Eating disorders Flashcards
are women or men more likely to have eating disorder
women
which age group of people are most likely to get eating disorders
teenagers/young adults
what chronic medical condition is a risk factor for developing an eating disorder
why
type 1 diabetes
deliberate poor adherence of insulin
which personality disorder is associated with bulimia
impulsive personality disorder
which personality disorder is associated with anorexia
obsessive compulsive personality disorder
also OCD (diff things though)
if someone with an eating disorder is acutely unwell, what is the treatment
acute admission (can use mental health act if incapacity and emergency)
renutrition - weight gain via oral nutrition support/NG tube
why is an NG tube used rather than parenteral nutrition in eating disorders
gut works fine
complications of renutrition in eating disorders
refeeding syndrome
chronic treatment of someone with an eating disorder
CBT
family therapy (for teens)
dietician
if onset of eating disorder is after puberty, what is the prognosis like
poorer
criteria of anorexia (5)
BMI <17.5 deliberate self induced weight loss body image disturbance fear of fatness amenorrhoea - cessation/abnormal periods
what type of hallucinations do people with anorexia get
auditory hallucinations - ‘youre fat’
why do people with anorexia drink lots of water
to compensate for hunger
is there a loss of interest in food in anorexia
no - often preoccupied by it, wont eat fattening foods
which haematological problem is strongly associated with anorexia
anaemia
why do people have poor dental hygiene in eating disorders
self induced vomiting
russells sign
calluses over knuckles from self induced vomiting
heart problems in anorexia
prolonged QT
bradycardia (hr <40)
systolic BP <80
squat test in anorexia
unable to stand up from a squatting position without using hands
inpatient weight criteria for anorexia
BMI <13
or >1kg/week weight loss
investigation
SCOFF questionnaire
sick - ever make yourself sick after food
control - loss of
one stone - every lost >1 stone in 3 months
fat - do you thin youre fat
food - does food dominate your life
what MSK problem are anorexics at higher risk of
osteoporosis and fractures
what potassium electrolyte problem is common in anorexia
hypokalaemia
hypoglycaemia or hyperglycaemia in anorexia
hypoglycaemia
after treatment, what is the relapse rate of anorexia
25%
is bulimia or anorexia more common
bulimia
compensatory methods after a binge (4)
self induced vomiting
laxatives/diuretics
excessive exercise
fasting
how does bulimia differ from anorexia
binges x2 per week for >3 months
in bulimia is there usually endocrine abnormalities
no - they are still eating, just bingeing on top (no starvation)
more significant in anorexia
which drug can reduced cravings to binge
SSRIs
what arterial blood gas (ABG) may someone with bulimia present with
metabolic alkalosis - from vomiting (losing stomach acid = alkalosis)
