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Clinical Disciplines-Eating Disorders Flashcards

1
Q

How long must eating of non-nutritive food, nonfood substances persist for it to be considered PICA?

A

1 month

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2
Q

At what age is eating non-nutritive food, nonfood substances considered developmentally inappropriate?

A

24 months

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3
Q

Are medications recommended in PICA?

A

No

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4
Q

List the psychosocial interventions in PICA

A

Behavior strategies:

  1. Training to discriminate between edible and non-edible
  2. Sensory reinforcement
  3. Correct the environment
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5
Q

What are avoidant/restrictive food intake disorder pt’s avoiding in the food?

A

sensory characteristics of food

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6
Q

List the DSM5 criteria for ARIFD

A

One or more of the following:

  1. Significant wt. loss
  2. Significant nutritional deficiency
  3. Dependence on general feeding or oral nutritional supplements
  4. Marked interference with psychosocial functioning
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7
Q

Treatment for ARIFD

A
  1. Refeeding
  2. Behavioral interventions
  3. Cognitive behavioral therapy
  4. exposure therapy
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8
Q

What are the two types of anorexia nervosa?

A
  1. Restricting Type-: In the last 3 months, wt. loss through dieting, fasting, and/or excessive exercise
  2. Binge-eating/purging type: In the last 3 months, recurrent episodes of Inge eating or purging behavior
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9
Q

Define partial remission in anorexia nervosa

A

Normal body wt BUT:

  1. Intense fear of gaining weight OR
  2. Disturbance in self-perception of weight and shape
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10
Q

Mild anorexia BMI

A

BMI > or equal to 17

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11
Q

Moderate anorexia BMI

A

BMI 16-16.99

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12
Q

Severe anorexia BMI

A

15-15.99

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13
Q

Extreme anorexia BMI

A

<15

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14
Q

Psychologic profile in anorexia

A
  1. Anxiety
  2. Major depression
  3. Dysthmic disorders
  4. OCD with rigid and ritualistic eating behaviors
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15
Q

SCOFF questionare for anorexia screening tool

A 
S-Sick
C-Control. (loss of)  
O-One (14 lbs) in a 3 month period 
F- Fat, even though you are told you are too thin
F- Food predominates
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16
Q

Eating Disorder Co-morbidities screening tools (4)

A
  1. Depression (PHQ-9)
  2. Anxiety (GAD-7)
  3. OCD (Yale-Brown obsessive compulsive scale)
  4. PTSD (7-item Breslau screen)
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17
Q

Endocrine complications in anorexia

A

Euthyroid Sick Syndrome

  • Normal TSH despite hyper metabolism
  • Edema
  • Estrogen declines
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18
Q

Skeletal complications in anorexia

A

Osteoporosis

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19
Q

Urinary complications anorexia

A

Increased BUN
Decreased GFR
Renal calculi
-Appearance of diabetes insipidus

20
Q

Skin changes in anorexia

A

Yellowing of skin from hypercaraotenemia

  • Lanugo hair or frank hirsuitsim
  • Dry and brittle hair/nails
21
Q

Neurologic complications anorexia

A

Decreased Serotonin and Norepinephrine

Hypothermia

22
Q

Cardiovascular complications anorexia

A 
Decreased CO (due to decreased muscle mass and chamber size)
Hypotension 
Bradycardia
Anemia
leukopenia
thrombocytopenia
23
Q

GI/Hepatic complications anorexia

A

Decreased gastric emptying
Abdominal pain and distention
Constipation and diarrhea
Increased hepatic enzymes (fatty liver)

24
Q

Is acute pharmacologic intervention necessary in anorexia?

A

No

Calcium supplementation if needed

25
Once anorexia pt's are stable, what pharmacologic treatment would be beneficial?
SSRIs and SNRIs
26
What syndrome are we worried about in anorexia?
Refeeding syndrome
27
DSM5 criteria for bulimia
1. Eating in a discrete period of time (within any 2-hr period), and a very large amount of food 2. Sense of lack of control over eating during the episode
28
Mild bulimia
1-3 episodes/wk
29
Moderate bulimia
4-7 episodes/wk
30
Severe bulimia
8-13 episodes/wk
31
Extreme bulimia
14+ episodes/wk
32
Female athlete triad
1. Eating disorder 2. Amennorhea 3. Osteoporosis
33
Screening tools in bulimia
1. SCOFF Q | 2. Eating disorder screen for primary care (ESP)
34
HEENT effects in bulimia
Swollen and sore cheeks Cavities, tooth enamel erosions, gum dz Sore/irritated throat Blood in vomit
35
Skin changes in bulimia
Russels sign-callused knuckles
36
GI effects in bulimia
Ulcers Delayed empyting abdominal pain
37
When IS hospitalization recommended for bulimia?
1. Major electrolyte disturbances 2. SI or attempt 3. No response to outpatient tx
38
What is the best treatment option in bulimia?
Intensive outpatient treatment 40 hrs/wk 5 days/wk
39
What psychotherapy is preferred in bulimia?
Group psychotherapy | -->superior to individual cognitive behavioral therapy
40
Effects of anti-depressants in bulimia?
Decrease bulimic sx's, even if NOT depresses
41
Other pharmacologic tx in bulimia?
Topiramate (Topamax) may decrease binge cycle | Odanssetron (zofran) for nausea
42
What drug is associated with increased incidence of seizures in bulimia nervosa?
Bupropion
43
Partial remission of binge eating
After criteria for binge eating met, episodes occurs about 1x week
44
Health consequences of binge eating
1. Increased psychopathology compared to obese pt's who don't binge - Major depression, panic disorder, borderline personality disorder, avoidant personality disorder 2. HTN 3. Type II DM 4. Dyslipidemias 5. Moderate obesity develops after 5 yrs
45
Psychotherapy treatment for bulimia
1. Cognitive behavioral 2. Dialectical 3. Interpersonal psychotherapy
46
Pharmacologic therapy for bulimia
SSRIs and Venlafaxine (SNRI) | Topiramate (Topamax)
47
What is considered safe weight gain during the acute treatment phase in eating disorders?
0.16 kg/day or 0.45-1/36 kf/wk

Aging- Phys (6 decks)

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