Eating disorders

Question 1

BMI of someone with anorexia nervosa

Answer 1

BMI<17.5

Question 2

Features of anorexia nervosa

Answer 2

Amenorrhoea in females 
Muscle wasting 
Hair loss 
Lanugo hair 
cold peripheries 
dry skin 
bruising 
bradycardia and hypotension 
hypercarotonaemia

Question 3

high risk anorexia nervosa

Answer 3

BMI<13 
prolonged QT interval 
unable to rise from squat 
cognitive impairment 
temperature <34

Question 4

Investigations in anorexia nervosa

Answer 4

BMI 
FBC, TFT, U+E, LFTs, ESR, glucose
ECG 
muscle power 
DEXA scan

Question 5

Management of anorexia nervosa

Answer 5

CBT-ED, MANTRA, SSCM
dietician
medical monitoring
inpatient if high risk

Question 6

What are patients with anorexia nervosa at risk of in treatment (metabolically)

Answer 6

Refeeding syndrome - hypophosphataemia

Question 7

What is bulimia nervosa

Answer 7

Binging and purging

Question 8

Signs of bulimia nervosa

Answer 8

Russell’s sign - calluses on knuckles
Parotid hypertrophy
Dental caries
Abnormal U+Es

Question 9

Medical complications of bulimia nervosa

Answer 9

Oesophageal rupture 
Mallory Weiss tear 
hypokalaemia 
dehydration 
subconjunctival haemorrhage 
seizures

Question 10

Management of bulimia nervosa

Answer 10

guided self help
CBT
SSRI
Dental hygiene

Question 11

biochemical features of anorexia nervosa

^ C+G

Answer 11

low: K+, LH + FSH, glucose
high: cortisol, GH, cholesterol, QT interval

Question 12

criteria for anorexia nervosa

Answer 12

body weight maintained at least 15% below what is expected