Eating Disorders Flashcards
Anorexia Nervosa
3 core features
BMI threshold
- Restriction of intake to reduce weight
- Fear of being fat
- Relies on compulsive compensatory behaviors when food cannot be avoided
Consider anorexic if 15% below ideal BMI or BMI <17.5
Name 5 compulsive compensatory behaviors when food cannot be avoided in anorexia nervosa
Self induced vomiting Laxative abuse Excessive exercise Abuse of appetite suppressant Diuretics
Anorexia Nervosa - manifestations
2 physiological protective factors
2 GI sx
2 effects on bone
Physiological protective factors - low BP, low core temp
GI: bloating, constipation (reduced motility)
Osteopenia, osteoporosis but bone density can be reversible
Bulemia Nervosa
3 core symptoms
Duration
- Episodes of binge eating with sense of loss of control
- Dissatisfaction with body shape and weight
- Binge eating followed by compensatory behavior of purging/non-purging type
Must be episodes that occur at least 2x per week for 3 months
Bulemia Nervosa
3 purging behaviours
3 non-purging behaviours
Purging
Self-induced vomiting
Laxative abuse
Diuretic abuse
Non-purging
Excessive exercise
Fasting
Strict diets
Name 6 purging related findings in bulimia nervosa
Mouth sores Pharyngeal trauma Dental caries Hypokalemia Heartburn, chest pain Esophageal rupture
Name 6 other findings in bulimia
Muscle cramps Weakness Bloody diarrhea Irregular periods Fainting, hypotension Swollen parotid glands
Etiology (Eating disorders)
Predisposing factors [3]
Precipitating factors [3]
Predisposing
- Genetic predisposition
- OCD, anxiety, perfectionism
- Life events, traumas
Precipitating factors:
- Puberty
- Dieting, increased exercise
- Stressful life events
Perpetuating factors of eating disorders [3]
Consequences of delayed gastric emptying interpreted as fatness
Narrowing focus on food, obsessionality
Interpersonal relationships eg high EE families
Management Bulimia Nervosa
Name 2 first line approaches + 2 adjunct
Describe 2nd line approach [2]
CBT and nutritional support - adjunct: SSRI, SNRI
2nd line:
SSRI or SNRi without CBT
plus nutritional support
Management Anorexia Nervosa
First line approach [4]
Rx [2]
1st line:
Structured eating plan
Plus inpatient admission with oral/parenteral nutrition
Correct fluid depletion and electrolyte imbalances
Assisted feeding may be necessary
Rx fluoxetine (SSRI) or olanzapine
Which piece of legislation can you use to detain patients
Which section would be most likely issued in an emergency department
Mental Health Care Act (Scotland) 2003
Emergency Detention Certificate
What are the requirements for the Detention Certificates? [5]
o Mental disorder likely: 1thumbs up – check
o Treatment required: second finger – gun
o Risk to safety: third finger – rude = risk
o Order necessary and the least restrictive: fourth finger – weakest/least restrictive finger
o Decision making impairment: pinkie promise to make decision to help pt
Types of detention certificates? [4]
o Emergency detention certificate: up to 72h by a registered medical practitioner
o Short term detention certificate: up to 28d by an approved medical practitioner
o Compulsory treatment order: up to 6m by an approved medical practitioner and a mental health officer (MHO)
o Nurse’s holding power: up to 3h to see a doctor
Adults with incapacity act (Scotland) 2000 [3]
- For adults aged 16y/o or over
- who lack capacity to make own healthcare decisions
- due to mental disorder or inability to communicate
