Eating Disorders Flashcards
Three things anorexia nervosa patients are preoccupied with?
Their weight, body image and being thin
What distinguishes anorexia nervosa from bulimia
anorexia nervosa involves low body weight
anorexia nervosa age of onset
bimodal age of onset (13-14 due to hormonal influences and 17-18 due to environmental influences
recurrent episodes of binge eating, recurrent, inappropriate attempts to compensate for overeating and prevent weight gain, binge eating and compensatory behaviors occur at least twice a week for 3 months, and perception of self worth is excessively influenced by body weight and shape
bulimia nervosa criteria
what is refeeding syndrome
occurs when severely malnourished patients are refed too quickly
what are the signs of refeeding syndrome
fluid retention, low calcium, phosphorous, and magnesium.
complications of refeeding syndrome
arrhythmias, respiratory failure, delirium and seizures
tx for refeeding syndrome
replace the electrolytes and slow down the feedings
what is often increased in patients with anorexia nervosa
cortisol levels
physical exam signs of bulimia and anorexia
salivary gland enlargement (sialadenosis), dental caries/erosions from vomiting, callouses/abrasions on dorsum of hand from self induced vomiting (russell’s sign), petechieae, peripheral edema, aspiration
lab/imaging abnormalities of anorexia and bulimia
hypOchloremic hypOkalemic alkalosis, metabolic acidosis (laxative abuse), elevated bicarb (compensatory), hypernatremia, increased BUN and amylase
anorexia and bulimia nervosa are risk factors for what?
cardiac arrhythmias due to electrolyte imbalances such as hypokalemia
an effective medication for bulimia
fluoxetine
in patients with bulimia what should you make sure they aren’t on (medication)
wellbutrin (buproprion) because it lowers seizure threshold
