Eating Disorders

Question 1

A healthy BMI for women over age 20 is what range?

Answer 1

19-25

Question 2

On the BMI scale, what is considered overweight?

Answer 2

over 25

Question 3

On the BMI scale, what is considered obese?

Answer 3

over 30

Question 4

Those under a BMI of what are considered to be at risk for health problems
related to anorexia?

Answer 4

17.5

However, young teenagers can have lower BMIs without necessarily being
anorexic

Question 5

What are some causes of eating disorders?

Answer 5

Genetics
Developmental events
Family dynamics
Peer pressures
Cultural influences

Question 6

More than a quarter of eating disorder patients have a comorbid what?

Answer 6

mood disorder

Question 7

> 90% have at least one additional ________ diagnosis in a lifetime

Answer 7

psychiatric

Question 8

Self imposed starvation is called what disorder?

Answer 8

Anorexia Nervosa

Question 9

Approximately what percentage of cases of anorexia nervosea occur in females?

Answer 9

90%

Question 10

What are the two types of Anorexia Nervosa?

Answer 10

Restricting

Binge Eating/Purging

Question 11

What are the criteria for anorexia nervosa?

Answer 11

Refusal to maintain body weight at or above that expected for age and height (<85%)

Intense fear of gaining weight or becoming fat despite being severely underweight

Distortion in the way one’s body size is experienced and denial of seriousness of low weight

Amenorrhea in postmenarcheal females

Question 12

What type of anorexia is described below?

Person eats very little and does not regularly engage in binge eating or purging behavior

Answer 12

Restricting

Question 13

What type of anorexia is described below?

Characterized by patient eating in binges and subsequent purging

Answer 13

Binge Eating/Purging

Question 14

What is a useful interviewing tool in screening for anorexia nervosa?

Answer 14

SCOFF Questionnaire

Question 15

When should an anorexia nervosa patient be hospitalized?

Answer 15

Hospitalization if patient is 20% below the expected body weight

Question 16

What antidepressants may be useful in anorexia nervosa?

Answer 16

Paroxetine (Paxil)

Mirtazapine (Remeron)

Question 17

What medications or classes of medications should be avoided in anorexia nervosa?

Answer 17

Stimulants
Buproprion
TCAs

Question 18

Recurrent episodes of binge eating and recurrent compensatory mechanisms

Answer 18

Bulimia Nervosa

Question 19

What are some recurrent compensatory mechanisms in bulimia nervosa?

Answer 19

Self-induced vomiting
Laxative use
Fasting
Excessive exercise

Question 20

The following list is characteristics of which eating disorder?

Greater incidence in people that tend to be high achievers succumbing to
pressure of being thin

Usually associated with overweight or obesity

eating behavior is more ego-dystonic

Answer 20

Bulimia Nervosa

Question 21

What are the two types of Bulimia Nervosa?

Answer 21

Purging

Non-Purging

Question 22

What is the diagnostic criteria for Bulimia Nervosa?

Answer 22

Binge/Purge episodes occur on average at least two or more times a week for at least three months

Characterized by the consumption of a larger amount of food in two hours than the average person would consume

Self-esteem influenced by weight/body shape

Current weight does not meet criteria for anorexia nervousa (>85% ideal body weight)

Binge eating episodes are associated with three or more of the following: Eating faster than normal, Eating until feeling uncomfortably full, Eating to excess, Eating even though not hungry, Eating alone out of embarrassment with feelings of disgust, guilt, or depression after the episode

Question 23

List some common cardiovascular medical issues seen in bulimia nervosa

Answer 23

Orthostatic hypotension
Bradycardia
Prolonged QT and T-wave abnormalities on EKG
Mitral valve prolapse
Cardiomyopathy

Question 24

List some common cell count medical issues seen in bulimia nervosa

Answer 24

Low WBC
anemia

Question 25

List some common GI medical issues seen in bulimia nervosa

Answer 25

Bloating Nausea Elevated liver enzymes Elevated cholesterol Constipation/decreased motility Esophageal tears (Mallory-Weiss)

Question 26

List some common fluid/electrolyte medical issues seen in bulimia nervosa

Answer 26

Dehydration Decreased albumin Peripheral edema and effusions Electrolyte disturbances

Question 27

List some common dermatologic medical issues seen in bulimia nervosa

Answer 27

Hair loss Dull hair Lanugo hair Dry skin Calloused or scarred knuckles (from purging) - Russell’s sign: Repeated induced vomiting over long periods of time, Contact with the incisor teeth Acrocyanosis

Question 28

List some common reproductive medical issues seen in bulimia nervosa

Answer 28

Reduced fertility at low weight Higher rates of obstetric difficulties Decreased intrauterine growth of baby Amenorrhea (for at least three cycles)

Question 29

Indications for Inpatient Care in bulimia patients

Answer 29

Syncope Hypokalemia (<3.2 mmol/L) Hypochloremia (<88 mmol/L) Esophageal tears Cardiac arrhythmias (including prolonged QTc interval) Intractable vomiting Hematemesis Failure to respond to outpatient treatment Severity of psychiatric comorbidities

Question 30

What medications or classes of medications should be avoided in bulimia nervosa?

Answer 30

Stimulants Buproprion TCAs