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Mental Health > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is the prevalence of anorexia nervosa?

A

10-30 per 100,000

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2
Q

What is the prevalence of bulimia nervosa?

A

50-150 per 100,000

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3
Q

What are the two subtypes of anorexia nervosa?

A

Restrictive type

Binge eating/ purging type

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4
Q

What is the ICD10 diagnostic criteria for anorexia nervosa?

A
  • refusal to maintain or achieve normal body weight BMI < 17.5
  • intense fear of gaining weight or becoming fat
  • body shape disturbance
  • undue influence of weight and shape on self evaluation
  • amenorrhoea (although can still have periods with low BMI)
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5
Q

What are some purging behaviours?

A 
Self induced vomiting (after binges or small amounts of food) 
Laxatives 
Diuretics 
Slimming aids/ fat blockers
Amphetamine like drugs
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6
Q

What are some typical rules associated with anorexia nervosa?

A

Calorie limitation - may start at 1500 then repeatedly revised down
Food groups avoided
Rules around eating e.g less than others, never eat if others don’t, exact times or not at all, not in-front of others

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7
Q

What is the ICD 10 criteria for bulimia nervosa?

A

A. Recurrent episodes of overeating (binges)
B. Persistent preoccupation with eating and a strong desire to eat (cravings)
C. The patient attempts to counteract the fattening effects of food by compensatory behaviours
D. A self perception of being too fat, with an intrusive dread of fatness (usually leading to underweight)

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8
Q

What are the two types of bulimia nervosa?

A

Purging type

Non- purging type

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9
Q

What are the compensatory mechanisms associated with purging in BN?

A

Self induced vomiting and laxative abuse are most common

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10
Q

What are the compensatory mechanisms associated with non purging type of BN?

A

Exercise

Fasting

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11
Q

What’s so different about a binge?

A 
Subjective loss of control
Large amounts, typically calorie laden, “forbidden” foods 
I just can’t stop 
Associated guilt afterwards
Secretive 
Alone 
Hiding the event
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12
Q

Is it true that if you have bulimia you must vomit?

A

No - there is non purging type

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13
Q

If you binge and vomiting you must have bulimia. True or false?

A

False - may have binge purge anorexia nervosa

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14
Q

What clinical signs are associated with anorexia nervosa?

A

Reduced BMI
Bradycardia
Hypotension
Enlarged salivary glands

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15
Q

What physiological abnormalities are associated with anorexia nervosa?

A 
Hypokalaemia 
Low FSH, LH, oestrogens and testosterone 
Raised cortisol and growth hormone 
Impaired glucose tolerance 
Hypercholesterolasmia 
Hypercarotinaemia 
Low T3
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16
Q

What cardiovascular complications can occur due to anorexia?

A 
Myocardial thinning
Bradycardia
Hypotension 
Arrhythmias 
Cardiomyopathy 
Mitral prolapse 
HF
17
Q

What electrolyte complications can occur due to anorexia nervosa?

A

Low K, Sodium, calcium, phosphate, zinc, thiamine, magnesium

18
Q

What GI, liver and endocrine complications can occur due to anorexia?

A

GI: delayed gut motility/ gastric emptying, constipation, Mallory weis tears
Liver: fatty liver/ hepatitis, liver failure - refeeding risk
Endocrine : amenorrhea, sick euthyroid syndrome - low T4 and normal TSH

19
Q

What skeletal and blood complications can occur due to anorexia?

A

Osteopenia

Bone marrow suppression - low Hb, WCC and platelets

20
Q

At what BMI is mortality a risk ?

A

Less than 13

21
Q

When is the most dangerous time for patients with anorexia?

A

Rapid refeeding

22
Q

What type of patients are at greatest risk during refeeding?

A

Very low weight, malnourished patients

23
Q

What type of refeeding is most risky?

A

High carbohydrate refeeding

24
Q

What happens during refeeding syndrome?

A

As the body rushes to rebuild itself it quickly runs out of trace elements/ vitamins - the deficiency of phosphate, K, and magnesium are most dangerous and can be fatal

25
Q

What is phosphate required for (at cellular level)?

A

Cell division (when tissue is regenerating due to refeeding)

26
Q

What can low phosphate cause?

A

HF and multi organ failure

27
Q

What psychological treatment is available for anorexia?

A

Individual eating disorder focused CBT
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
Specialist supportive clinical management (SSCM)

28
Q

How is bulimia nervosa treated?

A 
20 sessions CBT 
Regular eating 
Binge analysis 
Mood management 
Interpersonal issues 
Working on self esteem
29
Q

Why is anorexia so difficult to treat?

A

Unlike most psychiatric illnesses it is ego systonic - it feels right

30
Q

Why is anorexia so hard to give up?

A 
Functions: 
Managing emotions
Controlling relationships 
Self esteem 
Communication

Mental Health (13 decks)

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