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Psychiatry > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is anoreixa nervosa

A 
Restriction of food intake + 
Compulsive compensatory behaviour + 
BMI <17.5 or 15% below ideal weight  + 
Low self target weight + 
Fear of weight gain +

Used to need widespread endocrine disorder but no longer part of criteria

  • Amenorrhoea in F
  • Loss of sexual interest in M
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2
Q

What are compensatory behaviours in anorexia

A

Self-induced vomiting
Laxative / diuretics / appetite suppressant
Excessive exercise

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3
Q

What are other symptoms of anorexia

A 
Absence of menstrual cycle
Late menarche
Absence of 2 sexual characterisitcs
Delayed puberty 
Short stature
Languo hair growth
Cold intolerance
Blue hands and feet
Low BP
Bradycardia
Fainting
Bloating / constipation 
Dry. skin 
Early satiety
Enlarged salivary glands 
Weakness
Fatique
Hypothyroid 
Osteopenia / osteoporosis - bone density scan
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4
Q

What causes Brady and low BP

A

Heart slows and peripherally shut down

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5
Q

What do you do due to risk of osteoporosis

A

Bone density scan

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6
Q

What is it called if normal BMI but anorexic symptoms

A

Bulimia + anorexic drive

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7
Q

What is it called if low BMI but bulimic symptoms

A

Anorexia + bulimia sub type

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8
Q

What is atypical anorexia

A

Don’t meet full criteria

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9
Q

Are symptoms reversible

A

Yes with good nutrition

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10
Q

What questionnaire

A

SCOFF

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11
Q

How do you assess

A

Nutrition
BMI
Bloods - electrolytes

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12
Q

What are physiological consequences

A 
Hypokalaemia - risk of arrhythmia 
Low FSH and LH
Low oestrogen and testosterone 
Hypothyroid
Hypothermia 
Raised cortisol 
Raised GH
Raised glucose/ imapired
Raised cholesterol / carton
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13
Q

Summarisie physioogical

A

Most low

G+C up - glucose / GH / glands / cortisol / cholesterol

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14
Q

If someone presents to ED what may they have

A

Hypokalaemia
Do ECG
ABG - alkalosis + low Cl due to vomit
- Can cause palpitation

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15
Q

What is Bulimia Nervosa

A

Episodes of binge eating with a sense of loss of control +
Compensatory behaviour / purging
2x a week for 3 months

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16
Q

What are compensatory measures

A 
Vomiting
Laxatives
Diuretics
Metformin
Thyroxine as increase HR
Aphetamine - appetite suppressant and increase HR
Refusing insulin
Exercise
Fasting / strict diet
17
Q

What is it called when refusing insulin

A

Dibulimia

18
Q

What are dibulimics at risk of

A

Early diabetic complications

19
Q

What do people with Bulimia often have

A

Normal BMI

20
Q

What are other symptoms of bulimia

A 
Mouth sores
Pharyngeal trauma
Dental 
Heartburn 
Oesophageal rupture
Red knuckes = Russel signs 
Muscle cramps
Weakness
Bloody diarrhoea
Irregular period / amenorrhoea despite normal BMI 
Swollen salivary gland 
Impulsivity
Akalosis on bloods 
Hypokalaemia
21
Q

Dx of swollen salivary

A

Mumps

22
Q

What is binge eating disorder

A

Binge eating
Absence of burning
Ongoing and repetitive

23
Q

What is eating behaviour associated with binge

A

Fasting eating alone
Large amounts
Uncomfortably full
Get buzz then shame

24
Q

How do you treat binge

A

Outpatient CBT / group

Psychoeducation

25
Q

What is symptomatic Rx

A

PPI / H2

Laxative

26
Q

What other behaviour associated with eating disorder apart from avoid calories and getting rid

A 
Body checking
Pro-ana website
Compete lower target
Self harm
Personality disorder
OCD
Anxiety
27
Q

What are physical consequences

A 
Biochemical disruption 
K = important 
Seizures / arrythmia
Malnutrition
Hypoglycaemia
Heart damage
Fertility
Anaemia
Bone loss
Poor immune
Puberty delayed
Brain growth delayed 
Suicide
28
Q

What is patient at risk of with Rx

A

Refeeding Sx

29
Q

What are psychological consequences

A 
Over-valuation 
Narrow interest
Depression
Anxiety
OCD
Poor concentration
30
Q

Social consequences

A

Wtihdrawal

Isolation

31
Q

What causes / precipitates

A 
Genetic predisposition 
Personality - high achieving / OCD / anxious 
Biological - altered 5HT 
Puberty 
Diet
Increased exercise
Stesss
Social pressure
32
Q

What perpetuates

A

Delayed gastric emptying so feel full and think fat
Narrowing focus
High obsession
High EE

33
Q

How do you treat bulimia

A

REFER
CPT / IPT / family = 1st line
SSRI - Fluoxetine for obsessional thoughts

34
Q

What is important to do

A

Monitor electrolyte

K supplement

35
Q

How do you treat anorexia

A 
Family = 1st line in<21
CBT / IPT = 1st line in adult 
Nutritional supplements - vit B / thiamine / calcichew
Be careful of re-feeding
Daily blood + ECG monitoring
36
Q

What psychiatric meds

A

Anti-Depressant if low mood - SSRI

Olanzaprine to reduce anxiety and obsession - stimulate appetite and weight gain

Psychiatry (11 decks)

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