Eating Disorders Flashcards
What is the most fatal of all mental illnesses
Anorexia Nervosa
What is the ICD-10 F50.0?
Anorexia Nervosa
Who is Anorexia more common in male or female
Female
9:1
Causes of anorexia
Genetic predisposition OCD Anxiety disorders Perfectionism Life events Life traumas Perpetuating consequences of starvation and of avoidance
Precipitating factors for anorexia
Puberty
dieting or even non-deliberate weight loss
Increased exercise
Stressful life event
Which BMI is diagnostic of anorexia
<17.5
Which questionnaire can be used to screen for anorexia
SCOFF
What does the SCOFF questionnaire include?
Do you make yourself sick because you feel uncomfortably full?
Do you worry about losing control over how much you eat?
Have you recently lost more than one stone in a 3 months period?
Do you believe yourself to be fat when others say you are too thin?
Would you say that food dominates your life?
Which SCOFF score indicates anorexia nervosa
> 2
Psychological interventions for anorexia
CBT
Family therapy
IPT
Who should be contacted when re-feeding a pateent
Dieticians
Complications of an NG tube
Aspiration (so need to have initial x-ray)
Nasal trauma
Signs of bulimia
Russel sign
Lanugo sign
Dental problems (teeth enamel)
Swollen parotid glands
Complications of re-feeding someone too quickly
Arrhythmias
Seizures
Cardiac arrest
What type of typical pattern does bulimia follow
Binging
Purging
Clinical features of anorexia
Restriction of intake to lose weight Fears of weight gain Over-exercising Weight loss becoming an overvalued idea Disturbance of body image
What are the 2 subtypes of anorexia nervosa
Restrictive type
Bing eating/purging type
Which other psychological condition is typically associated with AN
OCD
Pharmacological treatments for Anorexia
Olenzapine (anti-psychotic)
Fluoxetine (SSRI)
Describe anorexia bulimia
Episodes of binge eating
With sense of loss of control
Followed by compensatory behaviour
What 2 types of compensatory behaviour are there in bulimia
Purging type
Non-purging type
Describe purging type compensatory behaviour in bulimia
Self-induced vomiting Laxative abuse
Diuretic abuse
Describe non-purging type behaviour in bulimia
Excessive exercising
Fasting
Strict diets
Why are urgent situations in bulimia usually less severe than in anorexia nervosa
As patients are often a more healthy weight
What is Russells sign
Calluses over the back of the hand due to repeated self-induced vomiting over long periods of time
Psychological therapy of bulimia
IPT
CBT
Pharmacological Rx of bulimia
Fluoxetine
Sertraline
Generally SSRI
Who is more affected in bulimia M or F
F
9:1
Aetiology of bulimia
FH/Genetic Perfectionism Personality Adverse life event Past dieting Anorexia nervosa Depression Low self esteem
Under which act do patients with eating dirsoders sometimes need to be detained under
Mental Health Act
What are the physiological effects of anorexia on the body
Hypokalaemia can lead to cardiac arrhythmias Decreased WCC Decreased RBC - anaemia Decreased electrolytes (decreased K+, Na+, phosphate, magnesium) Decreased creatinine - muscle weakness Bradycardia Hypotension Osteoporosis
Describe pathology of re-feeding syndrome
Someone is re-fed too quickly
Insulin is released
This causes cells to uptake already low levels of potassium, magnesium and phosphate
Leads to dangerously low serum levels
Can lead to cardiac arrhythmias and even death
