Eating Disorders

Question 1

If a patient has an eating disorder, does BMI matter if they are hemodynamically unstable?

Answer 1

No, if the patient has a suspected eating disorder and they are hemodynamically unstable, get them to the hospital, involuntarily if necessary, regardless of the patient’s BMI.

Question 2

How do you treat non-anion gap metabolic acidosis due to gastrointestinal losses?

Answer 2

Identify and address the cause: Stop laxative use.

Correct dehydration: IV fluids (e.g., isotonic saline).

Correct electrolyte imbalances: Potassium supplementation if needed.

Question 3

Chronic diarrhea or laxative abuse, which is common in anorexia nervosa, can lead to what electrolyte disturbances?

Answer 3

metabolic acidosis (bicarbonate is lost through GI)

hypokalemia

elevated urine chloride High (>20 mEq/L, indicating loss through the gastrointestinal tract).

Question 4

What contributes to osteoporosis in anorexia nervosa?

Answer 4

Hypogonadotropic hypogonadism: Low estrogen.

Malnutrition: Deficiency in calcium and vitamin D.

Hypercortisolism: From chronic stress/starvation.

Low BMI: Reducing bone strength.

Question 5

What diagnostic tests are used to evaluate osteoporosis-related back pain in anorexia?

Answer 5

Dual-energy X-ray absorptiometry (DEXA): To assess bone density.

Spine X-rays or MRI: To identify fractures.