Eating Disorders Flashcards by Izzy Burns

F:M eating disorders

10:1

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

During adolescence

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Biological aetiology anorexia nervosa

Monozygotic twin concordance

Neuro/endocrine changes

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Psychological aetiology anorexia nervosa (5)

Perfectionism 
Low self esteem 
Early sexual development 
Hx abuse
Personality disorder

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Social aetiology anorexia nervosa

Theories parental overprotection + family enmeshment

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Def anorexia nervosa

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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Biological aetiology bulimia nervosa

Changes levels serotonin

Monozygotic/dizygotic twins

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Psychological aetiology bulimia nervosa (7)

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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Social aetiology bulimia nervosa (2)

exposure to diet culture

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

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What % of pt w/ anorexia recover within 3y

1/3

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% mortality anorexia nervosa @ 10 y

10%

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Poor prognostic indicators - anorexia nervosa ((5)

V low weight 
Bulimic features 
Family difficulties 
Personality difficulties 
Longer illness duration

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What % of bulimics recover in 10y

70%

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Poor prognostic indicators - bulimia (2)

Low body W

Comorbid depression

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

Menstruation?
Sexual dysfunction
Complications of starvation
Digestive complications

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Social Hx anorexia/bulimia (5)

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

Skin features - anorexia/bulimia (3)

Lanugo hair
Loss of head hair
Russels sign

Dentition features - bulimia (2)

Abrasions

Tooth decay

MSK features - anorexia/bulimia (3)

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

Sx anorexia nervosa

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

Cardio features - anorexia (4)

BP drops
Pulse declines
Incr risk heart arrythmias
Risk HF

Metabolic disturbances anorexia

Hypoglycaemia 
Hyponatraemia 
Hypokalaemia 
Vit deficiency 
Hypercholesterolaemia
Deranged LFTs 
Anaemia

Sx bulimia - CNS

Poor concentration
Irritability
Seizures 2’ to electrolyte imbalance

Sx bulimia - face (4)

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

Sx bulimia - abdominal (7)

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

DSM V - Bulimia

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

DDx Anoreixa nervosa (5)

``` Organic - hyperthyroid Depression OCD Body dysmorphic disorder Psychosis ```

Biological Tx anorexia (5)

``` W restoration Regular W monitoring Regular blood monitoring Dexa if indicated ECG ```

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

FBC LFT Glucose

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

``` FBC LFT Glucose PO4 Mg Ca CK Zn B12 Folate ```

Psychological Mx anorexia

Therapy incl MI/ CBT/IPT/Compassion focussed therapy

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

if BMI <13

Social Mx anorexia

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

Biological Mx bulimia

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

Psychological Mx bulimia (5)

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