Eating disorders Flashcards
What is a sign of eating disorder in the hands?
russel’s sign!!
Russel’s sign indicates which eating disorder?
bulimia nervosa
What are the four aspects to physical examination of patient with eating disorder
BMI
ECG
Bloods
Examination
Which abnormality in blood pressure might you see in eating disorder?
postural hypotension, therefore measure lying and standing blood pressure!
List three aspects of general appearance/inspection you might see in patient with eating disorder
cachexia, dehydration signs, lanugo, bruising, hair loss, dry skin, cold intolerance, russel’s sign
Aside from general appearance, what else should you assess in examination?
HR BP temperature
BP
Muscle power
sit up squat stand test
List two blood tests and their results that you might see in eating disorder patient
low potassium
metabolic alkalosis- vomiting
hypoglycaemic
leukopenia
anaemia
raised urea and creatinine
What is a serious complication of treating anorexia nervosa after long periods of not eating?
re-feeding syndrome
List two features on ECG you might see in someone with eating disorder
bradycardia
raised QTC
hypokalaemia changes- u waves
What should you screen for in risk with eating disorders
suicide
self harm
why must you not aggressively treat acute deterioration of anorexia nervosa with fluids
due to risk of pulmonary oedema
Which crystalloid must be avoided due to risk of refeeding syndrome?
dextrose (only use if hypoglycaemic)
What is refeeding syndrome
Refeeding syndrome is caused by rapid refeeding after a period of under-nutrition, characterised by hypophosphataemia, electrolyte shifts and has metabolic and clinical complications. High risk patients include the chronically under-nourished and those with little intake for greater than 10 days
How does refeeding syndrome arise
any source of carbohydrate
paraenteral nutrition
IV dextrose fluids
oral food
enteral food
What is the treatment for eating disorders in adults?
CBT
