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Phase 3a Psych > Eating Disorders (anorexia > Flashcards

Eating Disorders (anorexia Flashcards

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1
Q

Name 3 eating disorders?

A

Anorexia Nervosa
Bulimia nervosa
Binge eating

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2
Q

Anorexia
MC or LC?
Mortality?
Sex and age

A

LC
Highest mortality
Female
20-40 y/o

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3
Q

What is anorexia nervosa diagnosed as?

A

<17.5 BMI with body dysmorphia, purging (vomiting, laxative) and compensation (excessive exercising/calorie restriction) + Physical Sx

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4
Q

RF for anorexia?

A

PHx fat, Family Hx (x12), EUPD, depression, trauma and abuse, body building/social media

Physical: Coeliacs, achalasia, Addisons

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5
Q

BMI centiles and meaning?

A

17-17.5 = Dx
16-17 = Moderate
<15 = extreme

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6
Q

Typical Px for anorexia?

A

Female adolescent, low self esteem

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7
Q

Sx of Anorexia?

A

Low BMI, Purging (laxatives/vomiting), Compensation (high exercise/calorie restriction), deliberate weight loss and body dysmorphia for 3+ months

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8
Q

what systemic Sx in anorexia?

A

Dry Thin skin and lanugo hair

Dental caries + gum recession

CVS = Arrhythmias, bradycardia, hypotension

Endo = Impaired glucose tolerance, amenorrhoea (2^ - hypogonadotrophic hypogonadism)

Osteopenia + muscle wasting

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9
Q

what criteria is used for anorexia screening?

A

SCOFF

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10
Q

what does SCOFF stand for and score that means +ve?

A

-Make self SICK after food

-lost CONTROL of food

-ONE stone + lost in last 3 months

-FOOD dominates life

  • FAT perception

3+ = +ve

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11
Q

What other test is done in eating disorders?

A

SUSS test

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12
Q

What is the SUSS test and what is it out of?

A

Sit up Stand Squat
/3

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13
Q

What would be seen on the bloods?

A

FBC (ANEMIA)
U+E (low Na, K, Mg, Ca, Po)
TFT (Low?)
Oestrogen (Low?)
HbA1C

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14
Q

Everything will be low except?

A

GH + Cortisol

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15
Q

What happens to BP and ECG in anorexia?

A

Low BP
ECG (Low K+)

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16
Q

Treatment for Anorexia?

A
  1. Structured eating plan + supplements (AdcalD3, vitamins, K+, Na+)
    Tx in community with CBT (MANTRA - maudsley model of anorexia nervosa for adults)
17
Q

Tx for anorexia if severe?

A

<15 BMI
Consider Inpatient and Fluoxetine

18
Q

When referring, what do we monitor and why?

A

Electrolytes for risk of REFEEDING SYNDROME

19
Q

What is the pathophysiology of referring syndrome?

A

Anorexic state = everything Is LOW
(Low Mg2+, K+, PO, B1, Glucose, Na+)
Therefore feeding fast means there is an insulin spike and body is in an anabolic state
Starts to build + use already depleted supply of electrolytes every more
Worse Sx

20
Q

How do we ensure referring syndrome doesn’t happen?

A

Introduce food SLOWLY
Monitor electrolytes regularly

21
Q

Complications of anorexia?

A

Referring syndrome
infertility
amenorrhoea
osteoporosis

22
Q

what other screening tool can be considered and what does it stand for?
typically used for?
out of?

A

MUST
Malnutrition Universal Screening Tool
(typically for gerries)
/5

23
Q

what is the MC eating disorder?

A

Atypical eating disorders
do not fit into one category
eg. body dysmorphia, severe weight loss, binge eating <2/wk + normal BMI

24
Q

What is bulimia nervosa?

A

Preoccupation with body image with 2+ weekly episodes for 3 months of binging + purge

25
Q

what is meant by binging?
time period?
feelings after?

A

Alone
less than 2 hours
eating till uncomfortable full
feel guilty
loss of control

26
Q

Typical Px?
age?

A

Female 20-35y/o Model/athlete

27
Q

Sx of bulimia?

A

2+ episodes weekly for 3+ months of binge + purge with Normal BMI

Russel Sign - knuckle callouses due to vomiting

GORD/Reflux

Parotitis (atrophy of salivary gland)

Halotosis (bad breath)

Dental caries

28
Q

Dx of bulimia?
bloods?
Other?

A

VBG
SUSS -ve
SCOFF questionnaire

29
Q

what would be seen on VBG?

A

Hypokalaemia, hypochloremic, metabolic alkalosis

30
Q

Tx for bulimia?

A

CBT alone

31
Q

what is binge eating?

A

Planned binge eating episodes 3+ months with overweight BMI

32
Q

Tx for binge eating?

A

CBT

Phase 3a Psych (11 decks)

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