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Behavioral Medicine > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

With eating disorders… when in doubt, do what?

A

REFER TO A SPECIALIST

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2
Q

What is SCOFF?

A

do you make yourself SICK

have you lost CONTROL

have you lost more the ONE stone… 14lbs

do you believe to be FAT

does FOOD dominate your life?

2+ = positive screen

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3
Q

What is the most serious eating disorder and what are the three main signs of this disorder?

A

Anorexia Nervosa

Low body weight
Restricting Calories
Intense fear of gaining wt

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4
Q

Mackenzie loves ortho…. what ortho concern do you need to have with patients who appear to have an eating disorder

A

> 90% of A.N patients have osteoporosis… it is a massive issue so SCREEN FOR STRESS FRACTURES

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5
Q

What is the first line treatment for eating disorders…. think carefully FIRST LINE BEST TREATMENT?

A

Psychotherapy

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6
Q

What is the first line medication for A.N.?

A

Fluoxetine- Prozac

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7
Q

When would you give adjunctive therapy to A.N. patients?

A

if they suffer from depression, anxiety or bipolar disorder.

Can treat what is around the E.D.

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8
Q

SSRI’s can help what two qualities in A.N patients?

A

depressive symptoms and ritualistic behaviors

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9
Q

Low dose atypical antipsychotics can be used for what kind of characteristics in A.N. patients?

A

severely obsessional or severely agitated patients

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10
Q

What drug should you avoid giving to patients with an eating disorder due to the increased risk of addiction?

A

benzodiazepines

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11
Q

What SSRI has the longest half life and the least amount of withdrawal symptoms?

A

Fluoxetine | Prozac

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12
Q

What SSRI has the shortest half life and many withdrawn side effects?

A

Peroxytine | Paxil

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13
Q

What drug can cause jitteriness, sleep disturbances, and with breast feeding the infants appetite may be supressed

A

Prozac

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14
Q

What SSRI should you use for a pregnant woman?

A

Zoloft

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15
Q

What SSRI should be avoided in anorexic patients due to the potential that they might already have QTC prolongation?

A

Citalapram- Celexa

Escitalapram- Lexapro

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16
Q

What SSRI should not be used in pregnant women and also contributes to dry mouth, constipation, and sexual dysfunction

A

Peroxytine - Paxil

17
Q

How many episodes and over how many months do bulimia nervosa patients have to have bulimia nervosa acts to be considered to have the disorder?

A

at least once a week for 3 month

18
Q

Is suicide risk higher in patients with anorexia or bulimia?

A

bulimia

19
Q

what are some signs on physical exam that a patient may have B.N.?

A

chronic vomiting causes:
- Perimyololysis - dental erosions

  • parotid glad enlargement
  • oral/pharyngeal damage
  • gastric tears
  • electolyte embalance K+
  • laxative abuse
  • dehydration
  • alternating constipation and diarrhea
20
Q

What is the first line medication for bulimia nervosa?

A

Fluoxetine

21
Q

What is second and third line treatments for B.N and the problems with the 3rd line txs.?

A

Second: any SSRI

Third: (3 T’s)

  • TCA - easy to OD
  • TOPAMAX - wt. loss
  • TRAZADONE-sedating
22
Q

What specific drug is contraindicated in all eating disorders due to eating disorder patients already having a decreased sz threshold?

A

Buproprion/Wellbutrin

23
Q

Does binge eating have fasting and purging episodes?

A

No!

anorexia and bulimia always trump the diagnosis of binge eating.

Binge eating is eating excessive amounts of food esp. to the point of shame and being uncomfortable

24
Q

What comorbidities are likely to develop with binge eating disorder?

A 
Chronic Pain
Diabetes
Hypertension
Obesity
OTHER MENTAL ILLNESS
25
Q

What medication should be initially prescribed to help with binge eating disorder?

A

Prozac

26
Q

If the first line medication for binge eating disorder fails then what should you prescribe? (2)

A

Anti-epileptic- topiramte/topamax

stimulant- lisdexamfetamine/vivance

27
Q

Why might you shy away from using topamax in an ED patient, but what ED could it be used in?

A

Topamax can cause weight loss but is indicated for binge eating disorder after prozac fails

28
Q

How does the stimulant vivance (sp?) help treat binge eating disorder?

A

surpasses appetite

29
Q

What is the hallmark feature in refeeding syndrome?

A

Hypophosphatemia

30
Q

What is directly related to the risk of developing refeeding syndrome?

A

amount of weight lost in the current episode

31
Q

How do you avoid refeeding syndrome?

A

judiciously limit calorie and fluid intake and monitor patient for the first few weeks during refeed

Behavioral Medicine (9 decks)

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