Eating disorders

Question 1

What are the symptoms of anorexia nervosa?

Answer 1

Weight loss is an over valued idea
Compulsive need to control eating and body shape

Low BMI, fatigue, dizziness, constipation, fullness, amenorhhoea, long QT, arrhythmias, dental problems

Question 2

How is anorexia diagnosed?

Answer 2

Weight <85% of predicted or less than 17.5
Fear of gaining weight/becoming fat
Feeling fat when thin

Question 3

What blood changes are seen in anorexia?

Answer 3

Low WCC, anaemia, platelets
Low/high glucose

Low K, phosphate
High bicarbonate

High LFTs, T3/4
Low TSH, LH, oestrogen

Poor renal function, osteoporosis

Question 4

How is anorexia treated?

Answer 4

Eating disorder unit
Refeeding
CBT
Olanzapine, fluoxetine

Question 5

What are the causes of death in anorexia?

Answer 5

Suicide
Cardiac - long QT and low K
Renal

Question 6

What is refeeding syndrome?

Answer 6

Potentially fatal

Low phosphate due to rapid initiation of food after 10 days of malnutrition

Question 7

What are the signs of refeeding syndrome?

Answer 7

Rhabdo
Resp/cardiac failure 
Low BP
Arrythmias 
Seizures

Question 8

How is refeeding syndrome managed?

Answer 8

Careful feeding plan
Prescribe thiamine, vit B complex and multivitamin
Monitor phosphate, glucose, K and Mg

Question 9

What is the diagnostic criteria of bulimia?

Answer 9

Recurrent episodes of binge eating
Preoccupation with controling body weigth
Measures teaken to overcome effects of binges - purging, laxatives, starvation, overexercise