Eating disorder Flashcards
what are the three diagnostic criteria for anorexia nervosa ?
weight <85% predicted or BMI <17.5
intense fear of gaining weight
feeling fat when thin
what are some psychological, developmental and social causes of anorexia nervosa?
psychological = depression, anxiety, OCD, low self esteem developmental = adverse life events, feeding problems early in life, parents preoccupied by food social = substance abuse, social media, bullying
what questionnaire can be used to screen for anorexia ?
SCOFF
ever make yourself sick worry about losing control over eating lost >one stone in weight in 3 months does food dominate thoughts do you believe you are fat when others say you are thin
if >2 then indicates eating disorder is likely
what are DD for eating disorder?
depression
crohns
coeliac
hypothalamic tumours
what are some signs of eating disorders?
fatigue, low cognition, altered sleep cycle, sensitivity to cold constipation amenorrhoea, sub fertility anaemia and low platelets low K, phosphate, TSH, LH, high bicarbonate, amylase, LFTs, GH, cortisol, CCK prolonged QT interval dry skin, brittle hair, lanugo hairs
what is the management of severe anorexia?
urgent referral to eating disorder unit
what is the management of moderate anorexia?
routine referral to local eating disorder unit
what is the management of mild anorexia?
focus on building relationships and acknowledging problem
if no response in 8 weeks, consider referral to secondary care
CBT
interpersonal therapy
family therapy
what is severe anorexia.
BMI <15, rapid weight loss and evidence of system failure
what is moderate anorexia
BMI 15-17.5 with no evidence of system failure
what is mild anorexia ?
BMI >17.5
what two medications can be used for eating disorders?
olanzapine (stimulate appetite)
fluoxetine
what should be monitored during fluoxetine use
ECG for long QT interval
what is re feeding syndrome ?
potentially fatal condition from low phosphate due to rapid initiation of food after >10days of undernutrition
what are the signs of re feeding syndrome?
rhabdomyolysis cardiac/resp failure low BP arrhythmias seizures sudden death
