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YEAR 3 PSYCH > Eating disorders > Flashcards

Eating disorders Flashcards

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1
Q

what is the criteria for diagnosis anorexia nervosa according to ICD-10

A 
BMI < 17.5 or (< 15% of expected)
self induced weight loss e.g. starvation, excessive exercising, vomiting
body image disturbance
fear of fatness
amenorrhoea
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2
Q

when is anorexia nervosa most commonly seen

A

teen girls

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3
Q

what is the most common cause of death in anorexia nervosa

A

cardiovascular complications

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4
Q

what are some common co-morbidities with anorexia nervosa

A

depression
OCD
substance misuse
diabetes

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5
Q

what are some s/s of anorexia nervosa

A

appearance - bruising, hypercarotenemia, blue cold peripheries, muscle wasting, dry skin, lanugo hair,
cognitive - reduced concentration, poor sleep, depression
bradycardia and hypotension
cold sensitivity
amenorrhoea

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6
Q

what is an oral complication of anorexia nervosa

A

dental caries

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7
Q

what are some cardiovascular complications of anorexia nervosa

A

hypotension
bradycardia
QT prolongation

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8
Q

what are some GI complications of anorexia nervosa

A

delayed gastric emptying

bloating

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9
Q

what are some derm complications of anorexia nervosa

A

dry skin
hair loss
lanugo hair

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10
Q

what are some neuro complications of anorexia nervosa

A

peripheral neuropathy

cognitive impairment

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11
Q

what are some endocrine complications of anorexia nervosa

A

HYPO - glycaemia, kalaemia, natraemia, thermia

altered TFT, osteoporosis, reduced fertility, delayed puberty, growth arrest

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12
Q

low risk BMI

A

16-17.5

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13
Q

moderate risk BMI

A

15-16

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14
Q

high risk BMI

A

13-15

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15
Q

very high risk BMI

A

< 13

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16
Q

what are some investigations for anorexia nervosa

A

haematology
biochemistry
ECG
DEXA

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17
Q

what is the management for high risk anorexia nervosa

A

immediate treatment as an inpatient

18
Q

what is the general management for anorexia nervosa

A

education/monitoring/dietician
psychological therapy e.g. CBT, family therapy
antidepressant if comorbid illness

19
Q

weight loss over what per week would be high risk

A

1kg

20
Q

HR and SBP are indicative of high risk

A

HR < 40

SBP < 80

21
Q

failure of what test indicates high risk

A

SUSS - sit up squat stand test

  • patient lies on floor and sits up without using hands
  • patient squats down and rises without using hands
22
Q

what is the scoring system for SUSS

A 
0 = unable
1 = able only using hands to help
2 = able with noticable dificulty 
3 = able with no difficulty
23
Q

what is refeeding syndrome

A

metabolic abnormalities that occur on feeding a person following a period of starvation - occurs when an extended period of catabolism ends with abruptly switching to carbohydrate metabolism

24
Q

how can refeeding syndrome be avoided

A

frequent blood monitoring
slow pace of initial feeding
no more than 50% of requirements for 1st 2 days

25
Q

why does refeeding syndrome occur

A

depletion of already inadequate stores of nutrients which are used up quickly as body starts to repair itself

26
Q

what nutrient imbalances are seen in refeeding syndrome

A

HYPO - phosphataemia, kalaemia, magnesaemia

27
Q

what may refeeding syndrome lead to

A

organ failure

electrolyte imbalance may predispose to TdP

28
Q

according to ICD-10 what are the requirements for Bullimia Nervosa

A
  • persistent preoccupation with food
  • irresistable craving for food
  • binge eats (2 times a week for at least 3 months, during binge cannot control amount of food eaten)
  • attempts to counter binge e.g. exercise, drugs, starvation, vomiting
  • morbid dread of fatness
29
Q

in Bullimia Nervosa the BMI is typically within what range

A

healthy

30
Q

when is Bullimia Nervosa most often seen

A

teen girls

31
Q

what are some signs seen in Bullimia Nervosa

A

Russels sign

parotic hypertrophy

32
Q

what is russels sign

A

callouses on knuckles caused by fingers being used to induce vomiting

33
Q

people with Bullimia Nervosa often have comorbidities such as

A 
depression
anxiety
substance misuse
self harm
impulsive personality
34
Q

what are some oral complications seen in Bullimia Nervosa

A

dental caries

35
Q

what are some general complications seen in Bullimia Nervosa

A

dehydration
hypokalaemia
subconjunctival haemorrhage

36
Q

what are some cardiac abnormalities seen in Bullimia Nervosa

A

arrhythmia

37
Q

what are some GI complications seen in Bullimia Nervosa

A

oesophageal erosions
oesophageal perforation
peptic ulcer
gastric perforation

38
Q

what are some neuro complications seen in bullimia nervosa

A

seizures due to electrolyte imbalance

39
Q

what is the management of Bullimia Nervosa

A

guided self help
CBT
SSRI - fluoxetine

40
Q

what is binge eating disorder

A

uncontrollable binges as in bullimia but no compensatory mechanism
once per week for 3 months

41
Q

what is Pica disorder

A

disorder associated with appetite for substances that are not nutritious e.g. hair, ice, chalk

42
Q

what is EDNOS

A

eating disorder not otherwise specified - when patient doesnt meet criteria for BN or AN but has an eating disorder - common

YEAR 3 PSYCH (14 decks)

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