CT 9 - Eating Disorders Flashcards

1
Q

What is an eating disorder

A

Mental disorder characterised by abnormal eating habits that negatively affect a persons physical or mental health

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2
Q

What % of women have anorexia

A

4%

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3
Q

What % of women have bulimia

A

2%

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4
Q

What % of women have binge eating disorder

A

2%

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5
Q

What is pica

A

Consumption of things that are not food and have no nutritional value

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6
Q

What is orthorexia

A

Unhealthy obsession with only eating foods that are healthy and pure

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7
Q

Incidence of anorexia nervosa

A

9 in 1000

More common in women 10: 1

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8
Q

What are the main risk factors for developing AN

A

Female gender
Living in western society
Family history
Pre morbid experience: sexual abuse, dieting behaviour in family, occupation or recreational pressure to be slim, criticism about weight
Personality traits: perfectionism, Low self esteem, obsessive traits, borderline PD
Severe life stresses

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9
Q

What are the clinical and physical features of AN

A

Clinical:
-Refusal to maintain normal BMI (either by refusing to put on weight or rapid loss of weight)
- dieting + restricting
-denying there is a problem
- enhancing weight loss with excessive exercise,laxatives and self induced vomiting

Physical :

  • amenorrhoea
    -GI (constipation,dysphagia, pain)
    -fatigue, fainting +dizzy
  • lanugo hair
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10
Q

What examinations and investigations would you do for someone with AN

A

-height weight and BMI
-core temp
-peripheral circulation + oedema
- pulse and BP (may be low)
- test muscle power

U&Es, bloods, ECG, DEXA

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11
Q

What is the psychological management of anorexia

A

CBT

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12
Q

What are some of the complications of anorexia

A

Hypokalemia

Hypotension

Anaemia

Osteoporosis

Hypoglycaemia

Infertility and lack of growth in teens

Renal stones

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13
Q

What is bulimia nervosa

A

ED characterised by repeated binges followed by compensatory weight loss behaviours (vomiting, restriction, intensive exercise + abuse of substances)

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14
Q

What things can patients abuse in order to lose weight

A

Laxatives
Diuretics
Thyroxine
Amphetamines

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15
Q

What are the risk factors for bulimia

A

Same as AN

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16
Q

Diagnostic criteria for bulimia

A

Regular binge episodes (1 a week for at least 3 months)
Preoccupation with weight, body shape and image)
Preoccupation with food + diet

17
Q

What are physical symptoms of bulimia

A

Bloating
Lethargy
Heartburn
Abdominal pain
Sore throat and poor dental health

Mood disturbances (more likely to be depressive than AN) + self harm

18
Q

Psychological management of BN

A

Under 18: BN focused family therapy or CBT-ED

> 18 =
Self help programmes
CBT-ED

19
Q

Complications of BN

A

Haematemesis

Metabolic abormalities after vomiting

Electrolyte imbalance.—> arrhythmia

Dental erosions

Enlargement of parotid gland

Tetany from hypocalcemia

10-15% develop anorexia

20
Q

What questionnaire for screening for AN and BN

A

SCOFF

21
Q

What organic causes may mimic eating disorders

A

Malabsorption
Endocrine
Cancer

22
Q

What are the features of binge eating disorder

A

Eating fast in short amount of time
Losing control over how much you eat or eating a lot when not hungry
Special binge foods - planned bites
Eating alone or in secret due to embarrassment of how much food consumed
Dazed mental state during binge
Feelings of shame, guilt or disgust following a binge

23
Q

Management of binge eating disorders

A

Self help programmes

CBT-BED

DBT

SSRI

24
Q

What is re feeding syndrome

A

Occurs 4 days to 2 weeks after commencing feeding after a period of starvation

Patients develop electrolyte imbalances, specifically hypophosphatemia. Coma, HF and convulsions
First visible sign is peripheral oedema
Cardiac arrhythmias most common cause of death