Eating disorder Flashcards
Define anorexia nervosa?
Psychiatric disorder resulting in overvalued idea of needing to lose weight and a fear of being overweight
Altered perception of their actual body size - distorted body image
Rapid weight loss, weight loss measures (calorie counting, not eating, vomiting, laxatives)
Risk factors of anorexia nervosa?
Female Young Western society Family history of psych Sexual abuse Occupational (dancers, models) Perfectionist Low self-esteem Anxiety Emotionally unstable personality disorder
Psych features of anorexia?
Refusal to maintain appropriate body weight for age
BMI below 17.5
Dieting or change in eating behaviour
Rapid weight loss
Low mood, social withdrawal
Use of laxatives, vomiting, diuretics
Denial and resistance to intervention
Physical features of anorexia nervosa?
Thin, wasting Lanugo hair Thin fragile skin and hair Hair loss Amenorrhoea Fainting, dizziness GI: constipation, abdo pain
Vomiting:
- Swollen parotid gland
- Poor dental health
- Mallory weiss tear
Investigations of anorexia?
Temperature
Bloods: U+Es, ESR, TFTs
DEXA scan
ECG: bradycardia, long QT
List some parameters that suggest severe anorexia?
BMI less than 13
Weight loss more than 0.5kg per week
Pulse below 40
BP below 90/70, postural drop more than 10
Squat test unable
Temp less than 35
Deranged blood tests
Abnormal ECG
What would you see on bloods of a severely anorexic person?
Low K, Na, Mg, P
Raised urea, creatinine
Low albumin
Low glucose
High cortisol
What would you see on an ECG of a severely anorexic person?
Prolonged QT
Bradycardia
Management of anorexia nervosa for under 18?
Family therapy (first line)
Individual CBT
Management of anorexia nervosa for adults?
CBT
Maudsley programme
Specialist practitioner therapy
List the complications of anoerxia nervosa?
Hypokalaemia
Hypotension
Cardiac: cardiomyopathy, CCF, mitral valve prolapse, arrhythmias
Anaemia and thrombocytopenia
Hypoglycaemia
Osteoporosis
Constipation
Infertility
Susceptible to infections
AKI or CKD
