Eating Disorders Flashcards
Define Anorexia Nervosa
Eating disorder characterised by deliberate weight loss, intense fear of fatness, distorted body image and endocrine disturbances
Give four predisposing risk factors for Anorexia Nervosa
Family History
Female
Sexual Abuse
Perfectionism
Give three perpetuating risk factors for Anorexia Nervosa
Starvation causes neuroendocrine changes that perpetuate anorexia
Perfectionism
Western Society
Describe the ICD10 diagnosis of Anorexia Nervosa
Present for Atleast 3 months in the absence of recurrent binge eating
- Fear of weight gain
- Endocrine disturbance resulting in Amenorrhoea/Impotence
- Emaciated (BMI<17.5)
- Deliberate Weight Loss
- Distorted Body Image
Give four physical symptoms of Anorexia Nervosa
Fatigue
Hypothermia
Bradycardia
Lanugo Hair
Describe the expected Appearance, Speech, Mood and Thought of an anorexic patient
Appearance - Thin, Weak, Slow, Anxious
Speech - Slow, Slurred
Mood - Euthymic or Low
Thoughts - Preoccupation with food/weight/appearance
Describe the typical blood results of an Anorexic Patient
Increased Urea and Creatinine Low Electrolytes Low Albumin Low Thyroid Hormones High Cholesterol High Cortisol
Other than bloods, Name three other investigations for Anorexic Patients
VBG (Alkalosis - Vomiting, Acidosis - Laxatives)
DEXA
ECG (Bradycardia or Long QT)
Name three complications that people with Anorexia Nervosa are at increased risk of
Pancreatitis
Hepatitis
Cardiac Failure
Describe the Biological Management of Anorexia Nervosa
SSRIs for Comorbid Depression
Aim for weight gain of 0.5-1kg/week if inpatient, or 0.5kg/week if outpatient
Name four Psychological interventions for Anorexia Nervosa
Psychoeducation about Nutrition
CBT
Interpersonal Psychotherapy
Family Therapy (ANFFT)
What is Refeeding Syndrome?
Downregulation of enzymes causes metabolic abnormalities if feeding is started at a rate too quick
Causes Fluid Imbalance, Hypokalaemia, Hypophosphataemia, Decreased Muscle Activity
How can Refeeding Syndrome be prevented?
Start feeding at 1200kcal and increase every 5 days
Define Bulimia Nervosa
Eating disorder characterised by repeated episodes of uncontrolled binge eating followed by compensatory weight loss behaviours and overvalued ideas regarding ideal shape and weight
Describe the aetiological cycle of Bulimia Nervosa
1) Sense of compulsion to eat
2) Binge eating
3) Fear of Fatness
4) Compensatory Weight Loss Behaviours
Patients often have a history of childhood obesity
What are the two types of Bulimia Nervosa?
Purging - the patient uses self induced vomiting/laxatives/diuretics after eating
Non Purging - less common, excess exercise or fasting
Describe the ICD10 criteria of Bulimia Nervosa
Behaviours to prevent weight gain
Preoccupation with eating
Fear of fatness
Overeating (Atleast 2 episodes a week for 3 months)
Give 5 consequences of repeated vomiting
Hypokalaemia Mallory Weiss Tear Dental Erosions Russell’s Sign Aspiration Pneumonitis
Describe the expected Appearance, Speech, Mood and Thought of a patient with Bulimia Nervosa
Appearance - Depression or Anxiety, Normal Weight, Parotid Swelling, Russell Sign
Speech - Slow or Normal
Mood - Low
Thought - Preoccupation with size/shape/eating
Define Kline Levin Syndrome
Sleep disorder characterised by recurrent episodes of BingeEating and Hypersomnia
Describe the biological management of Bulimia Nervosa
Fluoxetine
Treat any complications
Electrolyte Monitoring
Describe the Psychological management of Bulimia Nervosa
Psychoeducation about Nutrition
CBT-BN
Interpersonal Psychotherapy
Describe the Social management of Bulimia Nervosa
Food Diaries
Techniques to avoid binging (distractions, having company)
