Eating Disorders Flashcards
What are the core symptoms of most eating disorders?
Food restriction Weighing meals Restricting high calorie foods Weighing themselves Binging on high calorie food Purging via vomiting or laxatives
Anorexia Nervosa diagnosis
BMI <17.5 or less than 85% of expected Self induced weight loss Body Image disturbances Fear of being fat Amenorrhea or sexual dysfunction
How do patients self induce weight loss?
Excessive exercise
Vomiting
Medication
How do patients with Anorexia Nervosa present on a physical exam?
Muscle wasting Hair loss Lanugo hair (fine down baby hair) Cold blue peripheries Dry skin Hypercarotenaemia ( orange palms) Bradychardia Hypotension Bruising
What would out an Anorexia Nervosa patient in the high risk category?
BMI <13 1kg weight loss a week Prolonged Qt HR <40 Systolic BP <80 Core temp under 34 Unable to rise from a squat without using arms Cognitive Impairment
What might be seen on the biochemical review of a patient with Anorexia Nervosa?
Low K+ - Vomiting
High GGT ALT
Low Albumin
What investigate should be undergone in a patient with Anorexia Nervosa ?
Haemotolgy Biochemistry ECG DXA
What is refeeding syndrome and why is a risk?
In a severely malnourished patient too rapid reintroduction of a normal diet results in death.
What is the pathophysiology of refeeding syndrome
The body has depleted nutrient vitamin and ion stores, however when patient is introduced to new sources of nutrients by reintroduction of food the body is tricked into depleting its stores further leading to death.
What ions are involved in refeeding syndrome?
Mg+
Phosphate
How is someone who is severely malnourished reintroduced to food?
Through careful monitoring of their blood and calorie intake.
What is the management of someone with Anorexia Nervosa?
Psychological therapies - CBT, Art therapy Family therapy
Dietitian
Medical Monitoring
What co-morbidities are often found with Anorexia nervosa?
Depression OCD Substance Misuse ASD Diabetes Mellitus
In order to inset a NG in a patient with impaired capacity what is required?
Mental Health Act 2003
- high risk to themselves
- treatment plan is outlined
Second doctor to agree that NG tube is required
Bulimia Nervosa
Persistent preoccupation with eating.
Bing eating followed by purging
Morbid dread of being fat
Craving food but extreme guilt in doing so
