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CP2 Psychiatry > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

F:M eating disorders

A

10:1

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2
Q

At what age is the most common point of onset of eating disorders?

A

During adolescence

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3
Q

Biological aetiology anorexia nervosa

A

Monozygotic twin concordance

Neuro/endocrine changes

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4
Q

Psychological aetiology anorexia nervosa (5)

A 
Perfectionism 
Low self esteem 
Early sexual development 
Hx abuse
Personality disorder
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5
Q

Social aetiology anorexia nervosa

A

Theories parental overprotection + family enmeshment

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6
Q

Def anorexia nervosa

A

Overvalued ideas concerning body shape + W, pre-occupation w/ being thin + intrusive dread of fatness
Body W at least 15% below expected (BMI <17.5)

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7
Q

Biological aetiology bulimia nervosa

A

Changes levels serotonin

Monozygotic/dizygotic twins

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8
Q

Psychological aetiology bulimia nervosa (7)

A

Low self esteem
Hx abuse - sexual, physical, psychological, neglect
Hx self harm
Impulse personality trait
Personality disorder
Hx being overW
High value placed on food + eating behaviour

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9
Q

Social aetiology bulimia nervosa (2)

A

exposure to diet culture

F/Social culture - categorizing ‘good’ and ‘bad’ food

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10
Q

What % of pt w/ anorexia recover within 3y

A

1/3

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11
Q

% mortality anorexia nervosa @ 10 y

A

10%

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12
Q

Poor prognostic indicators - anorexia nervosa ((5)

A 
V low weight 
Bulimic features 
Family difficulties 
Personality difficulties 
Longer illness duration
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13
Q

What % of bulimics recover in 10y

A

70%

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14
Q

Poor prognostic indicators - bulimia (2)

A

Low body W

Comorbid depression

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15
Q

Medical Hx q to ask - anorexia/bulimia (4)

A

Menstruation?
Sexual dysfunction
Complications of starvation
Digestive complications

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16
Q

Social Hx anorexia/bulimia (5)

A 
Past abuse
Bullying + nature 
Loss of loved one 
Major change in situation 
Effect of eating behavior + assoc w/ loss on elements of social life
17
Q

Skin features - anorexia/bulimia (3)

A

Lanugo hair
Loss of head hair
Russels sign

18
Q

Dentition features - bulimia (2)

A

Abrasions

Tooth decay

19
Q

MSK features - anorexia/bulimia (3)

A

Mm wasting
Ability to rise from squat w/o using hands
Pathological #

20
Q

Sx anorexia nervosa

A 
Dry/brittle skin and hair 
Lanugo hair 
Inflexible thinking, difficulty making decision 
Poor concentration 
Obsessions, difficulty being spontaneous 
Interests only centred around food 
Irritable mood 
Flattened effect 
Reproductive Sx
21
Q

Cardio features - anorexia (4)

A

BP drops
Pulse declines
Incr risk heart arrythmias
Risk HF

22
Q

Metabolic disturbances anorexia

A 
Hypoglycaemia 
Hyponatraemia 
Hypokalaemia 
Vit deficiency 
Hypercholesterolaemia
Deranged LFTs 
Anaemia
23
Q

Sx bulimia - CNS

A

Poor concentration
Irritability
Seizures 2’ to electrolyte imbalance

24
Q

Sx bulimia - face (4)

A

Tooth decay/erosions
Hoarse voice
Bleeding mouth/throat
Swollen parotid glands

25
Q

Sx bulimia - abdominal (7)

A 
Swollen stomach 
Stomach pain 
Constipation 
Delayed gastric emptying 
Oesophageal tears/oesophagitis 
Rectal prolapse 
Renal failure/UTI
26
Q

DSM V - Bulimia

A

Rec eps of binge eating
+ rec inappropriate compensatory behaviour in order to prevent W gain
At least once a week for 3m
Self evaluation influenced by body shape + W

27
Q

DDx Anoreixa nervosa (5)

A 
Organic - hyperthyroid
Depression 
OCD
Body dysmorphic disorder 
Psychosis
28
Q

Biological Tx anorexia (5)

A 
W restoration 
Regular W monitoring
Regular blood monitoring 
Dexa if indicated 
ECG
29
Q

Regular bloods for anorexia nervosa - BMI > 16 (3)

A

FBC
LFT
Glucose

30
Q

Regular bloods for anorexia nervosa - BMI <16 (10)

A 
FBC
LFT
Glucose 
PO4
Mg
Ca
CK
Zn
B12
Folate
31
Q

Psychological Mx anorexia

A

Therapy
incl
MI/ CBT/IPT/Compassion focussed therapy

32
Q

At what point of anorexia would form psychological therapy be unlikely to be effective

A

if BMI <13

33
Q

Social Mx anorexia

A

Advise to informed loved one for extra support
Carer support
Increase flexibility + participation in social plans + lifestyle goals

34
Q

Biological Mx bulimia

A 
AntiD - esp SSRIs 
Advise cessation laxative use 
Advise cessation XS alcohol use
Reg W monitoring 
Reg blood monitoring - esp U+E
35
Q

Psychological Mx bulimia (5)

A 
Psychoeducation 
20 sessions CBT recommended by NICE
Mindfullness
Art psychotherapy 
Inpt from dietician - education on balanced eating

CP2 Psychiatry (15 decks)

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