eating disorders

Question 1

genetic component to obesity

Answer 1

leptin receptor mutation, melanocortin receptor mutation,

Question 2

iatrogenic

Answer 2

antipsychotics, antidepressants, antihistamines, D2 blockades increase prolactin.

Question 3

lifestyle and obesity

Answer 3

sedentary, dependence on automobiles, increased fat, carbs, processed food.

Question 4

anorexia nervosa

Answer 4

refusal to maintain 85% of typical body weight. fear of gaining, restriction of energy intake requirements, dysmorphism, missed menstrual cycles. there are different types. also severity based on BMI

Question 5

restricting type

Answer 5

does not eat, does not purge.

Question 6

binge/purge type

Answer 6

does binge and purge

Question 7

mild

Answer 7

17

Question 8

Moderate

Answer 8

16-16.99

Question 9

severe

Answer 9

15-15.99

Question 10

extreme

Answer 10

<15

Question 11

possible etiologies

Answer 11

endogenous opiate imbalance, media/industry, family sacrifice, fear of independence, lack of sense of autonomy, need control in life or being rigidly controlled, neuroepinephrine imbalance -low.

Question 12

comorbidies and personality types

Answer 12

depression 50%, suicide increase, OCD, anxiety disorders, rigid and perfectionist traits, delayed psychosexual development, denial, delusion, minimization

Question 13

medical issues associated with anorexia

Answer 13

weightloss, hypothermia, edema, bradycardia, hypotension, syncope, amenorrhea, electrolyte imbalance and cardiac arrhythmia, lanugo hair, osteoporosis, delayed gastric emptying, metabolic acidosis.

Question 14

treatment

Answer 14

hospitalization, tube feedings, behavioral plan. CBT, family, psychodynamic.

Question 15

medications

Answer 15

TCA, SSRI, ECT if depressed, treat all comorbidities.

Question 16

bulimia nervosa

Answer 16

recurrent binge eating (large amounts in discrete time). there are purging and non-purging. no anorexia present. loss of control and compensatory behavior. vomiting, laxatives, enemas, diuretic, exercise, must binge 1x/week, for 3 months. motte prevalent than anorexia, 40% college women. obese common.

Question 17

personality for bulimia

Answer 17

reckless, out of control. not typically type A. belongs to a dysfunctional family, but more conflicted than rigid. outgoing angry, impulsive traits, borderline personality. more addiction and anxiety.

Question 18

what is russel’s sign

Answer 18

abraided knuckles from hitting the teeth when purging.

Question 19

rumination

Answer 19

repeated regurge and chewing and then reswallowing.

Question 20

what meds are most reasonable for bulimia

Answer 20

SSRI