Eating Disorders Flashcards
What is the first line treatment for children and young people with anorexia nervosa?
Anorexia focused family therapy.
What is the most common cause of admissions to child and adolescent psychiatric ward?
Anorexia nervosa.
What changes in the oral cavity are seen in bulimia nervosa?
Tooth erosion.
Describe the purging behaviours in bulimia
Vomiting, laxatives, diuretics, exercising.
Define eating disorder
Mental disorder defined by abnormal eating habits that negatively affect a persons physical and mental health.
What is the role of the MHA in the management of a patient with an eating disorder?
Feeding against a patient will should only be done in the context of the MHA or Children Act. Highly specialised procedure.
List some complications of anorexia nervosa
Hypokalaemia, hyponatraemia.
Hypotension.
Arrhythmias.
Anaemia.
Hypoglycaemia.
Osteoporosis.
Infertility, amenorrhoea.
AKI or CKD.
Frequent severe infections.
Anxiety and mood disorders.
What is the BMI for anorexia nervosa?
<17.5 kg/m2
List some complications of bulimia nervosa
Haematemesis.
Metabolic abnormalities.
Electrolyte imbalances leading to arrhythmias, renal impairment and muscular paralysis.
Dental erosions.
Salivary gland enlargement.
Anorexia (in 10-15%).
What is one of the first visible signs of refeeding syndrome?
Peripheral oedema.
What is the most common cause of death from refeeding syndrome?
Cardiac arrhythmias.
Define anorexia nervosa
Eating disorder characterised by restriction of energy intake resulting in low body weight and an intense fear of weight gain.
What percentage of patients with anorexia nervosa are female?
90%
Which ages are at high risk of anorexia nervosa?
13-18
Describe the risk factors associated with anorexia or bulimia
Female, younger age, FHx, previous criticism of eating habits and weight, increased pressure to be slim, sexual abuse, low self-esteem, obsessive personality, BPD, abuse/trauma.
Describe the clinical features of anorexia nervosa
Low BMI, bradycardia, hypotension, enlarged salivary glands, lanugo hair, failure of secondary sexual characteristics, cold intolerance, amenorrhoea, anxiety & depression.
Describe the physiological abnormalities seen in anorexia nervosa
Raised cortisol and GH, hypercholesterolaemia, hypercarotinaemia, impaired glucose tolerance, low T3, hypokalaemia and low FSH, LH, oestrogen and testosterone.
Describe the main parts of the DSM 5 diagnostic criteria for anorexia nervosa
Restriction in energy intake leading to a low body weight.
Intense fear of gaining weight.
Disturbance in the way in which one’s body weight/shape is experienced.
What is the management for adults with anorexia nervosa?
Individual eating-disorder-focused cognitive behavioural therapy (CBT-ED).
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA).
Specialist supportive clinical management (SSCM).
What is the management for children and young people with anorexia nervosa?
Anorexia focused family therapy.
Define bulimia nervosa
Eating disorder characterised by binge eating followed by purging.
In bulimia nervosa, is an individuals body weight underweight, normal or overweight?
Normal, but it tends to fluctuate.
At which age do individuals commonly suffer with bulimia nervosa?
20s & 30s
What are the symptoms of bulimia nervosa?
Purgative behaviours, binge eating behaviours, distress over body image, frequent bathroom trips after meals, mood disturbance and anxiety.
What is Russell’s sign?
Calluses on knuckles where they’ve scraped against the teeth due to repeated self-induced vomiting.
What are the clinical signs seen in bulimia nervosa?
Normal body weight, tooth erosion, enlarged salivary glands, abdominal pain, mouth ulcers, gastro-oesophageal reflux and irritation, alkalosis, hypokalaemia, Russell’s sign.
What causes alkalosis in bulimia nervosa?
Loss of HCl from stomach upon vomiting.
Sum up the main points from the DSM 5 diagnostic criteria for bulimia nervosa
Recurrent episodes of binge eating.
Lack of control.
Recurrent purging behaviours.
Occurring once a week for 3 months.
Self-evaluation unduly influences by body shape and weight.
What is the management for adults with bulimia nervosa?
Bulimia-nervosa-focused guided self-help.
CBT-ED.
High-dose fluoxetine.
What is the management for children with bulimia nervosa?
Bulimia-nervosa focused family therapy.
Define binge eating disorder
Eating disorder characterised by episodes of excessive overeating, often as an expression of psychological distress. Patients likely to be overweight.
Define refeeding syndrome
Poetically fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding.
What 3 electrolyte abnormalities occur in refeeding syndrome?
Hypomagnesaemia.
Hypokalaemia.
Hypophosphataemia.
Which psychiatric illness has the highest mortality rate?
Anorexia nervosa.
Describe the features of anorexia
- Most things low
- G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
