Eating Disorders

Question 1

what is the diagnostic criteria for anorexia nervosa

Answer 1

BMI 17.5 or less
self induced weight loss: vomiting, medication or excessive excersise
body image disturbance
fear of fatness
amenorrhoea (in females)

Question 2

what are the signs seen on physical assessment of anorexia nervosa

Answer 2

muscle wasting, hair loss, lanugo hair (soft, thin, often unpigmented hair)
hypocarotenaemia (on palms of hands)

Question 3

give some of the defining criteria of high risk patients

Answer 3

BMI<13 or +1kg loss/week
prolongued QT, hr<40 or systolic BP< 80
core temp< 34
low score on squat test (using hands to risk from squat))

Question 4

which investigation would be ordered for anorexia

Answer 4

ECG, DXA scan (if amenorrhoea),

Bloods- GGT high, ALT high, protien and albumin low

Question 5

management of anorexia nervosa

Answer 5

CBT, dietician, family therapy, art/drama therapy

Question 6

what is refeeding syndrome

Answer 6

the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding

Question 7

what are symptoms of refeeding syndrome

Answer 7

cardiac arrhythmias, Hypophosphataemia, hypomagnesaemia, and hypokalaemia

Question 8

define some criteria of bulimia nervosa

Answer 8

persistent preoccupation with eating, irresistable cravings for food
binges, attempts to counter the binges through vomiting, medication and excessive exercise
binges occur once a week for 3 months with excessive preoccupation with body image

Question 9

what would be seen in a physical assessment of a patient with bulimia nervosa

Answer 9

parotid hypertrophy
russels sign (calluses on the back of the hand due to self induced vomiting)
dental caries

Question 10

what is the management for bulimia nervosa

Answer 10

CBT and high dose fluoxitine