Eating Disorders Flashcards
List the main features of anorexia nervosa:
Weight loss (or lack of weight gain in context of children) - body weight >15% below normal
- Weight loss is self induced by avoidance of “fattening foods”
- Self perception of being too fat / fear of fatness
- Widespread endocrine disorder involving the hypothalamic-pituitary-gonadal axis
What can happen if a young girl has anorexia prior to pubertal onset?
Breasts will not develop
Amenorrhoea
(in boys genitals will remain juvenile)
Will females who suffer anorexia before puberty, start puberty post recovery?
Yes
Menarche will be delayed
What is the ICD-10 criteria for bulimia nervosa?
- Recurrent episodes of overeating - large amount consumed in short time
- Persistent preoccupation with eating and strong desire/compulsion to eat
- Patient attempts to counteract fattening effects of food
- Self perception of being too fat, with n intrusive fear of fatness
(tend to be underweight)
What mechanisms will someone who suffers from bulimia nervosa use as a way of counteracting their food’s fattening effect
Self induced vomiting
Self induced purging
Alternating periods of starvation
Abuse of laxatives/diuretics etc
What is the DSM V criteria for binge eating disorders (BED)
- Recurrent episodes of binge eating
- A sense of a lack of control over eating during the episode
- Marked distress regarding the binge eating
- Binge eating occurring once a week for 3 months at least
- NOT associated with inappropriate compensatory methods like bulimia nervosa
How are binge eating episodes defined according to the DSM V criteria?
Three or more of the following:
- eating more rapidly than normal
- eating until uncomfortably full
- eating alone out of shame
- feeling disgusted, depressed or guilty post-binge
- eating large amounts of food despite not feeling hungry
List a few clinical signs specifically associated with bulimia nervosa:
Dental caries Russel's sign Enlarged parotid glands Oedema (from laxative/diuretics) Abnormal ECG Cardiomyopathy Tetany Gastric Dilation
List some of the symptoms of bulimia nervosa:
Fatigue Lethargy Feeling bloated Cardiac arrhythmias Constipation Abdo pain Abnormal menstruation
List some of the symptoms commonly seen in anorexia nervosa specifically:
Fatigue Decreased sleep cycle Sensitive to cold Dizziness Fullness after eating very little Dry skin Brittle hair Lanugo hair (fine down)
What are some neurological symptoms associated with anorexia nervosa?
Decreased visio-spatial ability
Decreased visual memory
Increased speed of processing
Peripheral neuropathy
List some of the red flags in anorexia nervosa;
BMI <13 Weight loss >1kg / week Core temp <34 Prolonged QT, HR <40 Systolic BP <80 Cognitive impairment Inability to rise from squat without using arms
What investigations should be done for patients with eating disorders:
ECG Us and Es WCC (low) Iron levels, LFTs - ALT and GGT will be deranged if liver breakdown is occurring DXA scan
What changes can occur to the brain when starved?
- Loss fo grey and white matter
- Increased compulsive behaviour
- Reduced social skills
- New learning is stunted
- Poor concentration and decision making
- Enhanced response to hedonic and nutrostat signals
What is refeeding syndrome?
A potentially fatal condition caused by rapid initiation of food after >10 days of undernutrition.
