eating disorder stuff Flashcards
disturbance in serotonin
bulimia
disturbance in serotonin, dopamine, or NE
anorexia
What are the screening forms we use for eating disorders?
SCOFF Questionaire (2+ positive = likely)
ESP Questionnaire (Eating disorder screen for primary care)
EAT form
PHQ form
how many positives on SCOFF = likely eating disorder
2+
Underweight child with an average BMI of 16 with low Bone mineral denisity
classic presentation of avoidant/restrictive food intake disorder
What is the DSM-V-TR Diagnostic criteria for avoidant/restrictive food intake disorder?
- Avoiding or restricting food intake (lack of interest/aversive experience)
- Nutritional needs not met manifested by at least 1 of the following:
* Clinically significant weight loss/poor growth/failure to achieve weight goal.
* Nutritional deficiency
* Oral supplements needed to achieve adequate nutrition
* Impaired psychosocial functioning
Must have both of the conditions present.
adolescent white female in puberty and college age
classic demographic of AN
Lanugo
AN
Sallow complexion (yellowish/pale)
AN
Russells sign
BN and AN
cardiac complications
AN
MCC death =
suicide
electrolyte imbalance
AN
also could be starvation
What is the workup for all suspected anorexic patients?
EKG
UA (sp. gravity)
Serum labs of CMP, phosporus, magnesium, INR, CBC with diff.
What would prompt us to admit someone for AN?
Unstable vitals OR hypothermia (< 35C/95F)
End-organ complications
Cardiac complications (HR < 30 or 40 w/ hypotension)
Psych complications (SI, acute food refusal)
Nutrition complications (Weight < 70% goal, marked dehydration, refeeding syndrome)
When are psych meds used for AN? Which ones? which ones are avoided
Not first line, but you can use olanzapine or lorazepam or prozac ideally.
AVOID ESCITALOPRAM (QT) or VENLAFAXINE (CARDIAC)
adolescent white female of normal or slightly above normal weight
classic BN patient
What characterizes BN?
Recurrent binge eating and inappropriate compensatory behaviors at least ONCE A WEEK FOR 3 MONTHS (usually vomiting).
Self-evaluation unduly influenced by body weight.
what are the types of BN compensatory mechanisms that you always forget billie
could be just excessive exercise or fasting
What are the GI complications of BN?
Salivary gland hypertrophy
Loss of gag reflex
GI tract dysmotility
GERD
Esophageal tears or rupture
Malabsorption
Diarrhea
Constipation
Pancreatitis
What is the workup for all suspected BN patients?
UA
Serum labs
LFTs
CBC w/ diff
EKG
Ca
Mg
P
first line tx for BN
fluoxetine
also CBT
How do we calculate BED severity?
Frequency of binge eating episodes per week.
* Mild: 1-3
* Moderate 4-7
* Severe: 8-13
* Extreme: 14+
complications include HTN, DM, CAD, HLD
BED
if there are no improvement with antidepressants, what medication can you give to patients with BN
TCA’s
