eating DO, epidimiology, non pharm treatments

Question 1

comorbid with anorexia. AND Prevelant in mothers of anorexia pts

Answer 1

OCD

Question 2

hawthorne effect

Answer 2

observer effect

participants change behavior due to knowledge that they are being studied.

Question 3

cluster analysis

Answer 3

breaks a large group into smaller groups (clusters) so that each individual cluster is more homogenous by some measure.

Question 4

chronic ipecac use

Answer 4

ipecac is a rapidly acting emetic.

SEs of chronic use are: cardiomegaly, reduced EF, prolonged QT interval, arrhythmias, leukopenia, mitral insufficiency, tricuspid insufficiency, elevated liver enzymes.

Question 5

halo effect

Answer 5

a researcher’s evaluation of a subject’s current performance is altered based on his or her opinion of the previous performance of the subject.

Question 6

TMS may be good for this sx of schizophrenia

Answer 6

hallucinations

Question 7

DSM5 anorexia

Answer 7

restricting calories
fear of gaining weight
disturbed by weight, self perception heavily influenced by weight, unable to recognize severity of low weight.

restricting type
binging eating/purging type

Question 8

attributable risk

Answer 8

risk of exposed group minus non-exposed group (control grp)

Question 9

ANOVA

Answer 9

compares means of multiple groups to determine if all are equal, thereby generalizing the two sample t-test to several groups.

will determine if there is a statistical difference between treatment arms.

Question 10

student’s t test

Answer 10

compares the means of two independent sample populations

Question 11

chi square test

Answer 11

used for frequency data

compares samples with non measurable nominal/categorical variables, as opposed to ordinal or interval measurements ie. zipcode

Question 12

most effective tx for depression

Answer 12

ECT

Question 13

sensitivity

Answer 13

liklihood of achieving a positive result when pt has disease of interest

true positives/ (true positives+ false negatives)

Question 14

specificity

Answer 14

likelihood of a negative result when the patient does not have depression of the disease of interest.

true negative/ (true negatives + false positives)

Question 15

criteria for admission with anorexia

Answer 15

<75% ideal body weight, refusal to eat, body fat < 10%, heart rate <50bpm daytime or <45bpm nighttime
systolic <80, orthostatic changes in pulse (increased >35 bmp), BP dec >10mmHg, hypothermia and arrythmia

Question 16

FDA indication for vagus nerve stimulation

Answer 16

Refractory epilepsy
Treatment resistant depression in adults

Question 17

cross sectional study

Answer 17

analyzes population at a single point in time to assess disease incidence and prevalence

Question 18

ECT absolute contraindications

Answer 18

there are none

Question 19

how to change ECT dose

Answer 19

vary time of exposure to fixed current

Question 20

meds that are contraindicated in ECT

Answer 20

theophylline- can cause prolonged seizures/status

use with caution:
hypoglycemics
b blockers- can cause asystole
lidocaine- can reduce seizure induction
lithium- can cause seizure and confusion

Question 21

case control

Answer 21

analyzes outocome and looks back in time to assess exposure

Question 22

only med approved for treatment of bulimia nervosa

Answer 22

prozac

Question 23

factor analysis

Answer 23

multiple observed variables have similar patterns of responses bc they are all associated with a laten variabel

investigate concepts that are not measured directly. ie cognition, socioeconomic status

by using interpretable underlying factors as surrogates for unmeasurable variables

Question 24

ECT produces this type of seizure

Answer 24

generalized tonic clonic

Question 25

treats constipation in anorexia

Answer 25

docusate- stool softener avoid laxatives, osmotic agents

Question 26

ECT modality that reduces cognitive SEs but is less effective in sx reduction

Answer 26

unilateral nondominant only travels through one hemisphere. only stimulates non dominant

Question 27

when ect was first used

Answer 27

1940s

Question 28

camphor

Answer 28

used for convulsive therapy since 1700s. Used IM in 1930s to induce seizures to treat catatonia,

Question 29

how long pts with eating disorders should be observed.

Answer 29

2 hours.

Question 30

deep brain stimulation for OCD target this structure

Answer 30

anterior limb of internal capsule ventral striatum nucleus accumbens caudate nucleus subthalamic nucleus of BG and inferior thalamic peduncle

Question 31

TMS mechanics

Answer 31

electromagnetic coil creates strong magnetic field. place coil on scalp and run electricity through it. can enter brain easily once enters the neurons, converted into electrical currents acting similar to ECT

Question 32

what does p value of 0.05 mean?

Answer 32

there is a 5% chance of the experimental result occurring by chance alone, if the null hypothesis is true

Question 33

null hypothesis

Answer 33

no significant difference

Question 34

cohort study

Answer 34

follows group of people over period of time to determine risk of developing disease or outcome of interest. no control group but can be stratified based on exposure or risk factor of interest.

Question 35

most common SE of ECT

Answer 35

anterograde ECT. , headaches, generalized muscle soreness, jaw pain. anterograde- inability to form new memories. versus retrograde amnesia- loss of remote memories and can be permanent. rare SE

Question 36

common medical condition asociated with anorexia nervosa

Answer 36

Lanugo bradycardia, pancytopenia, osteopenia, metabolic encephaly, arrhythmias, elevated LFTs, elevated BUN, dec T3, T4, parotid gland enlargement, seizures, peripheral neuropathy.

Question 37

crossover study

Answer 37

longitudinal study in which subjects receive different treatments over course of the study, typically sot hat all subjects eventually receive the same exposures. can be randomized controlled trials or observational

Question 38

bulimia

Answer 38

presence of binge eating and inappropriate compensatory behavior to prevent weight gain such as self induced vomitting misuse of laxatives or meds fasting excessive exersise at least once weekly for 3 mo

Question 39

hospitalization for anorexia

Answer 39

weight > 25% below expected weight. or children rapidly losing weight regardless of weight.

Question 40

refeeding syndrome

Answer 40

complications from fluid and electrolyte shifts during nutritional rehab of a patient who is malnourished.QT prolongation hypophosphatemia TX: oral sodium phospate

Question 41

med for weight gain in anorexia

Answer 41

olanzapine

Question 42

lowest relapse rate for eneruresis

Answer 42

enuresis alarm

Question 43

greatest efficacy in treating enuresis

Answer 43

classical conditioning

Question 44

relapse rate after discontinuation of desmopressin

Answer 44

60-70%

Question 45

DDVAP

Answer 45

chemically similar to vasopressin concentrates urine and provides regulation of BP. leads to renal water production, iatrogenic hyponatremia may result if intake is not appropriately restricted

Question 46

Maudsley model

Answer 46

family based therapy for treatment of anorexia up to 19yrs old .

Question 47

medical impact of anorxia

Answer 47

bradycardia pancytopenia lanugo osteopenia metabolic encephalopathy arrhytmias elevated LFTs elevated BUN dec T3 and T4 partoid gland enlargement seizures peripheral neuropahthy ankylosing spondylitis sjogren's syndrome ulcerative colitis selective IgA deficiency