Eating Disorders

Question 1

In young women with an eating disorder, at what point would you expect her menstrual periods to resume?

Answer 1

When they reach 90% of ideal body weight

Question 2

What is Russell’s Sign?

Answer 2

Calluses on the dorsum of the hand from self-induced vomiting

Question 3

What lab findings maybe associated with bulimia nervosa?

Answer 3

• Hypokalemia or hypomagnesemia (electrolyte imbalance may lead to cardiac arrhythmias)
• Increased amylase (from salivary gland hypertrophy and vomiting)
• Metabolic alkalosis

Question 4

What is the only FDA approved pharmacotherapy treatment for bulimia nervosa?

What adverse side effect are you most worried about with this drug?

Answer 4

Fluoxetine (Prozac)

It is associated with cardiovascular SE especially if electrolyte imbances are present

Question 5

What lab values are common in anorexia nervosa?

Answer 5

Patients usually have amenorrhea with low LH and FSH.

Also seen:
* Low ESR
* Low WBC
* Low potassium and high BUN due to vomiting, malnutrition and dehydration

Question 6

What gland is commonly enlarged in both anorexia nervosa and bulemia?

Answer 6

Parotid Gland

Question 7

Which of the following electrolyte abnormalities is associated with bulimic patients?

A Metabolic acidosis
B Respiratory acidosis
C Metabolic alkalosis
D Respiratory alkalosis

Answer 7

Metabolic Alkalosis

Question 8

Refeeding is severely malnourished patients cause what electrolyte abnormalities initially?

Answer 8

Hypophosphatemia, hypokalemia, hypomagnesimia

Question 9

What antidepressant is contraindicated in patients with bulimia nervosa?

Answer 9

Buproprion

Question 10

A 16-year-old girl presents to her pediatrician for her yearly well-child visit. Her only concern is that she frequently experiences constipation. She also reports amenorrhea for the past 6 months. She appears cachexic and tired. Physical exam findings include dry mucous membranes, dry skin, thin hair, and lanugo. Vital signs reveal an HR of 48 bpm, RR of 16 breaths/minute, BP of 97/60 mm Hg, SpO2 of 99% on room air, T of 97.7°F, and BMI of 16.5 kg/m2. Based on the most likely diagnosis, what condition should the patient be monitored for?

A. HyperkalemiaYour Answer
B. Hypertension
C. Hyperthyroidism
D. Osteoporosis

Answer 10

Osteoporosis