AN patients processed non-self images similarly to ______.
adjust accurately body size self image no activation difficulty attention referencing perceptual controls
What part of the brain has been found to be hypoactive in AN patients when looking at self-images?
Insula, which is for emotion/sensory regulation
AN patients also have greater ____ to _______, known as _____ _______. This was shown in an experiment where they see the details rather than the whole face. They also have difficulty __ ______, that is, the ability to move back and forth between tasks easily.
attention to detail
central coherence
set shifting
In pharmacotherapy for AN, what is used?
anti-depressants do not work
anti-psychotics help reduce anxiety
Re-feeding and hospitalisation is common in AN. This is because often the ______ symptoms have to be treated before the _______ ones. However, patients are very ______ of treatment.
scared
physical
psychological
Treatment for AN is not very successful, with ____% total recovery over 10 years.
30
What does psychotherapy for AN target?
Low self-esteem/depression
body image perception/valuing yourself for your body shape
perfectionism
obsessionality
Pica is characterised by…
persistent eating of non-food substances over 1 month period
Rumination disorder is characterised by…
repeating chewing and regurgitating of food over 1 month period (or chew and spit out)
