Eating Disorders Flashcards

1
Q

What group most often gets eating disorders?

A

Young (>22) women

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2
Q

How can we screen for eating disorders?

A

SCOFF questionnaire

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3
Q

What are the questions in the SCOFF questionnaire?

A

2+ yes answers = ED likely:

  • do you make yourself SICK?
  • do you worry you’ve lost CONTROL of how much you eat?
  • have you lost >ONE stone in any 3 months?
  • do you think you’re too FAT when others say you’re too thin?
  • does FOOD dominate your life?
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4
Q

What are the criteria for anorexia nervosa?

A

An obsessive fear of weight gain
+ Restriction of intake
+ Compulsive compensatory behaviours

A BMI <17.5 is also required

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5
Q

What signs can you spot in an anorexic patient?

A

Hypotension, bradycardia & Fainting

Cold intolerance

Constipation & bloating

Delayed puberty, amenorrhoea, impotence &decreased libido

Lanugo hair

Weakness/fatigue

Risk of osteopenia &osteoporosis

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6
Q

What compensatory behaviours are common in AN?

A

Excessive exercise
Vomiting
Drug abuse - Laxatives, diuretics & appetite suppresants

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7
Q

What make’s bulimia different to AN?

A

BN has obsessive fear of fat
+ compensatory mechanisms
+ Binge eating (vs AN’s restriction of intake)

BN can present at any weight

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8
Q

How often do BN suffers binge eat?

A

They must have a binge eating + compensation “Cycle” atleast twice/wk for atleast 3 months to be diagnosed

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9
Q

What signs would suggest BN?

A

Mouth sores, dental caries etc.

Heartburn/chest pain

Impulsive behaviour

Hypotension & fainting

Muscle cramps & weakness

Bloody diarrhoea

Irregular periods

Swollen parotids

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10
Q

Binge Eating Disorder is different to BN, how so?

A

IT involves binge eating but without the purging.

Instead they have cycles of binge eating followed by embarrassment, shame &guilt

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11
Q

What are the common forms of compensatory behaviours in eating disorders?

A

Restrictive - Diets, “allergies”, obsessed with gut symptoms, avoiding social occasions &med abuse

Purging - Vomiting, spitting out, overactivity, cooling, blood letting & med abuse

Others - Body checking, self-harm, competing in thinness, displaying emaciation & seeking out pro-ana sites

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12
Q

We split the aetiology of eating disorders into predisposing, precipitating and perpetuating factors. List some predisposing ones?

A
  • Genetic
  • Perinatal complications
  • Life events/traumas
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13
Q

List some factors that precipitate an eating disorder?

A

Puberty
Dieting/non-deliberate weight loss
Increased exercise
Life events e.g. loss, abuse or moving

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14
Q

What factors will perpetuate an existing eating disorder?

A

As a consequence of starvation syndrome:

  • Delays gastric emptying
  • Narrows focus (avoiding other interests)

Obsessionality (phobia worsens with avoidance)

Families/ clinical staff/ schools

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15
Q

How can we manage someone with an eating disorder?

A

If dangerously thin –> Admit and do re-feeding/dietary support

Otherwise:

  • CBT/IPT
  • Antidepressants
  • Olanzapine
  • Family interventions
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16
Q

Approach to have

A

Diagnose- DO NOT ACCUSE
Remember patients will defend their illness
Need to have patience- often can take 6-7 years to cure anorexia nervosa