Eating Disorders Flashcards
to have AN you have to have a BMI of ___
17.5 or less
diagnostic features of AN?
self induced weight loss
body image disturbance
fear of fatness eg weighing themselves
amenorrhea
how do patients with AN try to induce their weight loss?
strict dieting eg weighing food
vomiting
excessive exercise
medication eg laxitives/slimming pills
physical signs of AN?
muscle wasting hair loss lanugo hair cold/blue peripheries dry skin hypercarotenaemia bradycardia hypotension bruising
psychological comorbidities of AN?
depression
OCD
substance misuse
diabetes eg not taking insulin
substance misuse is more common in anorexia/bulimia?
bulimia
patients with a BMI under __ should be managed as inpatients?
13
when would you admit a patient who has a normal BMI
if theyre losing weight rapidly eg 1kg a week
cardiac complications of AN?
long QT
hypotension
a patient with a core temperature of __ should be managed as an inpatient
34
what movement test can be done to look for anorexia?
lie down and sit up without using your hands
squat-stand test without using hands
investigations for AN?
FBC - WCC low
biochem - U+Es, K+ (vomiting?), Na (if waterloading), LFTs
ECG- bradycardia
DXA- osteoporosis?
why do patients with AN drink alot of water?
to make them look heavier
to curb hunger pangs
what is broken down first and last when you starve?
use up spare fat stores then muscle then organs of your body for nutrients
osteoporosis is common in AN T or F
F, usually osteopenia
what sports should be avoided in young patients with or who have recovered from AN; why is this?
traumatic sports eg skiing, horseriding
their bone density won’t go back to normal as they’ve missed the crucial period for growth
patients will deteriorate when first refed T or F
T
what is refeeding syndrome?
depletion of inadequate stores of nutrients which are quickly used up s the body starts to repair itself
how should you monitor refeeding syndrome?
monitor with regular bloods
ion levels will be __ in refeeding syndrome
low
how are patients with AN fed as an inpatient?
NG tube
psychological Tx of AN?
CBT
dietician
medical monitoring
art/drama/family therapy
what therapy has proven to be the best therapy for adolescents?
family therapy
diagnostic features of bulimia
persistent preoccupation with eating irresistable craving for food binges attempts to counter binges morbid dread of fatness
how can patients with bulimia counter their binges?
starvation
vomiting
laxatives
drug misuse
physical signs of bulimia?
calluses on knuckles from putting fingers down their throats
parotid hypertrophy
dental caries
bad dentition
comorbidities of bulimia?
depression
self harm
substance misuse
impulsive rather than obsessional personality
complications of bulimia?
oesophageal reflux mallory-weiss tear hypokalaemia subconjunctival haemorrhage dehydration seizures
main electrolyte disturbance in bulimia?
hypokalaemia
Tx of bulimia?
guided self help
CBT
SSRI
there is loss of interest in food in AN T or F
F, they still have interest in food but dont eat because they have a morbid dread of food
male equivalent of amenorrhea as a category in ICD 10?
sexual dysfunction
