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PEDIATRICS > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What characterizes eating disorders (EDs)?

A

Body dissatisfaction related to overvaluation of a thin body ideal, dysfunctional patterns of cognition, and weight control behaviors leading to biologic, psychologic, and social complications.

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2
Q

Who can develop eating disorders?

A

Individuals of any age, gender, sexual orientation, ethnicity, or cultural background.

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3
Q

What improves the outcome in eating disorders?

A

Early intervention.

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4
Q

What are the key features of anorexia nervosa (AN)?

A

Significant overestimation of body size, relentless pursuit of thinness, and behaviors like dieting and compulsive exercising.

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5
Q

What distinguishes the binge-purge subtype of anorexia nervosa?

A

Intermittent overeating followed by attempts to rid calories through vomiting or laxatives.

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6
Q

What characterizes bulimia nervosa (BN)?

A

Episodes of eating large amounts of food followed by compensatory behaviors like vomiting, laxative use, exercise, or fasting.

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7
Q

What is Other Specified Feeding and Eating Disorders (OSFED)?

A

A subcategory for individuals not meeting full AN or BN criteria, requiring close monitoring over time.

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8
Q

What is avoidant/restrictive food intake disorder (ARFID)?

A

Limiting food intake based on subjective qualities without concern about body image, leading to unintended weight loss or nutritional deficiencies.

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9
Q

What is binge eating disorder (BED)?

A

Binge eating episodes without regular compensatory behaviors.

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10
Q

What are the DSM-5 criteria for anorexia nervosa (AN)?

A

Restriction of energy intake, intense fear of gaining weight, and disturbance in body weight perception.

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11
Q

How is the severity of anorexia nervosa classified?

A

Based on BMI: Mild (≥17), Moderate (16-16.99), Severe (15-15.99), and Extreme (<15).

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12
Q

What are the DSM-5 criteria for bulimia nervosa (BN)?

A

Recurrent binge eating, inappropriate compensatory behaviors, and self-evaluation influenced by body shape and weight.

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13
Q

What is the minimum frequency for compensatory behaviors in bulimia nervosa?

A

At least once a week for 3 months.

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14
Q

How is the severity of bulimia nervosa classified?

A

By frequency of compensatory behaviors: Mild (1-3/week), Moderate (4-7/week), Severe (8-13/week), Extreme (≥14/week).

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15
Q

What is the classic presentation of anorexia nervosa?

A

Early to middle adolescent female, above-average intelligence, conflict-avoidant, risk-aversive perfectionist.

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16
Q

What is the classic presentation of bulimia nervosa?

A

Emerges in later adolescence, sometimes evolving from AN, associated with impulsivity and depression.

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17
Q

What are the common comorbidities of avoidant/restrictive food intake disorder (ARFID)?

A

Anxiety disorders and autism spectrum disorder.

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18
Q

What influences the gender disparity in eating disorders?

A

Stronger relationship between body image and self-evaluation in females and societal thin body ideals.

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19
Q

What are common triggers for eating disorders?

A

Peer teasing, family interactions, and societal messages.

20
Q

What is the role of genetics in eating disorders?

A

Genetic predisposition to anxiety, depression, or obsessive-compulsive traits.

21
Q

What reinforces disordered eating behaviors in patients with EDs?

A

Biologic effects of malnutrition and positive reinforcement from reduced anxiety or emotional reactivity.

22
Q

What neurotransmitters are altered in eating disorders?

A

Serotonin and dopamine.

23
Q

What are the physical manifestations of anorexia nervosa?

A

Hypothermia, acrocyanosis, bradycardia, orthostasis, and muscle mass loss.

24
Q

What differentiates ARFID from other eating disorders?

A

Disturbance in neurosensory processes related to eating, not weight loss or body image concerns.

25
Q

What conditions mimic anorexia nervosa?

A

Hyperthyroidism, malignancy, celiac disease, Addison disease, and type 1 diabetes mellitus.

26
Q

What CNS conditions mimic eating disorders?

A

Craniopharyngiomas, Rathke pouch tumors, and mitochondrial neurogastrointestinal encephalomyopathy.

27
Q

What is the treatment significance of early satiety in EDs?

A

Linked to gastric atony in AN, not malabsorption.

28
Q

How does purging behavior reinforce bulimia nervosa?

A

Reduces anxiety and improves mood through neurotransmitter changes.

29
Q

What is the basis for diagnosing an eating disorder (ED)?

A

The diagnosis of an ED is made clinically and not through confirmatory laboratory tests.

30
Q

What routine lab tests are typically included when screening for ED?

A

Complete blood count, erythrocyte sedimentation rate, and a biochemical profile.

31
Q

What electrolyte imbalance is associated with severe vomiting in ED?

A

Hypokalemic, hypochloremic metabolic alkalosis.

32
Q

What ECG findings may be present in ED patients?

A

Low voltage, nonspecific ST or T-wave changes, and sometimes prolonged QTc.

33
Q

What are the most concerning organ targets of medical complications in ED?

A

The heart, brain, gonads, and bones.

34
Q

What is refeeding syndrome, and what does it cause?

A

Refeeding syndrome results from a rapid drop in serum phosphorus, magnesium, and potassium with excessive reintroduction of calories, causing acute tachycardia, heart failure, and neurologic symptoms.

35
Q

What are common reversible brain changes seen in anorexia nervosa (AN)?

A

Increased ventricular and sulcal volumes that normalize with weight restoration.

36
Q

What hormonal changes contribute to amenorrhea in AN?

A

Reduced gonadotropins due to hypothalamic dysfunction and physical/emotional stress.

37
Q

What is the significance of decreased bone mineral density (BMD) in ED?

A

It leads to osteopenia or osteoporosis, more pronounced in AN than in bulimia nervosa (BN).

38
Q

What dietary adjustments are recommended early in treating AN?

A

Gradually increasing caloric intake by 100-200 kcal increments every few days to support weight gain.

39
Q

What cognitive pattern is typical in patients with AN?

A

All-or-none thinking, overgeneralization, and catastrophic conclusions.

40
Q

How does refeeding in AN patients minimize the risk of refeeding syndrome?

A

By proceeding carefully, especially if weight is below 80% of the expected weight for height.

41
Q

What is the role of family-based treatment in adolescent AN?

A

It involves parents actively supporting healthy eating and weight restoration while professionals provide guidance.

42
Q

What is the first-line treatment for depressive symptoms in AN?

A

Food and weight restoration, as SSRIs are ineffective in underweight patients.

43
Q

What therapy is most effective for BN patients?

A

Cognitive-behavioral therapy, often combined with SSRIs.

44
Q

What are potential indications for inpatient hospitalization of AN patients?

A

Heart rate <50 beats/min, blood pressure <80/50 mm Hg, hypokalemia, hypoglycemia, body weight <80% of healthy weight.

45
Q

How do eating disorder partial hospital programs function?

A

They provide outpatient services for 4-5 days a week, focusing on meals, group therapy, and real-life challenges.

46
Q

What is the prognosis for AN with early diagnosis and effective treatment?

A

≥80% recover with normal eating and weight control habits and resumed menses.

47
Q

What prevention strategies for EDs are recommended?

A

Targeted interventions for high-risk groups, avoiding programs that normalize or glamorize EDs.

PEDIATRICS (17 decks)

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