Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics (Fall 2024) > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is Anorexia according to DSM-5

A

Intense fear of gaining weight or becoming fat, low body weight, disturbances in the way ones body weight is experienced and denial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is considered mild anorexia?

A

BMI >17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is considered moderate anorexia?

A

BMI 16-16.99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is considered Severe anorexia?

A

15-15.99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is considered extreme anorexia?

A

BMI <15Kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Bulimia?

A

Recurrent episodes of binge eating
Recurrent compensatory behavior to prevent weight gain

Binge eating and compensation 1xweek for 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the ways people living with bulimia prevent weight gain?

A

Laxatives, Vomiting, Diuretics, Diets, Drugs, Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is considered mild bulimia?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is considered moderate bulimia?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is considered Severe bulimia?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is considered extreme bulimia?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an important difference beteween BN and AN in terms of diagnostic criteria?

A

Does not include a specific BMI as these individuals are usually normal to slightly overweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

With regards to developing health problems which BMI has not highest?

A

Obese >30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Binge eating disorder?

A

Recurrent episodes of binge eating without compensatory behaviour to prevent weight gain

Lack of control over eating during the episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the criteria for Binge eating disorder?

A

Eating rapidly
eating untill uncomfortably full
eating large amounts when not hungry
Eating alone from embarrassment
feeling disgusted, depressed or guilty after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is thought to be the physiological state of AN/BN?

A

Imbalance of neurotransmitters and neuropeptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What occurs during AN/BN in terms of neurobiological dysfunction?

A

Increased levels of cortisol is released and this leads to HPA suppression, hypothalamic pituitary thyroid, and hypothalamic pituitary gonadal axes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does suppression of the Hypothalamic pituitary gonadal lead to?

A

Decreases in estradiol, progesterone, Luteinizing hormone leading to amenorrhea and decreased libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What also occurs during Hypothalamic pituitary thyroid suppression?

A

TSH inhibition reduces conversion of T4 to T3, reduced resting metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What neurotransmitter dysfunction occurs during AN/BN?

A

Da deficiencies leading to decreased energy and decreased feelings of reward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Between AN and BN which has a higher mortality rate?

A

AN ~10% vs 1-2% BN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What types of diseases may exacerbate death or hospitalizations in BN?

A

Cardiovascular events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the general course and outcome of AN (3)

A

No recovery after 1st episode
Fluctuating pattern of weight gain and loss
Chronic deteriorating course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the Course of BN?

A

Chronic or intermittent with periods of remission and reoccurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the general principles of treatment of AN/BN?

A

Emphasize normalization of eating behaviour.

Developing new coping mechanisms

Forming a treatment alliance

Identify stressors that predispose to eating disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the issues taht may arise with amenorrhea? (4)

A

Osteoporosis
Decreased growth
Low libido
Unexpected pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What was the approximate relapse of eating disorder and pregnancy?

A

22% had a relapse in eating disorder during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When do period return following eating disorder treatment?

A

Average 6 months of achieving a body wiehgt of 90% of the average age and height ~19-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Is the return of the menstrual cycle related to body fat?

A

No, its related with the amount of estrogen in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the cardiac complications of AN? (2 large ones)

A

Prolonged QT, Cardiac atrophy from starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is Myocardial mass important in AN?

A

Prolonged starvation leads to wasted cardiac muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are some other AN related cardiac complications that may occur

A

Sinus bradycardia
Cardiac arrythmias
Decreased heart rate variability
Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What cardiac outcomes are not reversible in AN?

A

Irreversible myocarditis,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

To avoid refeeding induced complications in AN what are the three points?

A

Refeed slow,
Phosphorus supplement
Clinical surveillance in hospital

35
Q

What is Gastroparesis?

A

paralysis of the stomach

36
Q

What medications can be used to help with gastroparesis?

A

Domperidone

37
Q

What is the risk of domperidone?

A

QT prolongation

38
Q

What medication similar to domperidone should be avoided?

A

Metoclopromide as it can lead to EPS

39
Q

What are the medical treatments for Constipation?

A

Bowel retraining with Peglyte, milk of magnesia, sennosides

40
Q

With regards to the liver what may occur during AN? (3)

A

Hypoalbuminemia
Increased INR (1.5)
Petechiae (Tiny spots on skin and mucous membranes

41
Q

What renal issues may occur during AN?

A

BUN elevation, decreased eGFR

42
Q

What are the 5 ways eating disorders contribute to Osteoporosis

A

Decreased Nutrition,
Decreased Body weight,
Decreased serum androgen,
Decreased levels of IGF-1
Increased cortisol levels

43
Q

What is the risk of Osteoporosis and eating disorders?

