Anorexia Nervosa Flashcards

1
Q

What is anorexia?

A

Restriction of food intake to reduce weight with compulsive compensatory behaviour if food is totally unavoidable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the criteria for anorexia?

A

BMI <17.5 or body weight >15% less than ideal weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the systemic symptoms of anorexia?

A

Hypotension
Hypoglycaemia
- these two cause fainting

Dry skin
Cold intolerance
Lanugo hair
Alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the MSK symptoms of anorexia?

A

Muscle cramps
Osteoporosis/penia
Weakness/fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the GI symptoms of anorexia?

A

Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the repro symptoms of anorexia?

A

Secondary amenorrhoea

Delayed puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs of anorexia?

A

Russels sign

Shortened stature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is russels sign?

A

Small abrasions of the knuckles from purging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What questionnaire can be used to screen for anorexia?

A

SCOFF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the criteria of SCOFF?

A

Do you ever feel SICK from eating food?
Do you feel you have lost CONTROL of your eating?
Have you lost >ONE stone in the last 3 months?
Do you see yourself as FAT when others don’t?
Is FOOD all you think about?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What investigations should be done in suspected anorexia?

A

FBC

U&Es
- Very important esp potassium

TFTs

ECG
- Due to potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the two branches of treatment for anorexia?

A

Pharmacological

Non-pharma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the first line treatment of anorexia?

A

Slowly refeed
Replenish all electrolytes
Detention often needed

Bloods daily to assess electrolyte correction

Referral to eating disorder unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What talking therapy is good for anorexia?

A

CBT but only individual

MANTRA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is MANTRA?

A

Maudsley Anorexia Nervosa Treatment for Adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What pharmacological treatment exists for AN?

A

Antidepressants

Antipsychotics

17
Q

When and what antidepressents should be used??

A

If the patient has depression too

Should ONLY be started once electrolyte balance is correct

SSRI - fluoxetine/sertraline

18
Q

What antidepressants are contraindicated in AN?

A

TCAs

MOAIs

Buproprion strongly contraindicated

19
Q

Why is buproprion strongly contraindicated in AN?

A

Lowers seizure threshold and AN are already low seizure threshold

20
Q

What is best treatment for AN <15 y/o?

A

Family interventional therapy

21
Q

Typical presentation of AN?

A

” 15 y/o presents with her mother complaining of fatigue and weakness. She is quite petite and wearing a baggy dress, and appears quite anxious. When asked to step on the scales she is very reluctant and states that she thinks she’s put on weight since last visit. Her mother says shes been not eating as much and doing a lot of exercise recently. “