Eating Disorder - 1 Flashcards
what hormone is found to be associated in bulimic women?
Cholecystokinin (Reduced)
what is ipecac?
It is a preparation syrup that makes one vomit in 15 -30 minutes.
what ingredient in ipecac causes vomiting?
Emetine, a toxic alkaloid that acts as stomach irritant
% of patients with eating disorder who experiment ipecac?
8%
% of patients with eating disorder who use it chronically?
1-2%
How can we know if someone has recently vomited?
Serum amylase level increases
effects of ipecac on heart (cardiac toxicity)?
Cardiomyopathy and left ventricular dysfunction
what eating disorders are recognised in ICD11
- Anorexia nervosa
-Bulimia nervosa
-Avoidant-Restrictive Food Intake disorder (ARFID)
-Pica
-Rumination-Regurgitation Disorder
BMI below 18.5
Underweight
BMI 18.5 - 24.9
Healthy
MBI between 25 and 29.9
Overweight
BMI 30-39.9
Obese
Lifetime prevalence of Bulimia
.63%
M:F ratio for Bulimia
1:9
Lifetime prevalence for Anorexia?
.16%
M:F ratio for anorexia
1:9
Lifetime prevalence of Binge eating
1.53%
M:F ration for binge eating
1:2
Main points on ICD 11 criteria for anorexia nervosa?
- Significant weight loss
-Persistent patterns of restrictive eating
-Excessive preoccupation with body weight and shape
how significant weight loss is defined on ICD 11 for anorexia nervosa?
- BMI below 18.5
-Rapid loss of 20% of body weight in 6 months
-MBI-for-age Below 5th percentile for children
-Failure to gain weight (rather than weight loss)
how persistent pattern of restrictive eating are defined on ICD 11 for anorexia nervosa?
Out of Fear of weight gain:
-Reducing energy intake (fasting, going with low calories)
-Purging behaviours (laxatives, diuretics, enemas)
-Excessive exercise & activity
How diabetic patient may act with anorexia nervosa to meet the ‘‘pattern of restric. eating…’’ criteria on ICD 11 for anorexia nervosa?
omission of insulin
how excessive preoccupation with body weight and shape are defined on ICD 11 for anorexia nervosa?
- body weight is overvalued and central to self-evaluation
-excessive checking using scales & tapes, or mirrors
-Avoiding mirrors, tight clothes…etc
How is anorexia nervosa with significant low body weight defined on ICD 11?
BMI between 18.5 - 14 kg/m2
For children BMI-to-age between 5th and 3rd percentile
How is anorexia nervosa with dangerously low body weight defined on ICD 11?
BMI < 14
for children >3rd percentile
for a full recovery, how long body weight have to be maintained after Rx termination?
at least 1 year
Enumerate specifiers used for anorexia nervosa on ICD 11
- With a restrictive pattern
-Binge-Purge patter
Usual onset of anorexia nervosa?
10-24 (typically following a life event)
anorexia nervosa onset in female vs male
earlier
most patient with anorexia nervosa have remission in 5 years, true or false?
true
is it common for anorexia nervosa patients in remission to keep some psychological symptoms of anorexia nervosa like perfectionism about body shape?
Hell, yeah!
Main points on ICD 11 criteria for Bulimia nervosa?
-Frequent, recurrent episodes of binge eating
-Repeated inappor. compensatory behaviours
-Excessive preocuup. with body weight&shape
-Marked distress
Main differenciating points between anorexia nervosa with binge-purging and bulimia nervosa?
- Body weight status
-Behaviour patterns
-Cognitive feature
- Behaviour pattern in AN with binge-purging vs bulimia nervosa
- in AN with binge purging:
Binging followed by purging happens in the context of a heavy food restriction and fear of weight gain
-In Bulimia nervosa:
The binging happens then compensatory activity happens to undo the binging and keep weight in control
- Cognitive feature in AN with binge-purging vs bulimia nervosa
-in AN with binge purging:
Individual has a distorted body image and extreme preoccupation with it
-In Bulimia nervosa:
Have an unhealthy relationship with food and self-esteem (with some preoccupation with weight)
- Body weight status in AN with binge-purging vs bulimia nervosa
- Very low in AN with binge purging
-In normal range in bulimia
Onset of bulimia nervosa
shortly after puberty begins
How long bulimia nervosa symptoms have to last according to ICD 11?
at least 1 month
which specifier ( type of ) Anorexia nervosa might evolve into binging and puring in bulimia nervosa?
restrictive pattern
if anorexia nervosa evolved into Bulimia nervosa, the dx can be changed too?
yes. after 1 year.
Main points on ICD 11 criteria for Binge Eating Disorder (BED)?
- Recurrent frequent binge eating ( one or more per week for 3 months, unless very severe [1 month would be enough])
-Periods of loss of control - Not regularly accompanied with compensatory behaviours
- Marked distress
Onset of BED
adolescent or young adulthood
weight of BED
overweight
Dx of Avoidant-Restrictive Food intake disorder (ARFID)
- Verry restricted food intake
- Significant impairment in function
-Not preoccupied with weight or shape
Dx Pica
Eating raw food or non food objects (for 2 years)
Dx of rumination-regurgitation disorder)
Intentional & repeated regurgitation and re swalled (rumination) or spat out (not vomiting) for at least several week
Duration required for PICA on icd11
2 years
Duration required for Rumination-regurgitation disorders on ICD 11?
several weeks.
Minimum age to diagnosis a patient with Rumination-regurgitation disorder?
2 years old
Which eating disorder is associated with constipation?
Anorexia Nervosa
which eating disorder is associated with hair loss?
Anorexia nervosa
which GI symptoms can occur in all eating disorders?
Slowed GI motility
which eating disorder associated with Russel sign?
AN-P/BN
which eating disorder associated with sialadenosis (swelling of parotids)?
AN-P/BN
