Eating Disorders

Question 1

Amenorrhea, GI complications upon refeeding, cold intolerance, lethargy, excess energy, hypotention, hypothermia, dry skin, bradycardia, erosion of enamel are all symptoms of which disorder?

Answer 1

Anorexia Nervosa

Question 2

What is the diagnostic criteria for Anorexia Nervosa?

Answer 2

1. Refusal to maintain normal weight for height
2. intense fear of gaining weight
3. disturbance of body image
4. females - absence of 3 consecutive menstrual cycles

Question 3

In regards to Anorexia, weight loss leading to body weight maintenance ___% below normal or failure to gain weight during period of growth leading to weight ___% below normal - BMI below ___

Answer 3

15; 15; 17.5

Question 4

What are the two types of Anorexia nervosa?

Answer 4

restricting; binge eating/purging

Question 5

This eating disorder can be described as recurrent episodes of binge eating accompanied by a sense of lack of control of eating during an episode at least twice a week for 3 months

Answer 5

Bulimia nervosa

Question 6

In regards to Bulimia nervosa, there are recurrent inappropriate compensatory behaviors in order to prevent weight gain such as?

Answer 6

self-induced vomiting, laxatives, diuretics, enemas, or other medications, fasting or excessive exercise

Question 7

True or false? Bulimia nervosa does not occur exclusively during episodes of Anorexia nervosa

Answer 7

true

Question 8

What are the two types of bulimia nervosa?

Answer 8

purging; non-purging

Question 9

This eating disorder can be described by recurrent episodes of binge eating. The episodes are associated with three of the following characteristics:
eating much more rapidly than normal
eating until feeling uncomfortably full
eating large amounts of food when not hungry
eating alone because of embarrassment

Answer 9

binge eating disorder

Question 10

In regards to binge eating disorder, binge eating occurs, on average, at least ____ days a week for __ months

Answer 10

2; 6

Question 11

Genertic research has found that some people with the restricting type of anorexia have an unusual variant of a gene that affects the reabsorption of ____

Answer 11

NE

Question 12

Identical twins have a ____% chance of both having the disorder vs. ___% for siblings

Answer 12

55; 7

Question 13

True or false? Many eating disordered patients have mothers who were preoccupied with weight and dieting

Answer 13

true

Question 14

How do you treat a patient with an eating disorder?

Answer 14

stabilize; evaluate suicide risk; cognitive-behavioral therapy; nutritional therapy; guard against refeeding syndrome

Question 15

A small dose of ____ 0.5-1.0 mg just prior to meals can help lower anxiety surrounding the eating process

Answer 15

lorazepam

Question 16

In weight stable recovering patients and bulimic patients, ____ are effective

Answer 16

SSRIs

Question 17

What is refeeding syndrome?

Answer 17

physiological and metabolic changes that occur with rapid reinstitution of feeding in a person with nutritional deprivaiton

Question 18

Why is refeeding syndrome such a concern?

Answer 18

anyone regardless of age, child, or adult who has not been fed adequately can undergo major changes with fluid and electrolytes once feeding has started

Question 19

What can be the resulting symptoms of refeeding syndrome?

Answer 19

death; worsening of respiratory and cardiac status

Question 20

Who are the people at risk for refeeding syndrome?

Answer 20

feeding disorders (especially anorexia nervosa), refugees, famine victims, burn patients, malignancies, chronic infeciton, crohn’s disease, cystic fibrosis

Question 21

What are some physiological changes that occur when feeding has been initiated?

Answer 21

anabolism; glucose becomes predominant fuel; insulin is released; sift from fat metabolism to carb metabolism; rapid intracellular shift of water, K+, Mg2+, phosphate, glucose; rise in basic metabolic rate

Question 22

In regards to important electrolytes, what clinical issue is associated with potassium?

Answer 22

life threatening arrhythmias

Question 23

In regards to important electrolytes, what clinical issue is associated with phosphate?

Answer 23

increased anabolism cause increased requirement of phosphorylated intermediates (ATP)

Question 24

In regards to important electrolytes, what clinical issue is associated with magnesium?

Answer 24

co-factor role (ATP)

Question 25

In regards to important electrolytes, what clinical issue is associated with calcium?

Answer 25

compounded by low Mg; tetany cardiac arrhythmias

Question 26

When beginning the feeding process, what percentage of caloric need should you implement?

Answer 26

50-75%

note: increase by 10% everyday

Question 27

In regards to weight gain; >1kg per week may be an indicator of what?

Answer 27

fluid retention