eating disorders Flashcards
what is anorexia nervosa
morbid fear of fatness, distorted body image, amenorrhoea, weight loss
diagnostic criteria anorexia
BMI
associated clinical features anorexia
preoccupation with food, self conscious about eating in public, vigorous exercise, constipation, cold intolerance, depressive and OCD
physical signs anorexia
dental cavies, hypotension, QT prolonged, arrhythmias, prolonged GI transit, fine lanugo hair on face and trunk, anaemia and leucopenia, hypo- kalamaemia natraemia glycaemia thermia thyroid.
what are the signs from repeated vomiting
hypokalaemia, alkalosis, pitted teeth, parotid swelling, scarring of dorsum of the hand- Russells sign, oesophageal erosions
why do you get amenorrhoea from anorexia
low levels LH and FSH despite low levels oestrogen
common psych symptoms in anorexia
memory and concentration problems, irritable, low self esteem, loss appetite, insomnia, social withdrawal
differentials anorexia
physical disease, brain tumours, GI eg crohns, loss of appetite, depression
management
family interventions, CBT, family therapy, interpersonal psychotherapy. fluoxetine, TCAs, education
when will admission to hospital be necessary
severe or rapid weight loss BMI, severe electrolyte imbalance, serious physiological complications, change in mental status, psychosis risk of suicide
what are the risks of refeeding
cardiac compensation- myocardium cant withstand increased metabolic load. bloating, oedema, CCF
what is a long term complication of anorexia nervosa
osteoporosis
what is bulimia nervosa
morbid fear of fatness, craving for food and binge eating, recurrent behaviours to prevent weight gain, preoccupation with body weight and shape
clinical features bulimia
normal or excessive weight, intense self loathing
DDX bulimia
consider anorexia nervosa, affective disorder, obesity
