Eating Didorders

Question 1

most common PICA and specific for iron deficiency

Answer 1

pagophagia - eating ice

Question 2

clinical manifestations of anorexia nervosa

Answer 2

lanugo hair, hypercarotenemia on palms and soles

Question 3

for bulimia nervosa, both binging and purging occur how often?

Answer 3

at least 1x/week over the 3 months

Question 4

physical signs in eating disorder px who purge

Answer 4

cheilosis (stomatitis), sialadenosis (enlarged salivary glands), russells sign (abrasion, redness, or callous on dirsum of hand and knuckles due to friction with palate while inducing vomiting), some px have NO physical findings

Question 5

physical signs of bulimia nervosa

Answer 5

perimyolysis- decalcification of lingual, palatal, and occlusive surfaes of teeth due to gastric acid erosion

russell’s sign

Question 6

more prevalent than anorexia or bulimia

Answer 6

binge eating disorder

Question 7

criteria for binge eating disorder

Answer 7

at least 3:
not hungry
eating rapidly
eating until too full
eating alone
feeling disgusted or guilty after overeating

2 days/week for at least 6 months

no purging or exercising

Question 8

prevalence of eating disorder, not otherwise specified

Answer 8

0.8-1.4%

Question 9

sports at risk for AN and BN

Answer 9

ballet, wrestling, track/running, gymnastics, dance, cheerleading

Question 10

female athletic triad

Answer 10

disordered eating, amenorrhea, osteoporosis

Question 11

mortality of eating disorders is due to

Answer 11

suicide, arrhythmia

Question 12

CV complications of AN

Answer 12

myocardial atrophy (loss of left ventricular wall thickness and mass), increased vagal tone, orthostatic changes in pulse and BP, re-feeding syndrome could cause cardiac arrest or heart failure

Question 13

cardiac complications of AN vs BN

Answer 13

AN: orthostatic changes, re-feeding syndrome

BN: arrhythmias secondary to electrolyte disturbances

Question 14

why do px with eating disorders have amenorrhea

Answer 14

low estrogen due to starvation- abnormal GnRH secretion, low LH and FSH

Question 15

metabolic abnormalities of BN

Answer 15

hypokalemia, metabolic alkalosis (vomiting/diuretics)

Question 16

lab results of eating disorder px are usually..

Answer 16

normal, which does not exclude the possibility of an eating disorder

Question 17

treatment of AN px

Answer 17

cognitive behavioral therapy, weekly office visits

Question 18

meds for BN px

Answer 18

SSRIs works to improve outcomes for BN, but not AN; in AN px, SSRIs can be useful once goal weight has been achieved

Question 19

what is the biochemistry behind re-feeding syndrome?

Answer 19

starvation induces hypophosphatemia; when glucose is infused or ingested, the phosphate shifts from extracellular to intracellular; all ATP the body needs is depleted