Eating Disorders Flashcards

1
Q

Mortality rate of anorexia

A

10%

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2
Q

Average age of onset for anorexia

A

14-18

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3
Q

Common co-morbidities w/ anorexia

A

Depression (65%), social phobia (35%) and OCD (25%).

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4
Q

What biological factors are involved w/ anorexia?

A

Diminished NE and thyroid function. Increased 5HT and HPA axis activation.

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5
Q

DSM Criteria for anorexia
3 main things
2 subtypes

A
  • A – Restriction of energy intake –> low body weight.
  • B – Intense fear of gaining weight / becoming fat, or persistent behavior that interferes w/ weight gain, even though at a significantly low weight
  • C – Disturbance in the way in which one’s body weight or shape is experienced, strong influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
  • Restricting type – During last 3 months: individual has not engaged in binge eating / purging or use of laxative, diuretics, or enemas. Weight loss is achieved through dieting, fasting or excessive exercise
  • Binge eating / purging type – During last 3 months: recurrent episodes of binge eating or purging. Main diff b/w this and bulemia: Bulemia pxs don’t restrict calories and aren’t nearly as underweight as anorexia pxs. No fear of gaining weight as seen in anorexia.
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6
Q

Consequences of anorexia

A

Dehydration, hypothermia, bradycardia, hypotension, electrolyte disturbances, amenorrhea

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7
Q

Predictors of poor outcome for anorexia

A

longer duraction of illness, OLDER AGE AT ONSET, prior psychiatric hospitalization, poor pre-morbid adjustment, co-morbid personality disorder.

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8
Q

Medical complications of purging

A

Hypocalcemia, hypokalemia, metabolic alkalosis, ECG changes, fatty degneration of liver, malnutrion, parotid gland enlargement

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9
Q

DSM Criteria for Bulemia (5 things)

A
  • A – Recurrent episodes of binge eating and sensing a lack of control over eating
  • B – Compensatory behaviors to prevent weight gain including vomiting, laxatives, diuretics, fasting, or excessive exercise
  • C – Binging / purging occurs at least twice a week for 3 months
  • D – Self-evaluation is strongly influenced by body shape / weight
  • E – Disturbance does not occur only during episodes of anorexia
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10
Q

Treating eating disorders

A
  • Hospitalization for severe starvation, hypotension, hypothermia, electrolyte imbalance, depression, or suicidal ideation.
  • CBT – emphasizes monitoring food intake, binging / purging, identification of emotions, challenging distorted beliefs about self-image.
  • Interpersonal psychotherapy – effective for bulimia and binge eating disorder due to common interpersonal stressors triggering binging.
  • Maudsley Method – Tx anorexia in girls greater than 18 y/o living at home. Gives parents permission to set reasonable, healthy expectations at each meal
  • Fluoxetine (SSRI) is helpful for anorexia and bulimia
  • TCA’s are contraindicated in pxs w/ anorexia due to risk of cardiac rhythm disturbance
  • Bupropion is contraindicated in pxs w/ anorexia and bulimia due to risk of seizures
  • Atypical antispychotics may tx distorted beliefs about weight
  • Naltrexone (opioid antagonist) and ondansetron (5HT3 receptor antagonist; anti-emetic) are useful for bulimia
  • Both refeeding and return to healthy weight may have antidepressant effects
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11
Q

What is re-feeding syndrome?

A

Sudden shift from fat to carb metabolism and sudden increase in insulin may lead to increased cellular uptake of phosphate as well as a fall in serum phosphate, K, Mg, glucose, and thiamine. May cause respiratory failure, cardiac failure, hypotension, irregular heartbeats, seizures, coma, or sudden death. Avoid by using progressive calorie / electrolyte / vitamin intake.

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12
Q

Diff dx for eating disorders

A

Seizures, tumors, TB, type 1 DM.

All may cause weight loss.

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13
Q

What is a common delusion in eating disorders/

A

That someone is poisoning their food

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14
Q

How is body dysmorphic disorder diff than eating disorders?

A

Body dysmorphic disorder is usually regarding 1 specific part of body, not weight.

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