Eating Disorders Flashcards
What is the lifetime prevalence for anorexia nervosa in women and what age group has highest incidence?
2-4%
15-19year olds
What are investigations that can be done for anorexia nervosa by CAMHS in community?
Weight Height % weight for height Physical exam Blood tests ECG Junior MARSIPAN risk assessment
What is CAMHS outpatient treatment for anorexia nervosa?
Family based therapy Dietitian Monitor refeeding risk & medical monitoring Individual therapy Meds - olanzapine, SSRI
What is CAMHS inpatient treatment for anorexia nervosa?
Psychiatric and physical health assessment
Weight, height, % weight for height, physical exam, blood tests, ECG
Dietitian
MDT
Monitor refeeding risk and medical monitoring
Meal time support
Use of oral supplement/ nasogastric feeding
Individual/group therapy
Transitions
Meds
What is adult outpatient treatment for anorexia nervosa?
Psychiatric and physical assessment, weight, height, BMI
Person centred care
Co-morbidity assessment/treatment
Dietitian
Medical monitoring
Therapy e.g. CBT-ED, MANTRA, SSCM, psychodynamic therapy
What is additional inpatient treatment for adult anorexia nervosa treatment?
Blood tests ECG MDT Monitoring refeeding risk and medical monitoring Meal time support Use of oral supplement and nasogastric feeding Individual/group therapy Meds
What is the Waterlow scale used for?
Pressure ulcer risk score
What is refeeding syndrome and describe process ?
Metabolic response to too rapid re-feeding after starvation. Body switches from carbs to fats and protein as energy source
-> intracellular minerals become depleted but serum levels may remain normal because re-feeding stimulates insulin production which causes potassium/magnesium and phosphate to be taken into cells whilst serum levels fall
Rapid change in basal metabolic rate with serum electrolyte depletion causes symptoms
Who is most at risk of refeeding syndrome? (3)
Severely underweight
Rapid weight loss
Minimal take in preceding 7-14 days
What is prevention/treatment for refeeding syndrome?
Start with low level energy replacement with high phosphate content e.g. milk and build up every 2-3 days
Supplement with multivitamins e.g. forceval & thiamine for at least 10 days
Daily monitoring of bloods
Correct electrolyte and fluid imbalances e.g. phosphate sandoz, sando k
What is ARFID? (Avoidant-restrictive food intake disorder)
Avoidance +/ restriction of certain foods or types of food. Can be sensory based, concern with consequences of eating particular foods, little interest in eating
What are some consequences of ARFID?
Failure to grow Weight loss Physical health impacts Psychological health impacts Social impacts
