Eating Disorders Flashcards

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1
Q

What are some of the symptoms we look for with an eating disorder?

A

body image distortion, fear of being fat, desire to reduce weight, purging, compulsive exercise, poor self-esteem

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2
Q

What is a good tool to screen for anorexia? How does it go?

A

SCOFF Self Test
Do you make yourself Sick? Worry you have lost Control over how much you eat? Recently lOst 14+ lbs within 3 months? Believe you are Fat when others say you’re thin? Would you say that Food dominates your life?

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3
Q

How is anorexia diagnosed based off of DSM-5 criteria?

A

Persistent restriction of energy intake leading to significantly low body weight; behavior that interferes with or fear of weight gain (even though significantly low weight); or disturbance in the way one’s body weight or shape is experienced (thinking they’re fat when they are obviously very thin)

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4
Q

When a patient presents with eating only minimal meals what diagnosis should you keep on your differential?

A

IBS, Upper GI disease, Hyperthyroidism, malignancies, AIDs, psych – anorexia, anxiety, depression

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5
Q

What are the 2 types of anorexics?

A
Binge eating/purging type (unable to refrain from binge eating & purging even with use of laxatives with continued weight loss)
Restrictive type (limit their intake to as little as 300-600 cal/day; limited food selection; OCD symptoms regarding food)
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6
Q

If you have diagnosed a patient with anorexia and they have a BMI of 15-15.99, what level are they?

A

Severe

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7
Q

What’s mild & moderate AN?

A

Mild = >17

Moderate = 16-16.99

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8
Q

If a patient eats an amount of food that is definitely larger than what most individuals eat in the same time period; and the patient absolutely no control over eating during this time period – what is it known as?

A

Binging

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9
Q

If a patient has recurrent incidences of binging and purging in order to prevent weight gain – but they are not underweight - what diagnosis?

A

Bulimia Nervosa

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10
Q

On what criteria would you diagnose BN?

A

Must occur on average 1/week for 3 months

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11
Q

So, what are the categories of BN?

A

Lack of control while eating
Inappropriate compensatory behaviors (vomiting, laxatives, enemas, increased exercise)
Are of a normal weight

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12
Q

If a patient has 4-7 episodes of BN per week, what level are they?

A

Moderate

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13
Q

What is considered mild and severe BN?

A

Mild = 1-3/week

Severe = 8-13/week

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14
Q

What does the female athlete triad consist of?

A

Nutritional (disordered eating); Endocrine; MSK

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15
Q

What are some medical complications you can look for on PE from purging?

A

Russel’s sign (on the knuckles from going in the mouth); tooth erosion; overuse injuries/stress fractures; heart arrhythmias; constipation; and frequent UTI’s

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16
Q

If you are highly suspicious of BN, what tests could you order?

A

Urine (ketones, pH, hydration, specific gravity); Ht & Wt in GOWN; Temp; Orthostatic BP’s; EKG; CBC, CMP, Amylase/Lipase, TSH

17
Q

If an overweight patient is presenting because they are gaining more weight what would you think of on DDx?

A

Pregnancy!; PCOS; Hypothyroidism; Diabetes; Cushing’s; steroid use; CHF; Pituitary

18
Q

If a patient binge eats, but has no compensatory behavior so they then gain weight, what is the diagnosis?

A

Binge Eating Disorder

19
Q

Binge eating episodes are associated with at least 3 of 5 things, what are they?

A

Eating very rapidly
Until uncomfortably full
Eating alone due to embarrassment
Large amounts of food when not hungry
Feeling disgusted with oneself/depressed/guilty afterwards

20
Q

How do we treat eating disorders?

A

Referral to psychotherapy or psychiatrist (who specializes in eating disorders); cognitive behavioral therapy (is the cornerstone of Tx!); family based Tx/Support
Referral to dietician (consider school involvement for accommodations)

21
Q

What medications might help with AN, BN, and Binge Eating?

A

SSRI’s