Eating disorders

Question 1

whats more common, anorexia or bulimia?

Answer 1

anorexia

Question 2

how common is anorexia in females?

Answer 2

1 in 250

Question 3

ICD-10 criteria for anorexia nervosa?

Answer 3

1. dread of fatness = intrusive overvalued idea
2. deliberately keeping weight below 85%
3. endocrine effects
4. BMI <17.5

Question 4

dread fatness in anorexia is a what

Answer 4

intrusive overvalued idea

Question 5

2. deliberately keeping weight below 85%

is part of ICD-10 . how could they do this?

Answer 5

restricted diet
excessive exercise
induced vomiting / laxatives

Question 6

3. endocrine effects

is part of ICD-10 . examples?

Answer 6

amenorrhoea

men - less libido / impotence

Question 7

some signs of eating disorder on examination.

Answer 7

russell's sign (knuckles, vomiting)
lanugo hair
dry skin/hair
parotid swelling
oedema of hands, feet
angular stomatitis (iron b12 def)
orange palms
weak proximal muscles

Question 8

how do you test for weak proximal muscles in anorexia?

Answer 8

sit up squat stand test

Question 9

what are the marsipan guidelines?

Answer 9

management of really sick patients of anorexia nervosa
they ASSESS RISK.
RED risk = inpatient
(weight loss per wk etc)

Question 10

what’s in the SCOFF screening?

Answer 10

Sick - make yourself sick?
Control - lost?
One stone - lost in 3 months?
Fat - think you're fat?
Food - dominates your life?

Question 11

what will you be looking out for on U+Es of patient with anorexia?

Answer 11

HYPOKALAEMIA (vomiting/laxatives)

Question 12

U+Es in anorexia will tell you about K and Na. What other electrolytes do you want to test?

Answer 12

Mg, Phos

Question 13

what is the most common cause of death in anorexia?

Answer 13

cardiac arrhythmias

Question 14

anorexia psychological treatment for adults?

Answer 14

CBT-ED

MANTRA

Question 15

what is MANTRA

Answer 15

maudsley anorexia nervosa treatment for adults

Question 16

anorexia psychological treatment for <18s?

Answer 16

family therapy

MDT

Question 17

weight gain aim in inpatient refeeding?

Answer 17

0.5-1 kg per wk

Question 18

weight gain aim in outpatient treatment?

Answer 18

0.5kg per wk

Question 19

why would you treat anorexia as inpatient?

Answer 19

failed outpt, 
refuse oral intake, 
BMI <13.5, 
suicidal, 
ECG changes

Question 20

what % of anorexia patients make full recovery

Answer 20

50%

prognosis worse if alcohol misuse, male, repeateed admissions

Question 21

therapy for bulimia?

Answer 21

Bulimia-focussed guided Self-help programme

Question 22

hyperthyroidism, IBD, malabsorption, CF, cancer, b12 def, coeliac, CF, congenital heart disease, malnutrition, DIABETES,

substance misuse, depression, OCD, delusional beliefs, autistic spectrum disorder (avoidant food refusal)

all differentials for…

Answer 22

eating disorder