Eating disorders

Question 1

Diagnostic criteria for anorexia nervosa

Answer 1

1. Weight

Question 2

Co-morbidities/risk factors for anorexia nervosa

Answer 2

Depression; anxiety; anxious-avoidant-dependent personality; adverse life events/difficulties

Question 3

Red flags in anorexia nervosa

a) BMI
b) weight loss
c) vascular
d) muscles
e) skin
f) blood
g) ECG

Answer 3

a) >13

b)

Question 4

Mortality of anorexia nervosa

Answer 4

20% in severe cases

Question 5

Concordance in MZ twins of anorexia nervosa

Answer 5

55%

Question 6

Physical signs of anorexia nervosa

Answer 6

Muscle wasting,hair loss
Lanugo
Cold, blue peripheries
Dry skin
Bradycardia and hypotension
Bruising
Hypercarotenaemia

Question 7

How does refeeding syndrome occur?

Answer 7

Upon refeeding,body begins to attempt to “repair”- uses nutrients such as Mg, K+ and phosphate which are already severely depleted

Question 8

Evidence based treatment for anorexia in adolescents

Answer 8

Family therapy

Question 9

Management of anorexia

Answer 9

CBT
Diet monitoring
Dietician
Inpatient treatment for high risk (detention under Mental Health Act)

Question 10

Diagnostic criteria for bulimia

Answer 10

Persistent pre-occupation with eating
Irresistible craving for food
Binges
Attempts to counter effects of binges
Morbid dread of fatness

Question 11

Physical signs of bulimia nervosa

Answer 11

Calluses on knuckles (Russell’s sign- from tooth marks)
Parotid hypertrophy
Dental caries

Question 12

Medical complications

Answer 12

Oesophageal reflux/tears/ruptures
Hypokalaemia (and heart dysrhythmia)
Dehydration
Seizures

Question 13

Treatment of mild bulimia

Answer 13

Guided self help, CBT, SSRI (e.g. fluoxetine)