Eating Disorders Flashcards
what is the ICD-10 diagnostic criteria for anorexia nervosa?
BMI 17.5 or less self-induced weight loss body image disturbance fear of fatness amenorrhoea
what would you see upon physical examination in anorexia nervosa?
muscle wasting, hair loss lanugo hair cold, blue peripheries dry skin hypercarotenaemia bradycardia, hypotension bruising
what other medical conditions may you see alongside AN?
depression
OCD
substance misuse
diabetes mellitus
which BMI and weight loss rate puts someone with AN in high risk category?
BMI <13
weight loss >1kg/week
what cardiac problems puts someone with AN in high risk category?
prolonged QT
HR <40
systolic BP <80
what core temperature puts someone with AN in high risk category?
<34
what movement puts someone with AN in high risk category?
unable to rise from squat without using arms for leverage
cognitive impairment is not a sign of high risk AN - true or false?
false
what investigations should take place in AN?
haematology
biochemistry
ECG
DXA
what blood results would indicate AN?
GGT - 485
ALT - 442
protein - 56
albumin - 34
what is refeeding syndrome?
caused by depletion of already inadequate stores of nutrients eg magnesium, potassium, phosphate which are quickly used up as body starts to repair itself
how do you prevent refeeding syndrome?
frequent blood monitoring and slow pace of initial refeeding
what blood results would indicate refeeding syndrome?
ALT - 208 albumin - 27 phosphate - 0.66 magnesium - 0.68 Hb - 96
what does MARSIPAN stand for?
management of really sick patients with anorexia nervosa
what physiological management methods could be used for AN?
therapies - CBT dietician medical monitoring art therapy / drama therapy family therapy inpatient treatment for high risk
