Eating Disorders Flashcards
Risk factors
Family hx, social stressors (changing schools), females, middle to upper classes, 15-16 y/o
Anorexia diagnostic criteria
BMI <17.5 (or 85% of expected weight) Fear of gaining weight Body dysmorphia Amenorrhoea Delayed puberty
Endocrine complications of anorexia
High cortisol Low gonadotrophins, oestrogen, testosterone
Metabolic complications of anorexia
Hypoglycaemia Hypokalaemia, natramia, calcaemia Hypercholesterolaemia
Neurological complications of anorexia
Enlarged ventricles, seizures, peripheral neuropathy, autonomic dysfunction
Other complications (hair, skin, bones) of anorexia
Lanugo hairs Hypothermia Dry skin Osteoporosis
SCOFF questionnaire
Do you make yourself Sick Worry about losing Control over food One stone weight loss in 3 months Do you think you’re Fat Does Food dominate your life? Sick Control One-stone Fat Food
Management of anorexia
MANTRA - mix of psychological therapies MARSIPAN guidelines
Risk factors for bulimia
Obesity Earlier episode of anorexia Psych disorders
ICD 10 diagnosis of bulimia
BMI >17.5 Prolonged fasting, excessive exercise, vomiting, laxative or diuretic misuse
Management of bulimia
Family therapy best for children, CBT for adults SSRI - fluoxetine
Indications for urgent admission to hospital for anorexia
Low weight (85% or less of expected weight and/or less than the third percentile for BMI) Lack of any weight gain Significant oedema Severe electrolyte imbalance (life-threatening risks created by sodium and potassium derangements), Cardiac disturbances or other acute medical disorders Altered mental status or other signs of severe malnutrition Orthostatic differential greater than 30/min Temperature less than 36°C Pulse below 45 beats per minute Psychosis or a high risk of suicide
Sit up and squat stand test
Used to assess patients with anorexia 0 = unable 1 = uses arms 2 = significant difficulty 3 = some difficulty 4 = easily
Anorexia blood test results
•Hypokalaemia •Low FSH, LH, oestrogens and testosterone •Raised cortisol and growth hormone •Impaired glucose tolerance •Hypercholesterolaemia •Hypercarotinaemia •Low T3
