Anorexia Nervosa Flashcards
What is anorexia?
Restriction of food intake to reduce weight with compulsive compensatory behaviour if food is totally unavoidable
What is the criteria for anorexia?
BMI <17.5 or body weight >15% less than ideal weight
What are the systemic symptoms of anorexia?
Hypotension
Hypoglycaemia
- these two cause fainting
Dry skin
Cold intolerance
Lanugo hair
Alopecia
What are the MSK symptoms of anorexia?
Muscle cramps
Osteoporosis/penia
Weakness/fatigue
What are the GI symptoms of anorexia?
Constipation
What are the repro symptoms of anorexia?
Secondary amenorrhoea
Delayed puberty
Signs of anorexia?
Russels sign
Shortened stature
What is russels sign?
Small abrasions of the knuckles from purging
What questionnaire can be used to screen for anorexia?
SCOFF
What are the criteria of SCOFF?
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?
What investigations should be done in suspected anorexia?
FBC
U&Es
- Very important esp potassium
TFTs
ECG
- Due to potassium
What are the two branches of treatment for anorexia?
Pharmacological
Non-pharma
What is the first line treatment of anorexia?
Slowly refeed
Replenish all electrolytes
Detention often needed
Bloods daily to assess electrolyte correction
Referral to eating disorder unit
What talking therapy is good for anorexia?
CBT but only individual
MANTRA
What is MANTRA?
Maudsley Anorexia Nervosa Treatment for Adults
What pharmacological treatment exists for AN?
Antidepressants
Antipsychotics
When and what antidepressents should be used??
If the patient has depression too
Should ONLY be started once electrolyte balance is correct
SSRI - fluoxetine/sertraline
What antidepressants are contraindicated in AN?
TCAs
MOAIs
Buproprion strongly contraindicated
Why is buproprion strongly contraindicated in AN?
Lowers seizure threshold and AN are already low seizure threshold
What is best treatment for AN <15 y/o?
Family interventional therapy
Typical presentation of AN?
” 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. “
