Chapter _14_Eating_Disorders_ Flashcards
What are the three main DSM-5 eating disorders?
Anorexia nervosa, bulimia nervosa, and binge-eating disorder
What are the DSM-5 criteria for anorexia nervosa?
Restriction of energy intake → significantly low weight, intense fear of weight gain, disturbed body image
Name the subtypes of anorexia nervosa.
Restricting type and binge-eating/purging type
What are common physical findings in anorexia nervosa?
Amenorrhea, lanugo, bradycardia, hypotension, osteoporosis, alopecia, peripheral edema, seizures
What lab abnormalities are associated with anorexia nervosa?
Hypokalemia, hypochloremic alkalosis, elevated cortisol, leukopenia, anemia, transaminitis, QTc prolongation
What is refeeding syndrome?
Fluid and electrolyte shifts during refeeding leading to ↓phosphate, ↓Mg, ↓Ca; can cause arrhythmia, delirium, seizures
How is anorexia nervosa treated?
Nutritional rehab, CBT, family therapy (Maudsley method), olanzapine for weight gain, SSRIs for comorbid depression/anxiety
DSM-5 criteria for bulimia nervosa?
Recurrent binge eating + inappropriate compensatory behavior ≥1x/week for ≥3 months, excessive influence of body shape on self-image, not during anorexia
Common physical findings in bulimia?
Parotid enlargement, dental erosion, Russell’s sign, esophagitis, aspiration
Common lab abnormalities in bulimia?
Hypokalemic hypochloremic alkalosis, elevated amylase, hypernatremia, increased BUN
What is the only FDA-approved medication for bulimia nervosa?
Fluoxetine (60–80 mg/day)
What medications should be avoided in bulimia and why?
Avoid bupropion due to risk of seizures
DSM-5 criteria for binge-eating disorder?
Binge episodes ≥1x/week for ≥3 months with ≥3: rapid eating, overeating, eating when not hungry, eating alone, guilt; no compensatory behaviors
Medical complications of binge-eating disorder?
Obesity-related: metabolic syndrome, T2DM, cardiovascular disease
Pharmacologic treatments for binge-eating disorder?
SSRIs, lisdexamfetamine (Vyvanse), topiramate, orlistat
What is the most common comorbidity with eating disorders?
Mood disorders, anxiety, OCD, personality disorders, substance use
How do anorexia and bulimia differ in weight status?
Anorexia: underweight; Bulimia: normal or overweight
What personality traits are commonly associated with anorexia?
Obsessive-compulsive traits, perfectionism, need for control
What is a red flag for potential eating disorder on physical exam?
Lanugo, bradycardia, hypotension, parotid enlargement, Russell’s sign
What is the mortality risk in anorexia nervosa?
5% per decade; most common causes: starvation, suicide, cardiac arrest
Which of the following is a DSM-5 criterion for anorexia nervosa?
A. Intense fear of gaining weight
B. Overeating without purging
C. Excessive exercise only
D. BMI > 30
A
A 17-year-old female presents with amenorrhea, lanugo, and a BMI of 16. What is the most likely diagnosis?
A. Bulimia nervosa
B. Binge-eating disorder
C. Anorexia nervosa
D. Atypical depression
C
Which lab abnormality is most commonly seen in patients with purging-type anorexia nervosa?
A. Hyponatremia
B. Hyperkalemia
C. Hypokalemic hypochloremic metabolic alkalosis
D. Hyperchloremic acidosis
C
What medication is FDA-approved for treatment of bulimia nervosa?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Venlafaxine
A
Which finding is most consistent with bulimia nervosa?
A. Lanugo
B. Russell’s sign
C. Severe underweight
D. Bradycardia
B
Which eating disorder is most associated with obesity?
A. Anorexia nervosa
B. Binge-eating disorder
C. Bulimia nervosa
D. Pica
B
What is the most dangerous early complication of refeeding in anorexia?
A. Hypoglycemia
B. Hypertension
C. Refeeding syndrome (hypophosphatemia)
D. Aspiration
C
Which of the following is NOT a DSM-5 criterion for bulimia nervosa?
A. Recurrent binge eating
B. Use of inappropriate compensatory behaviors
C. Binge eating ≥1x/week for 1 month
D. Self-image influenced by body shape
C
A patient with binge-eating disorder is most likely to present with which of the following?
A. Underweight BMI
B. Compensatory purging
C. Feelings of guilt after bingeing
D. Amenorrhea
C
Which medication is associated with increased seizure risk in bulimia nervosa?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Topiramate
C
Which personality trait is commonly associated with anorexia nervosa?
A. Impulsivity
B. Perfectionism
C. Aggression
D. Sociability
B
Which of the following is the most accurate marker of nutritional status in anorexia nervosa?
A. BMI
B. Serum albumin
C. Calcium
D. Creatinine
A
What is Russell’s sign?
A. Calluses on knuckles from induced vomiting
B. Hyperpigmentation in anorexia
C. Hair loss in malnutrition
D. Bradycardia in bulimia
A
A 23-year-old female with parotid gland enlargement and dental erosions likely has:
A. Anorexia nervosa
B. Binge-eating disorder
C. Bulimia nervosa
D. ARFID
C
First-line psychotherapy for eating disorders is:
A. DBT
B. CBT
C. EMDR
D. Exposure therapy
B
Which disorder is associated with binge eating without compensation?
A. Bulimia nervosa
B. Anorexia nervosa
C. Binge-eating disorder
D. Pica
C
Which drug is approved for moderate to severe binge-eating disorder?
A. Olanzapine
B. Lisdexamfetamine
C. Aripiprazole
D. Escitalopram
B
Which of the following is NOT typical of anorexia nervosa?
A. Amenorrhea
B. Bradycardia
C. Elevated cholesterol
D. Hyperphagia
D
In anorexia, osteoporosis is primarily due to:
A. Vitamin D deficiency
B. Hypocalcemia
C. Hypoestrogenism
D. Inactivity
C
Which of the following signs is common to both bulimia and anorexia purging type?
A. Lanugo
B. Dental enamel erosion
C. Extreme thinness
D. Constipation
B
A patient binge-eats and uses laxatives but has a normal BMI. Diagnosis?
A. Anorexia nervosa, binge-purge type
B. Bulimia nervosa
C. Binge-eating disorder
D. ARFID
B
Electrolyte imbalance that can predispose to arrhythmias in purging patients is:
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
C
What is the mortality rate of anorexia nervosa per decade?
A. 1%
B. 2%
C. 5%
D. 10%
C
Which therapy is most effective in adolescents with anorexia?
A. Group therapy
B. DBT
C. Maudsley family-based therapy
D. Hypnotherapy
C
What is a typical finding in binge-eating disorder?
A. Underweight
B. Nighttime awakenings for eating
C. Recurrent compensatory behaviors
D. Eating rapidly until uncomfortably full
D
