Anorexia Nervosa/Bulemia Flashcards
Define Anorexia Nervosa?
Self induced starvation resulting in marked weight loss.
Define Bulimia?
A condition in which a patient binges on food, particularly carbohydrates, and then induces vomiting.
What is the epidemiology of anorexia and bulimia?
Mostly healthy women in their 20’s who develop an obsession with thinness and body image.
What might be a neurological reasoning behind anorexia and bulimia?
Alteration of serotonin metabolism.
What is the diagnostic feature of anorexia? Why do these features present?
Amenorrhea resulting from decreased GnRH production which leads to decreased FSH and LH production, resulting in no ovulation and thus amenorrhea.
What are other diagnostic symptoms of anorexia that is not related to the menstrual cycle? Think estrogen and thyroid hormone.
Decreased thyroid hormone release, resulting in cold intolerance, bradycardia, constipation and changes in skin (becomes dry and scaly) and hair. Also dehydration and electrolyte imbalances are seen. Low estrogen levels results in bone density decrease and mimics the postmenstrual acceleration of osteoperosis.
What blood dyscrasias may be present in an anorexic patient?
Anemia, lymphopenia, hypoalbuminemia.
What is a major life threatening risk of anorexia and bulimia?
Cardiac arrhythmias and sudden death resulting from hypokalemia.
How do menstrual irregularities relate to bulimic patients and the reasoning for this?
Menstrual irregularities are common although it will present in less than 50% of the patients. Weight and gonadotropin levels are maintained near normal and therefore the menstrual cycle can remain intact.
What is the major concern of a bulimic patient?
The chronic induced vomitting as well as the use of laxatives and diuretics.
What medical consequences do bulimic patients face?
Electrolyte imbalances particularly hypokalemia, which can lead to arrythmias, pulmonary aspiration of gastric contents, esophageal/gastric cardiac rupture.
How is bulimia diagnosed?
There is no diagnostic feature for bulimia as there is for anorexia, dx depends on a comprehensive physical assessment.
