anorexia_nervosa_flashcards
What is anorexia nervosa associated with in terms of clinical signs and physiological abnormalities?
Characteristic clinical signs and physiological abnormalities
What is a common body mass index characteristic in anorexia nervosa?
Reduced body mass index
What is bradycardia?
Slow heart rate
What cardiovascular feature is associated with anorexia nervosa?
Hypotension
What gland enlargement is a feature of anorexia nervosa?
Enlarged salivary glands
What electrolyte abnormality is often seen in anorexia nervosa?
Hypokalaemia
What are the levels of FSH, LH, oestrogens, and testosterone in anorexia nervosa?
Low levels
What hormones are typically elevated in anorexia nervosa?
Raised cortisol and growth hormone
How is glucose tolerance affected in anorexia nervosa?
Impaired glucose tolerance
What lipid abnormality is common in anorexia nervosa?
Hypercholesterolaemia
What is hypercarotinaemia?
Increased levels of carotene in the blood
What thyroid hormone level is typically low in anorexia nervosa?
Low T3
summarise anorexia nervosa
Anorexia nervosa: features
Anorexia nervosa is associated with a number of characteristic clinical signs and physiological abnormalities which are summarised below
Features
reduced body mass index
bradycardia
hypotension
enlarged salivary glands
Physiological abnormalities
hypokalaemia
low FSH, LH, oestrogens and testosterone
raised cortisol and growth hormone
impaired glucose tolerance
hypercholesterolaemia
hypercarotinaemia
low T3
Which one of the following is not a recognised feature of anorexia nervosa?
Raised cortisol levels
Low FSH
Raised growth hormone levels
Hyperkalaemia
Impaired glucose tolerance
Hyperkalaemia
Anorexia features
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
The correct answer is Hyperkalaemia. Anorexia nervosa does not typically present with hyperkalaemia. In fact, patients with anorexia nervosa often have hypokalaemia due to malnutrition and purging behaviours, which can lead to electrolyte imbalances.
Raised cortisol levels are a recognised feature of anorexia nervosa. This occurs as a physiological response to the stress of chronic starvation in these patients. Elevated cortisol levels can result in various physical symptoms such as insomnia, anxiety, and cognitive impairment.
Low FSH (Follicle Stimulating Hormone) is also associated with anorexia nervosa. The reduction in body fat below a certain threshold in these patients disrupts the normal functioning of the hypothalamic-pituitary-ovarian axis leading to low levels of gonadotropins like FSH and LH (Luteinising Hormone). This can result in amenorrhoea (absence of menstrual periods) which is a common feature in females with anorexia nervosa.
Raised growth hormone levels, specifically the inactive form of growth hormone known as ‘GH isoform 1’, are seen in patients with anorexia nervosa. However, despite high GH levels, these patients exhibit features of GH resistance such as reduced lean body mass and bone mineral density. This paradoxical situation arises due to severe malnutrition which induces changes at the level of the GH receptor leading to its impaired function.
Lastly, Impaired glucose tolerance may be seen in some cases of anorexia nervosa but it’s not a universal finding. It’s thought that this could occur due to prolonged starvation leading to insulin resistance or dysfunction within beta cells of the pancreas affecting insulin secretion.
