Eating Disorders

Question 1

what is Russels sign?

Answer 1

callouses on knuckles from sticking hands down throat to vomit

Question 2

Treatment of bullemia nervosa?

Answer 2

CBT

Fluoxetine

Question 3

why seizures in bullemia?

Answer 3

electrolyte imbalance

Question 4

Binges followed by regret, preoccupation with food, compensator actions and body image distortion?

Answer 4

bullemia nervosa

Question 5

BMI in anorexia?

Answer 5

less than 17.5

Question 6

main difference between anorexia and bullemia?

Answer 6

weight. anorexia must technically be classified as underweight. Bullemia more aware of their behaviours, anorexia are not

Question 7

self induced weight loss, body image distortion, endocrine disorders, delayed or arrested puberty ?

Answer 7

ANOREXIA

Question 8

signs of anorexia?

Answer 8

cold peripheries, lanugo hair, cold sensitivity, poor sleep, bradycardia, hypotension

Question 9

what BMI constitutes very high risk?

Answer 9

under 13.5

Question 10

what cardiac abnormalities do you get in anorexia?

Answer 10

QT prolongation

Question 11

General management of anorexia?

Answer 11

education, monitoring, dietician input, CBT, family therapy

Question 12

when do you use anti depressants anorexia?

Answer 12

those who have co morbid illness

Question 13

Difference between binge eating disorder and bullemia?

Answer 13

no compensation to counter the binges and body shape and weight less important

Question 14

most things are low in anorexia. which levels are high?

Answer 14

G’s andC’s raised:growth hormone,glucose, salivaryglands,cortisol,cholesterol,carotinaemia

Question 15

examples of TCAs?

Answer 15

amytryptyline, nortryptyline, lofepramine

Question 16

what is their mode of action?

Answer 16

they primarily block the reuptake of noradrenaline and serotonin from the synapse by blocking their transporters

Question 17

why do you get side effects from TCAs?

Answer 17

they antagonise dopamine, histamine and muscarinic acetyl choline receptors

Question 18

when would you use a TCA?

Answer 18

they are usually second line to SSRIs

Question 19

ability to drive and operate machinery with TCA?

Answer 19

t for tired

they are a strong sedative. This may affect ability to drive or operate heavy machinery

Question 20

what is worse to over dose on? SSRI or TCA?

Answer 20

TCA

Question 21

when would a TCA be avoided ?

Answer 21

if recent MI or history of arrhythmia

Question 22

effect of TCA on anxiety?

Answer 22

tackles anxiety

Question 23

side effects of TCAs?

Answer 23

sedation and weight gain

Question 24

remember they block Acetylcholine, side effects due to this?

Answer 24

dry mouth, constipation, blurred vision, urinary retention, sexual dysfunction

Question 25

what are SNRIs?

Answer 25

serotonin and noradrenaline reuptake inhibitors

Question 26

examples of SNRIs?

Answer 26

venlafaxine and duloxetine

Question 27

method of action of SNRI?

Answer 27

block serotonin and noradrenaline reuptake

Question 28

side effects of SNRIs?

Answer 28

GI upset

hypertension, palpitations, diziness

Question 29

mirtazipine - what drug class?

Answer 29

NASSA

Question 30

mechanism of NASSA?

Answer 30

antagonizes presynaptic noradrenaline, serotonin and histamine receptors

Question 31

when would you use mirtazipine?

Answer 31

weight loss and sleep issues

Question 32

what type of drug is phenelzine?

Answer 32

MAOI

Question 33

is phenelzine reversible?

Answer 33

no

Question 34

reversible MAOI?

Answer 34

moclobemide

Question 35

when would you use MAOI?

Answer 35

atypical depression

Question 36

side effects ?

Answer 36

diziness, postural hypotension, anticholinergic effects

Question 37

if you are starting a MAOI, what do you need to do about SSRI/SNRI?

Answer 37

need to stop these first as SSRI/SNRI interacts with MAOI