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Eating Disorders Flashcards

1
Q

Define obesity

A

BMI greater than or equal to 30 or body weight 20% or greater over the ideal body weight

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2
Q

About 50% of patients with obesity experience ________

A

binge eating episodes

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3
Q

What are the four categories of obesity treatment?

A
  1. Behavior modification
  2. Medical therapy
  3. Medications
  4. Surgical
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4
Q

What are behavior modifications for obesity?

A

Exercise/ diet and group therapy

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5
Q

What medical therapy is indicated for obesity?

A

Antidepressants for underlying depression

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6
Q

What medications exist for obesity?

A

Orlistat and Lorcaserin

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7
Q

What is the MOA of Orlistat?

A

Decreases GI fat digestion

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8
Q

What is the MOA of Lorcaserin?

A

Serotonin agonist

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9
Q

What surgical options exist for obesity?

A

-Gastric bypass
-Gastric sleeve
-Gastric band
-Bariatric surgery

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10
Q

Who should be screened for obesity?

A

Everyone 6 and older

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11
Q

Binge Eating Disorder:

-Recurrent episodes of _______
-Severe distress over binge eating
-May be triggered by stress or mood changes

A

binge eating at least weekly for three months

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12
Q

Binge Eating Disorder:

-Recurrent episodes of binge eating at least weekly for three months
-Severe ________
-May be triggered by stress or mood changes

A

distress over binge eating

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13
Q

Binge Eating Disorder:

-Recurrent episodes of binge eating at least weekly for three months
-Severe distress over binge eating
-May be _______

A

triggered by stress or mood changes

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14
Q

Describe episodes of binge eatin

A

Recurrent episodes of eating within a 2 hour period more than people would eat in a similar period with lack of control during an overeating episode

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15
Q

Unlike Bulemia Nervosa, binge-eating episodes….

A

are not associated with compensatory behaviors, and they are not as fixated on the body shape or wait

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16
Q

What are the four managements for binge eating disorder?

A
  1. Psychotherapy
  2. Strict diet and exercise plan
  3. Topiramate
  4. Stimulants
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17
Q

Why is topiramate indicated for binge eating disorder?

A

Antiepileptic associated with weight loss

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18
Q

Define anorexia nervosa

A

Failure to maintain a normal body weight, fear and preoccupation with body weight, body image and being thin

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19
Q

Anorexia nervosa is most commonly seen in

A

Teenage girls ages 14-18 (often athletes, dancers etc)

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20
Q

There is a 60% incidence of _____ in anorexia nervosa

A

Depression

21
Q

What psychiatric condition has the highest mortality rate and why?

A

anorexia nervosa secondary to arrhythmias

22
Q

What are the clinical manifestations of anorexia nervosa?

A

Behaviors targeted at maintaining a low weight (excess water intake, food-related obsessions)

23
Q

Is anorexia nervosa ego-syntonic or dystonic?

24
Q

What are the two types of anorexia nervosa?

A
  1. Restrictive type
  2. Binge eating / purging type
25
What does restrictive anorexia nervosa present with?
Strict reduced calorie intake, dieting, fasting, excessive exercise and diet pills
26
What does binge/purging anorexia nervosa look like?
Self induced vomiting, diuretic, laxative or enema abuse
27
What can be seen on physical exam in anorexia nervosa?
-Emaciation -Hypotension -Bradycardia -Skin or hair changes (lanugo) -Dry skin -Salivary gland hypertrophy -Amenorrhea -Arrhythmias -Osteopenia Russel's Sign
28
What is Russel's SIgn?
Callouses on the dorsum of the hand from self induced vomiting
29
What are the weight categories of anorexia nervosa?
BMI 17.5 or less OR body weight <85% of ideal weight
30
What are the diagnostic criteria of anorexia nervosa (3)
1. Restriction of calories leading to significantly low body weight 2. Intense morbid fear of fatness or gaining weight 3. Distorted body image
31
What might be seen on labs of anorexia nervosa?
Hypokalemia Lactic Acidosis Maybe also: -Increased BUN -Hypochloremia -Hypogonadotropic hypogonadism -Hypothyroidism
32
What are the treatments for anorexia nervosa? (4)
1. Medical stabilization 2. Nutritional rehab 3. Psychotherapy 4. Pharmacotherapy
33
When should patients be hospitalized with anorexia nervosa?
<75% expected weight or significant complication
34
What is the most dangerous complication of anorexia nervosa?
Electrolyte imbalances > arrhythmias
35
What is the most common complication of nutritional rehab in anorexia nervosa?
Refeeding syndrome
36
What is refeeding syndrome?
Increased insulin leads to hypophosphatemia and cardiac complications
37
What medications may be useful in anorexia nervosa?
If depressed: SSRIs and atypical antipsychs
38
What is the basic definition of bulemia nervosa?
Binge eating combined with compensatory behaviors to prevent weight gain
39
What two things differentiate bulimia nervosa from anorexia?
1. Bulimia usually maintains a normal weight (or even overweight) 2. Bulimia behaviors are often dystonic
40
What three things may be seen on physical exam in bulimia nervosa?
1. Teeth pitting or enamel erosion 2. Russell's Sign 3. Parotid gland hypertrophy
41
What are the lab findings of bulimia nervosa?
Increased amylase (from salivary gland hypertrophy and vomiting) Maybe also: -Hypokalemia -Hypomagnesemia -Metabolic alkalosis
42
What are the diagnostic criteria for bulimia nervosa?
1. Recurrent episodes of binge eating at least weekly for 3 months plus compensatory behaviors -Perception of self worth excessively influenced by body shape and weight
43
What are the two types of compensatory behaviors in bulimia nervosa?
Purging type and nonpurging type
44
What are the behaviors of purging type in bulimia nervosa?
Primarily vomiting DIuretic, laxative or enema abuse
45
What are the behaviors of non-purging type of bulimia nervosa?
Reduced calorie intake, dieting, fasting, excessive exercise and diet pills
46
What is the management of bulimia nervosa?
1. Psychotherapy 2. Fluoxetine
47
What is the only medication FDA approved for bulimia nervosa?
Fluoxetine
48
What are the dangers of fluoxetine in bulimia?
Cardiac effects, esp in the setting of electrolyte abnormalities.

Behavioral Health (19 decks)

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