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Y3 - Psych > Eating Disorders > Flashcards

Eating Disorders Flashcards

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1
Q

What are the core features of anorexia nervosa?

A

Low body weight
Self-induced weight loss
Body image distortion

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2
Q

What does body weight have to be to be classed as anorexia nervosa?

A

> 15% less than expected

BMI <17.5

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3
Q

What methods are commonly used to lose weight in anorexia nervosa?

A

Diet restriction
Excessive exercise
Vomiting
Use of medication

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4
Q

What is body image distortion in anorexia nervosa?

A

Self-perception of being fat, with intrusive dread of fatness that leads to self imposed low weight threshold

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5
Q

What are physical symptoms of anorexia nervosa?

A

Cold sensitivity
Poor sleep
Reduced concentration
Amenorrhoea

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6
Q

What are some endocrine complications of anorexia nervosa?

A 
Fertility problems
Raised GH levels
Altered TFT
Metabolic (hypoglycaemia, hypokalaemia, hyponatraemia)
Osteoporosis
Growth arrest
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7
Q

What oral complications can be seen in anorexia nervosa?

A

Dental caries

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8
Q

What cardiovascular complications can be seen in anorexia nervosa?

A

Hypotension

QT prolongation

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9
Q

What GI complications can be seen in anorexia nervosa?

A

Bloating

Delayed gastric emptying

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10
Q

What neurological complications can be seen in anorexia nervosa?

A

Peripheral neuropathy

Cognitive impairment

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11
Q

What dermatological complications can be seen in anorexia nervosa?

A

Dry skin
Hair loss
Languo hair

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12
Q

What are the subtypes of anorexia nervosa, and describe them

A

Restricting - weight loss primarily accomplished by restricting food intake and excessive exercise
Binge-purge - regularly engaging in binge-eating, purging or both

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13
Q

What signs of anorexia nervosa can be seen in their general appearance?

A 
Cyanosis
Cold peripheries
Dry skin
Muscle wasting
Languo hair
Signs of dehydration
Russell's sign - calluses on the knuckles or back of hand due to repeated self-induced vomiting over long periods of time
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14
Q

What cardiac signs of anorexia nervosa can be seen on examination?

A 
Low HR
Low BP
Postural hypotension
QT prolongation
T wave changes
Hypokalaemia
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15
Q

What MSK signs of anorexia nervosa can be seen on examination?

A

Reduced muscle power

Unable to perform sit up-squat-stand test

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16
Q

How is BMI used to assess risk in anorexia nervosa?

A

16-17.5 - low to moderate risk
15-16 - moderate risk
13-14.9 - high risk
<13 or rapid weight loss >1kg/week - very high risk

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17
Q

What blood test abnormalities are seen in anorexia nervosa?

A 
Low sodium (water loading, SIADH secondary to chest infection)
Low potassium (vomiting, laxative abuse)
Raised transaminases
Metabolic alkalosis (vomiting)
Hypoglycaemic
Leukopenia, anaemia
Raised urea, creatinine
18
Q

What are the options for location of management for adults and children with anorexia nervosa?

A

CAMHS - community, outpatient or inpatient

Adult - outpatient or inpatient

19
Q

What is involved in community management of children with anorexia nervosa?

A

Psychiatric and physical assessment to determine risks and further management

20
Q

What is involved in outpatient management of anorexia nervosa?

A 
Family based treatment
Individual therapy
Dietitian
Monitor refeeding risk
Medications (olanzapine, SSRI) if co-morbid conditions, and to help distress
21
Q

When is inpatient management considered in anorexia nervosa?

A

If severely underweight and physical health compromised

22
Q

What is involved in inpatient management of anorexia nervosa?

A

Medical support depending on physical health
Family based treatment
Individual therapy
Dietitian
Monitor referring risk
Medications (olanzapine, SSRI) if co-morbid conditions, and to help distress
Meal time support

23
Q

What is refeeding syndrome?

A

Potentially fatal metabolic response to too rapid re-feeding after a period of starvation

24
Q

Who is most at risk of refeeding syndrome?

A

Severely underweight
Rapid weight loss
Minimal intake in preceding 7-14 days

25
Q

What are the core features of bulimia nervosa?

A

Recurrent food binges
Preoccupation with food
Recurrent compensatory actions to avoid weight gain after binges
Body image distortion

26
Q

What is the criteria for food binges in bulimia nervosa?

A

At least once a week for minimum 3 months

27
Q

What are the features of food binges?

A

Large amount of food consumed over short period of time
Loss of control of how much they eat
Feeling of elation and release at start of binge
Feelings of regret following binge

28
Q

What is BMI like in bulimia nervosa?

A

May be within healthy range or fluctuating

29
Q

What physical complications can be seen in bulimia nervosa?

A 
Oesophageal erosions
Oesophageal perforation
Peptic ulcers
Gastric perforation
Seizures (due to electrolyte imbalance)
Dehydration
Dental caries
Arrhythmia
30
Q

What are management options for bulimia nervosa?

A

Guided self-help
CBT
SSRI
Inpatient if serious medical complications

31
Q

What is avoidant restrictive food intake disorder?

A

Avoidance and/or restriction of certain foods or types of food for a variety of reasons

32
Q

What could avoidant restrictive food intake disorder be due to?

A

Sensory issues with texture, smell etc.
Concern about consequences of eating particular foods (e.g. vomiting)
Little interest in eating

33
Q

What are management options for avoidant restrictive food intake disorder?

A

Tailored to individual’s needs
Anxiety driven: CBT, SSRI
Co-morbid ASD: help to manage sensory problems
Dietitian

34
Q

What is meant by ‘other specified feeding and eating disorders’?

A

A group of disorders that do not fit the exact diagnostic criteria for AN, BN or binge eating disorder but mimic them in some way
Common and just as serious

35
Q

What are examples of other specified feeding and eating disorders?

A

Atypical anorexia
Bulimia nervosa of low frequency and/or limited duration
Binge eating disorder of low frequency and/or limited duration
Purging disorder
Night eating syndrome

36
Q

What is atypical anorexia?

A

All symptoms of anorexia but weight remains within the ‘normal’ range

37
Q

What is bulimia nervosa of low frequency and/or limited duration?

A

All symptoms of bulimia but the binge-purge cycles do not happen as often or over as long a period of time

38
Q

What is binge eating disorder of low frequency and/or limited duration?

A

All symptoms of binge eating disorder but the episodes do not happen as often and last for less time

39
Q

What is purging disorder?

A

Where purging occurs to affect their weight or shape, but not as a part of binge-purge cycles

40
Q

What is night eating syndrome?

A

Where someone repeatedly eats at night, either after waking from sleep, or by eating a lot of food after their evening meal

41
Q

What is the management of other specified feeding and eating disorders?

A

Offer the treatment recommended for the type of ED your symptoms are most similar to

Y3 - Psych (12 decks)

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