Brainscape's Knowledge GenomeTM

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


See full index

PHAR 358 > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

what is the DSM-5 criteria for anorexia nervosa?

A
  • intense fear of gaining weight or becoming fat
  • significantly low body weight (less than what is ideally expected) in related to age, sex, development and physical health
  • disturbances in the way ones body weight or shape is experienced and denial of the seriousness of the current low body weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two subtypes of anorexia and how are they different?

A

restricting type: during the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behaviour
- weight is accomplished primarily through dieting, fasting, and/or excessive exercise

binge-eating/purging type: during the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behaviour

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

how is the severity of anorexia classified?

A

based on BMI

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

what is the DSM-5 criteria for bulimia nervosa?

A
  • recurrent episodes of binge eating
  • recurrent compensatory behaviour to prevent weight gain
  • binge eating and compensation 1x/week x 3 months
  • self-evaluation is disproportionately influenced by body shape and weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the remission specifications of bulimia?

A

in partial remission: after full criteria for BN were previously met, some but not all, of the criteria have been met for a sustained period of time

in full remission: after full criteria for BN were previously met, none of the criteria have been met for a sustained period of time

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

how is the severity of bulimia classified?

A

based on the frequency of inappropriate compensatory behaviours per week

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

T or F
diagnosis for bulimia nervosa includes specific BMI?

A

false
patients with BN are commonly normal to slightly overweight

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

what BMI is considered underweight?

A

<18.5

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

what is the diagnostic criteria for binge eating disorder?

A
  • recurrent episodes of binge eating without compensatory behaviour to prevent weight gain
  • eating, in a discrete period of time, an amount of food much larger than most people would eat during the same period of time
  • lack of control over eating during the episode
  • > 3 of the following: eating rapidly; eating until uncomfortably full; eating large amounts when not hungry; eating alone from embarrassment; feeling disgusted, depressed or guilty after eating
  • binge eating 1x/weekly for 3 months
  • causes marked distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the etiology of eating disorders?

A

genetic predisposition

physiologic state: imbalance of NTs and neuropeptides

environmental - complex bio-psychosocial

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

what is the major appetite and eating control center of the brain?

A

hypothalamus

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

what is the most common trigger for binge eating?

A

stress

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

what does suppression of the HPG axis cause?

A

decrease in estradiol, progesterone, and LH production = amenorrhea and decreased libido

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

what is the average episode duration of AN and BN?

A

AN: 8 months
BN: 2.9 months

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

what is the mean duration of illness of AN and BN?

A

AN: 9-15 years
BN: 7.7-11.7 years

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

what is the death rate of AN?

A

10%

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

which tends to be more fluctuating, AN or BN?

A

BN

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

what are some common psych co-morbidities of anorexia?

A

anxiety: OCD, social phobia
mood disorders: MDD, dysthymia, bipolar
personality disorders - cluster C: avoidant, obsessive compulsive
substance use disorder

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

what are some common psych co-morbidities of bulimia?

A

cluster B and C personality disorders: borderline, avoidant, impulsive, narcissistic
substance use
anxiety: OCD, panic, social
mood disorders: MDD, dysthymia, bipolar
impulse control disorder: compulsive buying, kleptomania, self-mutilation

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

what are the consequences of amenorrhea?

A

increase risk of
- osteoporosis/osteopenia
- decreased growth velocity
- lack of sexual desire/sexual dysfunction
- unexpected pregnancies

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

what percentage of women have a relapse in their eating disorder during pregnancy?

A

22%

22
Q

what are the risks to the baby if a women suffers with anorexia during pregnancy?

A

17% newborns failure to thrive
increased risk of child obesity

23
Q

when will periods return after amenorrhea caused by an eating disorder?

A

within 6 months of achieving body weight of about 90% of the average for age and height
- related to serum estrogen, but amount of body fat

24
Q

what the the CV complications associated with anorexia?

A
  • prolonged QT
  • cardiac atrophy
  • myocardial mass
  • sinus bradycardia
  • cardiac arrhythmias
  • decrease HR variability
  • hypotension
25
Q

what is myocardial mass and why does it occur in anorexia?

A

prolonged starvation leads to wasted cardiac muscle

myofibrillar atrophy and destruction secondary to malnutrition +/- due to decreased preload

26
Q

T or F
most CV abnormalities normalise with weight restoration

A

true

27
Q

what cardiac complication is seen with chronic ipecac ingestion?

A

irreversible myocarditis

28
Q

what is the most common arrhythmia seen in anorexia?

A

bradycardia

29
Q

what is the treatment of gastroparesis in anorexia?

A

domperidone

avoid metoclopramide as can cause EPS

30
Q

what is the treatment of constipation in anorexia?

A

bowel retraining: PegLyte, Peg, milk of magnesia
bowel taper: sennosides or cascara prn

31
Q

how do eating disorders contribute to osteoporosis?

A
  • decrease nutrition = decrease peak bone mass
  • decrease body weight = amenorrhea = decrease estrogen levels
  • decrease serum androgen levels
  • decrease levels of IGF-1
  • increase cortisol levels
32
Q

what percentage of people with anorexia have osteoporosis/osteopenia?

A

40-66% osteoporosis
92% osteopenia

33
Q

is estrogen replacement useful for preventing osteoporosis in eating disorders?

A

no

34
Q

what is the recommended daily intake of calcium and vitamin D in eating disorders?

A

1200-1500 mg calcium
1000 IU vitamin D

35
Q

are bisphosphonates useful in preventing osteoporosis in anorexia?

A

maybe?

36
Q

what is the best way to prevent osteoporosis in eating disorders?

A

weight recovery

37
Q

what are some skin complications seen in eating disorders?

A
  • dry, scaling skin
  • calluses on back of hand (from purging)
  • hair loss
  • lanugo hair (fine hair growing on the skin)
38
Q

what is refeeding syndrome?

A

occurs when malnourished patients are fed high CHO loads

39
Q

what are the complications of refeeding syndrome?

A

may precipitate cardiac changes and heart failure

40
Q

what are symptoms of refeeding syndrome?

A

gastric bloating
nausea
edema

41
Q

when is cardiac decompensation at the highest risk in refeeding syndrome?

A

in initial phases of reintroduction of nutrition

42
Q

is pharmacotherapy effective in treating anorexia?

A

no

43
Q

which mineral is recommended for anorexic patients and why?

A

zinc
individuals with zinc deficiency exhibit symptoms similar to anorexia

44
Q

which antipsychotic is recommended in anorexia?

A

olanzapine shown modest weight increases but should be used in combination with behavioural interventions

45
Q

which antidepressant is CI in eating disorders?

A

bupropion
can precipitate seizures

TCAs not recommended due to OD risk and potential for fatal arrhythmias

46
Q

are antidepressants useful in eating disorders?

A

yes but only after weight restoration

47
Q

what are some complications associated with bulimia?

A

symptoms of purging
- parotid gland enlargement
- callus on dorsum of hand
- dental caries
- esophageal rupture
- gastric rupture

consequences of abused substances
- electrolyte imbalance
- serious cardiac/skeletal myopathies and death from ipecac
- irreversible submucosal nerve fiber damage from phenothalein

amenorrhea
orthostatic hypotension, bradycardia, ECG changes
osteoporosis/osteopenia
guilt and depression after binge

48
Q

what is the most effective psychotherapy in eating disorders?

A

CBT

49
Q

what are the drug of choice for bulimia?

A

SSRIs

topiramate also has shown short term efficacy

50
Q

what is the only FDA approved medication for bulimia?

A

fluoxetine

51
Q
A

PHAR 358 (10 decks)

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