Eating disorders Flashcards

1
Q

List a screenin tool to use for eating disorders

A

SCOFF

Do you make yourself sick
Do you worry you have lost all control over how much you eat
Have you recently lost more than one stone (14 lbs) in a 1 month period
Do you believe yourself to be fat while others say you are too thin
Would you say food dominates your life

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2
Q

List five things on physical exam you may see in eating disorders

A
Low Weight 
Low BMI 
Bradycardia
Hypotension
Dental erosions
Marks to knuckles 
Palor 
Lanugo hair
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3
Q

What are some types of eating disorders (list three and their differences)

A
  1. Anorexia: Restriction or energy relative to requirements with low body weight and fear of gaining weight
    (Can be restricting or purghing)
  2. Bulemia: Binge eating with compensatory behavior (vomiting, exercising, laxatives etc) with image issues around weight
    -Has to happen at least once per week for 3 months
  3. Eating disorder NOS
  4. Binge eating disorder-Loss of control over what you are eating
  5. Avoidant/Restrive Food intake disorder-Doesn’t have the low body weight that anorexia has

Amenorrhea is no longer required for diagnosis

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4
Q

What do dx a thin gymnast who doesn’t have her period

A

Relative energy deficiency in Sport (no longer female athlete triad)

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5
Q

List some common co morbidities

A

anxiety
OCD
Personality disorder
Depression

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6
Q

What would you tell a family about prognosis of this condition

A

Highest mortality of all psych disorders

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7
Q

Risk factors

A
Dieting in childhood 
PRessure about weight 
Sports 
family history 
Substance abuse 
Psychiatric illness
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8
Q

What BMI constitutes Mind Moderate and severe and extreme eating disorders

A

> 17=Mild
16-17=Moderate
15-16=Severe
<15=extreme

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9
Q

What referrals could you make

A
Dietician
Group counseling 
Family counseling**
ON line training 
CBT
Yoga
Eating disorders clinic 
ED if any metabolic abnormalities or unstable
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10
Q

General treatments:

A

Family counseling
Dietician
Monitor closely
Target weight

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11
Q

What investigations would you get

A
CBC
Extended lyste with phosphate 
LFTs
TSH
Lipids 
HCG
ECG
BMD 
Echo
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12
Q

Risk factors for refeeding and how to prevent

A

little or no intake for >10 days
Abnormal lytes
Rapid wt. loss

Admit
Monitor lytes and cluids
Refeed slowly

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13
Q

Pharm management for Anorexia

A

SSRI (usually just for comorbid anxiety or depression but they probably have that so ends up being most people)

No SNRI or bupropion

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14
Q

Pharm treatment for bulemia

A

Fluoxetine

Consider olanzapine for intrusive thoughts

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15
Q

DDX for wt loss

A

Malignancy
Diabetes
Hyperthyroid
Celiac

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