Eating Disorders

Question 1

Anorexia nervosa is the most common cause of admissions to child and adolescent psychiatric wards.

Answer 1

True

Question 2

Anorexia nervosa Epidemiology

Answer 2

90% of patients are female
predominately affects teenage and young-adult females
prevalence of between 1:100 and 1:200

Question 3

Anorexia nervosa BMI and amenorrhoea is part of diagnosis criteria

Answer 3

false

no longer specifically mentioned

Question 4

Anorexia nervosa - Diagnosis is now based on the DSM 5 criteria.

Answer 4

1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Question 5

For adults with anorexia nervosa, NICE recommend we consider one of:

Answer 5

individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
specialist supportive clinical management (SSCM).

Question 6

Anorexia In children and young people, NICE recommend

Answer 6

‘anorexia focused family therapy’ as the first-line treatment. The second-line treatment is cognitive behavioural therapy.

Question 7

The prognosis of patients with anorexia nervosa is good

Answer 7

false

poor. Up to 10% of patients will eventually die because of the disorder.

Question 8

Anorexia nervosa is associated with a number of characteristic clinical signs

Answer 8

reduced body mass index
bradycardia
hypotension
enlarged salivary glands

Question 9

Anorexia nervosa causes hypo/hyperkalaemia

Answer 9

hypokalaemia

Question 10

Anorexia nervosa causes hypo/hypercholesterolaemia

Answer 10

hypercholesterolaemia

Question 11

Anorexia nervosa causes hypo/hypercarotinaemia

Answer 11

hypercarotinaemia

Question 12

Anorexia nervosa causes hypo/hyper cortisol and growth hormone

Answer 12

raised

Question 13

Anorexia nervosa causes impaired glucose tolerance

Answer 13

true

Question 14

Anorexia nervosa causes low FSH, LH, oestrogens and testosterone

Answer 14

true

Question 15

Bulimia nervosa is a type of eating disorder characterised by

Answer 15

episodes of binge eating followed by intentional vomiting or other purgative behaviours such as the use of laxatives or diuretics or exercising.

Question 16

DSM 5 diagnostic criteria for a diagnosis of bulimia nervosa:

Answer 16

the binge eating and compensatory behaviours both occur, on average, at least once a week for three months.

recurrent episodes of binge eating

a sense of lack of control over eating during the episode

recurrent inappropriate compensatory behaviour in order to prevent weight gain

self-evaluation is unduly influenced by body shape and weight.

the disturbance does not occur exclusively during episodes of anorexia nervosa.

Question 17

recurrent inappropriate compensatory behaviour includes

Answer 17

self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.

Question 18

Bulimia nervosa can be managed in primary care

Answer 18

false

referral for specialist care is appropriate in all cases

Question 19

Bulimia nervosa mx

Answer 19

NICE recommend bulimia-nervosa-focused guided self-help for adults

unacceptable, contraindicated, or ineffective after 4 weeks of treatment, NICE recommend that we consider individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

children should be offered bulimia-nervosa-focused family therapy (FT-BN)

Question 20

Bulimia nervosa pharmacological treatments have a limited role

Answer 20

true

trial of high-dose fluoxetine is currently licensed for bulimia but long-term data is lacking