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Clinical Disciplines (Melicia) > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is Pica?

A

persistent eating of nonnutritive, nonfood substances over a period of at least one month

(i.e. eating dirt)

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2
Q

Risk factors for Pica?

A

parent-child psychopathology, environmental deprivation, pregnancy, epilepsy, brain damage, intellectual disability

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3
Q

At what age does pica become developmentally inappropriate?

A

in those over 24 months

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4
Q

what are some signs/sxs of pica?

A

ascariasis, mechanical bowel obstruction/perforations, dental problems

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5
Q

Pica tx

A

generally goes away on its own in children

psychosocial interventions

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6
Q

What is avoidant/restrictive food intake disorder?

A

An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by not meeting nutritional needs

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7
Q

When does ARFID typically develop? What are some characterisitics?

A

infancy/childhood and continue into adult

young infants may be sleepy/agitated to feed

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8
Q

ARFID tx?

A

re-feeding and behavioral interventions

cognitive behavioral therapy

exposure therapy

(no med therapy)

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9
Q

Describe anorexia nervosa

A

life threatening eating disorder characterized by inability to maintain a normal weight, fear of weight gain

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10
Q

How do we rate the severity of anorexia nervosa?

A

based on BMI

mild: BMI >17
moderate: BMI 16-16.99
severe: BMI 15-15.99
extreme: BMI <15

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11
Q

What are the 2 subtypes of anorexia nervosa?

A

restricting type

binge-eating/purging type

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12
Q

Complications of anorexia nervosa?

A

dif to resolve, CV complications, endocrine/metabolic, GI, neuro, integumentary, renal

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13
Q

Who is at higher risk for anorexia nervosa?

A

females > men

dancers, runners, skater, models etc.

occurs in both young and old

gay/bisexual males

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14
Q

What screening tools are available for anorexia nervosa?

A

SCOFF questionnaire

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15
Q

Anorexia Nervosa PE

A

may have obvious emaciation, may hide under bulky clothing

hair and nails become dry and brittle

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16
Q

Anorexia nervosa tx

A

dif. to treat due to denial/lack of insight

directed at correcting/preventing disease complications

re-establish normal eating pattern

hospital admission often necessary

psychological therapy

vitamine supplementation- Ca

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17
Q

What types of psychological therapy are available for anorexia nervosa pts?

A

individual therapy, cognitive (analytic) therapy, cognitive behavioral therapy, interpersonal therapy, group therapy, family based therapy

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18
Q

Anorexia nervosa prognosis?

A

Guarded

morbidity rates 10-20%

50% make full recovery, other 50% (20% remain emaciated, 25% thin, 10% overweight or die of starvation)

19
Q

What is bulimia nervosa?

A

potentially life threatening, cycles of binge eating and compensatory behaviors to undo binge

20
Q

What is binge eating

A

eating in a discrete period of time an amt of food larger than what most ppl would eat

sense of lack of control over eating during episode

21
Q

mild bulimia

A

1-3 episodes of inappropriate compensatory behaviors/wk

22
Q

Moderate bulimia

A

4-7 episodes of inappropriate compensatory behaviors/wk

23
Q

Severe bulimia

A

8-13 episodes of inappropriate compensatory behaviors/wk

24
Q

extreme bulimia

A

> 14 episodes of inappropriate compensatory behaviors/wk

25
Q

In which populations is bulimia nervosa most common?

A

in those where weight gain/weight loss rapidly is required

i.e. wrestlers, competitive body builders

26
Q

At which age does bulimia typically onset?

A

~19

27
Q

What is the female athlete triad?

A

eating disorder + hypothalamic amennorhea + osteoporosis

28
Q

What screening tools are available for bulimia?

A

SCOFF questionnaire, eating disorder screen for primary care (ESP)

29
Q

Warning signs of bulimia nervosa

A

disappearance of large amt of food in short period, discarded food wrapper/containers, freq. trips to bathroom after meals, presence of laxatives or diuretics

unusual jaw pain/cheek swelling, calluses on backs of hands and knuckles from self induced vomiting

30
Q

Bulimia nervosa tx

A

best: intensive outpt treatment 40hrs/wk 5 days a wk

group psychotherapy

nutritional counseling

antidepressants

31
Q

Hospitalization is not required for bulimia nervosa unless…

A

major electrolyte disturbances,

SI or attempt

no response to outpt tx

32
Q

Which drug is associated with increased incidence of seizures in bulimia pts?

A

Buproprion

33
Q

Which drug may decrease the binge-purge cycle in bulimia?

A

Topiramate (Topamax)

34
Q

What is binge eating disorder?

A

recurrent episodes of binge eating

35
Q

Binge eating disorder: epidemiology

A

mostly over weight/obese females

36
Q

binge eating disorder may be a…

A

familial disorder

37
Q

Why do ppl binge?

A

maladaptive coping skill

use food to numb/protect against emotions

attempt to fill an emotional void

form of self-punishment

BUT can intensify all feelings the person is trying to cover up

38
Q

What are some health consequences of binge eating?

A

increased psychopathology

HTN, DM, dyslipidemia

moderate obesity develops after about 5 yrs

39
Q

tx for binge eating disorder

A

psychotherapy

nutritional counseling

SSRI and venlafaxine (SNRI): reduces binge freq.

Topiramate

40
Q

Eating disorders in males

A

less likely to be dx

41
Q

What labs should you order when you suspect an eating disorder?

A

CBC (anemia/immune suppression)

CMP 
LFT
Cr, BUN 
Lipid panel 
Thyroid func. 
Hormones 
ECG
42
Q

What is included in acute tx of all eating disorders

A

nutritional and fluid/electrolyte stabilization

  • break binge-purge cycle in bulimia
  • correct starvation state in anorexia

weight gain of 0.16g/day considered safe

43
Q

What is considered severe malnutrition?

A

weight <75% ideal body weight

Clinical Disciplines (Melicia) (9 decks)

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