Anorexia Nervosa

Question 1

Anorexia Nervosa Criterion A:

Answer 1

Restriction of energy intake, leading to a low body weight

Question 2

Anorexia Nervosa Criterion B:

Answer 2

Fear of gaining weight or becoming fat

Question 3

Anorexia Nervosa Criterion C:

Answer 3

Disturbance in the way one’s body weight or shape is experienced

Question 4

Describe the severity ranges for Anorexia

Answer 4

Mild BMI >17
Moderate BMI 16 - 16.99
Severe BMI 15 - 15.99
Extreme BMI <15

Question 5

Are women or men more affected? How many men are affected?

Answer 5

women mainly, but about 25% of men

Question 6

What is known about the aetiology?

Answer 6

AN has a strong genetic component, but unless you starve yourself these genes will not be expressed.

Question 7

What is AN comorbid with?

Answer 7

Anxiety disorders, depression

Question 8

AN is a ________ illness, describing an illness with _________ and ________ symptoms. Those with AN have a good ______ and enjoy food, but deliberately _______ themselves

Answer 8

psychosomatic
psychological and physical
appetite
starve

Question 9

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)

Answer 9

anxiety/depression
high achievers
schizophrenic

Question 10

What are some of the PHYSIOLOGICAL symptoms of AN?

Answer 10

hypothermis
bradycardia <60bpm
prolonged Qt interval
hypotension <90/50
heart failure
arrhythmia
Electrolyte abnormalities (decr. Mg and K)

Question 11

What are the changes to HAIR/SKIN and BONES

Answer 11

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

Question 12

AN can also lead to severe ______ failure, and ______ deficiencies. Further, _____ may be present, where the woman’s menstrual cycle stops, or never starts

Answer 12

kidney, vitamin, amenorrhea

Question 13

What are some of the changes in the BRAIN due to AN?

Answer 13

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.

Question 14

What happens to the stomach during AN?

Answer 14

empties very slowly due to starvation

constipation

Question 15

Describe re-feeding syndrome

Answer 15

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

Question 16

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 ______.

Answer 16

adjust
accurately
body size
self image
no activation
difficulty
attention
referencing
perceptual
controls

Question 17

What part of the brain has been found to be hypoactive in AN patients when looking at self-images?

Answer 17

Insula, which is for emotion/sensory regulation

Question 18

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.

Answer 18

attention to detail
central coherence
set shifting

Question 19

In pharmacotherapy for AN, what is used?

Answer 19

anti-depressants do not work

anti-psychotics help reduce anxiety

Question 20

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.

Answer 20

scared
physical
psychological

Question 21

Treatment for AN is not very successful, with ____% total recovery over 10 years.

Answer 21

30

Question 22

What does psychotherapy for AN target?

Answer 22

Low self-esteem/depression
body image perception/valuing yourself for your body shape
perfectionism
obsessionality

Question 23

Pica is characterised by…

Answer 23

persistent eating of non-food substances over 1 month period

Question 24

Rumination disorder is characterised by…

Answer 24

repeating chewing and regurgitating of food over 1 month period (or chew and spit out)

Question 25

Avoidant/Restrictive Food intake disorder is characterised by…

Answer 25

lack of interest in eating certain foods based on their colour, texture, etc

Results in significant weight loss and nutritional deficiency