Eating disorders Flashcards
Is anorexia nervosa in adolescence greater or lesser than T1D and IBD?
Greater
When is peak onset of mental illness?
Mid-teens to mid-twenties
What is the SCOFF questionnaire?
2 or more positives then ED is likely
Do you make yourself sick because you feel uncomfortably full?
Do you worry you have lost Control over how much you eat?
Have you recently lost more than One stone (14 pounds or 6.35 kg) in a three month period?
Do you believe yourself to be Fat when others say you are too thin?
Would you say that Food dominates your life?
How does F50.0 anorexia nervosa present?
Restriction of intake to lose weight
Compulsory compensatory behaviours when food cannot be tolerated
Fear of weight gain
Loss of secondary sexual characteristics such as amenorrhoea
What are some compulsory compensatory behaviours in anorexia nervosa?
Self-induced vomiting
Laxative abuse
Excessive exercise
Abuse of appetite suppressants/diuretics
Can anorexia nervosa trigger cold intolerance?
Yes
May show blue hands or feet
How might Anorexia nervosa affect GI symptoms?
Bloating
Constipation
Can anorexia nervosa affect CV function?
Yes
Hypotension
What effect may anorexia nervosa have on puberty?
Delay
Primary or secondary amenorrhea
What effects may anorexia nervosa have on hair/scalp?
Lanugo hair
Scalp hair loss
What are some MSK effects of anorexia nervosa?
Short stature Osteopenia Osteoporosis Weakness Fatigue
What is F50.2 bulimia nervosa?
Episodes of binge eating with a sense of loss of control
Followed by compensatory purging or non-purging behaviour
What are some examples of purging behaviours?
Self-induced vomiting
Laxative abuse
Diuretic abuse
What are some non-purging behaviours seen in bulimia nervosa?
Excessive exercise
Fasting
Strict diets
How does bulimia nervosa present?
Binges and the resulting compensatory behaviour must occur a minimum of two times per week for three months
Dissatisfaction with body shape and weight
What are some GI tract signs and symptoms of bulimia nervosa?
Mouth sore Dental caries Pharyngeal trauma Oesophageal rupture Bloody diarrhoea Heartburn/chest pain
What are some behavioural/social changes seen in bulimia nervosa?
Impulsivity
E.g. stealing, drug abuse
Unable to interpret emotion
What are some MSK symptoms of bulimia nervosa?
Muscle cramps
Weakness
Can bulimia nervosa cause any CV symptoms?
Chest pain
Fainting
Hypotension
What is binge eating disorder?
Similar to bulimia nervosa
Absence of purging behaviours
What are some psychological consequences of eating disorders?
Malnourished brains experience depression, anxiety, obsessionality and loss of concentration on anything but food
Depression at low weight rarely responds to medication
Failure to develop other ways to cope
How do ED’s affect neurochemical balance?
Massive disruption especially affecting the brain (seizure) and heart (arrhythmia)
Potassium is one measure
What are some genetic predispositions to anorexia?
OCD
Anxiety
Perfectionism
What are some causes of precipitating factors of anorexia?
Genetic predisposition
Perinatal factors
Puberty
Stressful life events
What are some perpetuating factors in anorexia?
Delayed gastric emptying and narrowing focus from starvation syndrome result in feeling fat (when actually just full) and focussing solely on food above all else
Obsessionality and body checking only increase concern
How is AN managed?
Re-feeding CBT IPT Fluoxetine 60mg daily Olanzapine
What is re-feeding?
Medical/dietician led approach to re-introducing a normal diet very gradually
How do we treat AN with drugs?
Not really any direct medication
Can treat side effects like depression
Supplement vitamins
What is the first line treatment in BN or AN under the age of 21?
Family therapy
CBT
What is the first line treatment in BN or AN over the age of 21?
CBT
IPT
What is Lanugo?
Thin downy hair usually present on babies
People who are malnourished may grow this hair on their face and body later in life
What is Russell’s sign?
Patients inducing vomiting a lot may have callouses on backs of hands
What is the bio-psycho-social model?
Framework for psych treatments involving biological, psychological and social treatments
