Anorexia Nervousa

Question 1

Signs and symptoms of anorexia nervosa

Answer 1

Physical - Bradycardia, postural hypotension, Dehydration, Hypothermia, electrolytes abnormalities (eg hypokalaemia, hypernatraemia)
Severe wt loss.
Psychiatric - risk of suicide or other at risk behaviour

Question 2

DSM V criteria of Annorexia nervousa

Answer 2

Refusal to maintain body weight over a minimum normal weight for age and height
Intense fear of gaining weight or becoming fat, even though underweight
Distorted body image (not always clear particularly in younger patients)

Question 3

DDX for anorexia nervousa

Answer 3

Physical disorder - thyrotoxicosis, malabsorption

Psychiatric disorder - major depression, OCD.

Question 4

Complications of anorexia nervousa

Answer 4

Potentially very severe
If onset in prepubertal or peripheral stages - growth retardation, and osteoporosis
Cardiac arrhythmia a, substance abuse, self harm, suicide
Mortality rate is greater than any other psychological disorder

Question 5

Mx of anorexia nervousa

Answer 5

MDT outpatient care
Family based treatment
Hospitalisation if physical safety if compromised. Refeeding and then NGT if needed.