Eating Disorders (Cooley)

Question 1

What are the 3 eating disorder types?

Answer 1

1. anorexia nervosa
2. bulimia nervosa
3. binge eating disorder

Question 2

Which two eating disorders are often accompanied by suicide?

Answer 2

anorexia nervosa (5X) and bulimia nervosa (7X)

Question 3

Anorexia nervosa

Answer 3

restriction of energy intake resulting in significantly low body weight with an intense fear of gaining weight or becoming fat; these patients have a distorted perception of body weight and shape

Question 4

What are the two types of anorexia nervosa according to the DSM-5

Answer 4

1. restricting type - excessive exercising, fasting or dieting
2. binge-eating/purging type - self-induced vomiting or misuse of laxative, diuretics or enemas

Question 5

The severity of anorexia nervosa is based on what?

Answer 5

current body mass index (BMI)

Question 6

What is the diagnostic criteria for severe and extreme anorexia nervosa?

Answer 6

Severe BMI 15 - 15.99 kg/m2
Extreme BMI < 15 kg/m2

Question 7

Rituals associated with eating disorders share characteristics with what other disorder?

Answer 7

Obsessive-compulsive disorder (OCD)

Question 8

When is it common to see the fear of weight gain worsen in patients with an eating disorder?

Answer 8

worse as patients lose more weight

Question 9

Why is it important to screen primary care patients for eating disorders?

Answer 9

screening is important because eating disorders are often undetected and untreated

Question 10

The SCOFF questionnaire

Answer 10

most commonly used questionnaire to screen for eating disorders

• Do you make yourself SICK because you feel full?
• Worry you’ve lost CONTROL over how much you eat?
• Lost more than ONE stone (14 lbs) in 3 months?
• Do you believe you are FAT?
• Does FOOD dominate your life?

Question 11

A yes to how many of the SCCOFF questionnaire questions is indicative of a positive screen and should prompt further assessment?

Answer 11

2

Question 12

What are some cardiac complications of anorexia nervosa?

Answer 12

bradycardia, hypotension, QT dispersion, cardiac atrophy and mitral valve prolape

Question 13

What are some gynecologic complications of anorexia nervosa?

Answer 13

amenorrhea and decreased libido

Question 14

What are some endocrine complications of anorexia nervosa?

Answer 14

osteoporosis, hypothermia, euthyroid and hypoglycemia

Question 15

What are some GI complications of anorexia nervosa?

Answer 15

gastroparesis and constipation

Question 16

What are some electrolyte complications of anorexia nervosa?

Answer 16

dehydration, hypokalemia, hypophosphatemia and hypomagnesium

Question 17

Protocol for re-feeding syndrome in a patient with anorexia nervosa?

Answer 17

DO NOT rehydrate or feed patients beyond their current capacity. This is a serious complication of treatment

Question 18

Re-feeding Syndrome

Answer 18

a clinical complication that occurs as a result of fluid and electrolyte shifts during aggressive nutritional rehabilitation of malnourished patients; is potentially fatal when not detected or treated early

Question 19

Recommendations on how to avoid re-feeding syndrome?

Answer 19

limit the calories and fluid provided in the early stages of re-feeding, and avoid very rapid increases in the amount of daily calories ingested and closely monitor the patient during first few weeks of the re-feeding process

Question 20

Why is recognizing and treating co-morbidities of anorexia nervosa?

Answer 20

mortality is 18X higher with another psychiatric disorder is present (ie. depression, anxiety, PTSD)