Eating disorders Flashcards
What is AN?
Restriction of energy intake causing significantly low body weight (BMI <17.5)
Intense fear of becoming fat
Disturbed body image (body dysmorphia, weight = self worth)
What are the subtypes of AN?
Restrictive
Binge-purge
What are the physical symptoms of AN?
Constitutional: cold intolerance, hair loss, lanugo hair, dry skin, fatigue
Amenorrhea
Hypothyroidism
CV: hypotension, bradycardia
Constipation
Edema, dehydration
Neuro: proximal weakness, peripheral neuropathy
What are the DDx of low body weight?
Medical: endocrine (DM, hyperthyroidism, hypothalamic disease), GI (IBD, malabsorption), malignancy, AIDS, genetic (Turner)
Psychiatric: MDD, BN, OCD, psychotic disorder, alcohol/SA, dementia
How to manage AN?
Psychotherapy: motivational therapy
Monitor weight & Cx
Hospitalization for supervised refeeding: medical (BMI <13.5, electrolyte, rapid LOW, syncope), psychiatric (suicidal, social crisis)
What is refeeding syndrome?
Severely malnourished patients are refed too quickly, causing electrolyte & fluid shifts
Sx of fluid retention, hyponatremia, low P, Mg & Ca, metabolic acidosis, thiamine deficiency
Cx: respiratory failure, arrhythmia, seizure, delirium, muscle weakness, peripheral edema, hypotension
What is BN?
Recurrent episodes of binge eating (objectively large amount of food, within 2 hr, sense of loss of control)
Inappropriate compensatory behavior: purge, restrict, exercise
Duration: once a week for 3m
BMI: normal or overweight
What are the physical symptoms of BN?
Enlarged parotid glands Russell’s sx Teeth erosion Esophagitis, tear, rupture Peripheral edema
What are the lab findings for different compensatory behaviours of overeating?
Vomiting: hypochloremic metabolic alkalosis
Laxatives: hypokalemic metabolic acidosis
What are the comorbidities of BN?
Depression, bankruptcy, SA, suicidal, shoplifting (impulse control)
How to manage BN?
Fluoxetine + CBT
Nutritional counselling & education
Stimuli control: x buy & store foods
Stress mx