A

Usually AN occurs during adolescent therefore higher risk of anorexia when older

44
Q

What are the possible treatments to preventing/improve bone mass in eating disorders? (4)

A

Estrogen replacement?
Calcium and Vitamin D
Bisphosphonates
Weight recovery

45
Q

According to a trial revolving anorexia and woman did estrogen help with BMD?

A

No

46
Q

What is the recommendations for calcium intake and Vitamin D?

A

1200-1500mg, VItmain D 1000 IU

47
Q

In Teenagers has alendroante shown to benefit BMD?

A

No

48
Q

In adult women with anorexia is alendronate shown benefit BMD?

A

Yes

49
Q

What is the best way to recover BMD

A

Gaining weight

50
Q

What occurs with the skin in eating disorder

A

Dry scaling skin
Calluses on back of hand
Hair loss
Lanugo hair (Fine hair growing on the skin)

51
Q

What are the 6 goals of therapy for AN?

A
52
Q

What is nutritional rehabilitation?

A

Restore weight gradually and prevent re-feeding syndrome

53
Q

What does the caloric intake levels usually start at?

A

30-40kcal/kg/day and may advance to 70-100kcal/kg/day

54
Q

What electrolytes should be monitored with regards to nutritional rehabilitation

A
55
Q

What is refeeding syndrome?

A

Occurs when malnourished patients are fed high carbohydrate loads

56
Q

What symptoms occur due to re-feeding syndrome?

A

Gastric bloating, nausea, edema

57
Q

What can refeeding syndrome lead to?

A

Cardiac changes due to the replenishment of electrolytes and fluid

58
Q

What is cardiac decompensation the highest during refeeding syndrome?

A

Initial phase

59
Q

Next slide is of refeeding syndrome.

A
60
Q

What are the non-pharm tx of AN?

A

Psychotherapy
CBT

61
Q

What are the AN pharmacological tx? (3)

A

Pharmacotherapy not really effective in underweight malnourished patients.

Options:
Zinc, AP, Antidepressant

62
Q

What are the benefits of Zinc?

A

Zinc deficiency exhibit symptoms similar to AN, therefore foten suggest for nutritional deficiency

Studies indicate Zinc led to weight gain

63
Q

What may zinc benefit?

A

Weight, mood/anxiety possibly

64
Q

Which AP may have benefit for AN?

A

Olanzapine because of weight gain, but may lead to increase AE such as sedation

65
Q

What is the overall note on AP in AN?

A

Did not fix the psychological symptoms, but helped gain weight

66
Q

What are the AE of AP?

A

EPS, anticholinergic toxicity, QTc prolongation, tardive dyskinesia

67
Q

Which Antidepressants are not recommended for ED?

A

TCAs and Bupropion due to safety

68
Q

Which antidepressant may help in ED?

A

SSRI may help with comborbid depression and OCD after weight restoration has occurred, but limited data and mixed efficacy

69
Q

What is the conclusion about Pharmacotherapy for AN?

A

Data on the long term efficacy of drus are scarce, and short/long term drugs of anorexia remain challenging

70
Q

What are the symptoms of purging in BN? (5)

A
71
Q

What are the consequences of abused substances such as ipecac, diuretics or laxatives? (3)

A
72
Q

What are the 7 goals of therapy in BN/

A
73
Q

What are the treatment options for BN?

A

CBT, Nutritional rehab, pharmacotherapy

74
Q

What is the goal of CBT and BN?

A

Superior in efficacy to drug therapy, focuses on change of thought pattern and specific behaviours

75
Q

What are the medical treatments of BN? (3)

A
76
Q

What are the drugs of choice for BN?

A

SSRIs

77
Q

Which SSRIs are well studied for BN?

A

Fluoxetine, citalopram, sertraline

78
Q

What is the Onset of SSRIs in BN?

A

2-4 weeks, duration 6-12 months of treatment

79
Q

What is the duration of treatment with an SSRI in BN?

A

6-12 months

80
Q

What is Topiramate and its treatment in for BN?

A

At mean dose of 100mg/day it has shown efficacy for 10 weeks in decreasing binge/purge episodesW

81
Q

What is the issue with using topiramate?

A

The brain fog associated ADE

82
Q

What are the monitoring requirements for BN? (8)

A
83
Q

What does 5ht regulate?

A

Postprandial satiety, anxiety, sleep mood, impulse control, OCD

84
Q
A

Therapeutics (Fall 2024) (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions