Feeding and Elimination disorders Flashcards
diagnostic criteria for pica
-eating nonfood items for at least 1 month
-inappropriate to developmental level
-not part of culture
how old does someone have to be before they can be dx with pica
at least 2
what are some things that can be associated with the development of pica
lack of food availability
vitamin deficiencies
pica manifestation during pregnancy
may manifest when specific cravings occur but is only diagnosed if severe enough to cause possible medical complications
most common pica comorbidities
autism
intellectual disability
what other disorders might pica be associated with
-trichotillomania
-excoriation disorder
-avoidant/restrictive food disorder
what should be included in pica assessment
possible GI complications
poisoning
infection
nutritional deficiency
definition of rumination disorder
repeated food regurgitation over a period of at least one month that is not attributed to GI or other medical condition
what excludes a dx of rumination disorder
if it occurs exclusively in the course of anorexia, bulimia, binge-eating, or avoidant/restrictive food intake disorder
how is rumination disorder manifested in infants
may strain and arch back while making sucking movements with tongue to promote regurgitation
diagnostic criteria for avoidant/restrictive food intake disorder
-feeding/eating disturbance presenting with at least one additional manifestation
4 additional manifestations of avoidant/restriction food intake disorder, of which, one has to be present
-significant weight loss/failure to make weight gains
-significant nutritional deficiency
-dependence on enteral feeding/nutritional supplements
-marked interference with psychosocial functioning
tempermental risk factors for avoidant/restrictive food intake disorder
presence of comorbid anxiety, autism, OCD, ADHD
environmental risk factors for avoidant/restrictive food intake disorder
family anxiety
mother’s with eating disorders
diagnostic criteria for anorexia nervosa
-restriction of food that results in significantly low body weight
-persistent fear of getting fat or persistent behavior to interfere with gaining weight
-disturbance in the way body weight/shape is experienced
-excessive self-judgement
-lack of recognition of seriousness
type specifiers for anorexia
restricting type
binge eating/purging type
severity specifiers for anorexia
mild: BMI17 or higher
moderate: BMI 16-16.99
severe: BMI 15-15.99
profound: BMI <15
physical sx r/t starvation that may be associated with anorexia
amenorrhea
VS instability
irreversible bone mineral density loss
typical onset of anorexia
adolescence
hematological lab abnormalities in anorexia
-leukopenia
-mild anemia
-bleeding problems (rare)
serum chemistry abnormalities with anorexia
-elevated BUN d/t dehydration
-hypercholesterolemia
-elevated hepatic enzymes
-hypomagnesemia
-hypokalemia from vomiting
-metabolic alkalosis or acidosis
endocrine lab abnormalities with anorexia
low normal T4
decreased T3
low estrogen in females
low testosterone in males
common ECG abnormalities with anorexia
sinus bradycardia
may have significant QTc prolongation
most common anorexia comorbidities
bipolar
depression
anxiety
diagnostic criteria for bulimia
-recurrent binge/purge episodes
-behaviors to avoid gaining weight
-at least weekly x 3 months
-self-evaluation r/t weight
-does not occur only during anorexia
what has to be present to meet criteria for a binge/purge episode
-eating more food than normal in a short period of time (within 2 hours)
-sense of lack of control over eating
severity specifiers for bulimia
mild: 1-3 episodes weekly
moderate: 4-7 episodes weekly
severe: 8-13 episodes weekly
profound: 14+ episodes weekly
forms of purging
vomiting
laxatives
diuretics
enemas
onset of bulimia
typically adolescence
possible fluid/electrolyte imbalances in bulimia
hypokalemia
hypochloremia
hyponatremia
what causes metabolic alkalosis in bulimia
loss of gastric acid from vomiting
(elevated bicarb)
what can cause metabolic acidosis in bulimia
frequent laxative/diuretic use
other physical findings in bulimia
loss of dental enamel
enlarged salivary glands (particularly parotid)
diagnostic criteria for binge eating disorder
recurrent episodes of binge eating associated with at least 3 other manifestations occurring at least weekly x3 months and not associated with purging
criteria for binge eating episode
eating more than normal in a short periods (within 2 hours)
sense of lack of control over eating
5 additional manifestations of binge eating disorder (must have 3)
-eating faster than normal
-eating until uncomfortably full
-eating a lot when not hungry
-eating alone because of embarassment
-feeling disgusted, depressed, guilty afterwards
severity specifiers for binge eating disorder
mild: 1-3 episodes weekly
moderate: 4-7 episodes weekly
severe: 8-13 episodes weekly
profound: 14+ episodes weekly
types of other specified feeding or eating disorders
-atypical anorexia nervosa
-bulimia w/ low frequency and/or limited duration
-binge eating of low frequency and/or limited duration
-purging disorder
-night eating syndrome
atypical anorexia nervosa
criteria for anorexia met except weight is still ok
bulimia with low frequency and/or limited duration
criteria met except episodes are not frequent enough
binge eating of low frequency and/or limited duration
criteria is met except episodes aren’t frequent enough
purging disorder
purging in the absence of binge eating
night eating syndrome
-eating after being asleep or excessive food consumption after evening meal
-awareness and recall of eating
-causes significant distress
-not better explained by another disorders
diagnostic criteria for enuresis
-repeated wetting that is clinically significant
what makes enuresis clinically significant
at least twice weekly x3 months
OR
clinically significant distress
how old do you have to be to get a dx of enuresis
at least 5
specifiers for enuresis
nocturnal only
diurnal only
nocturnal and diurnal
is enuresis involuntary or intentional
can be either
primary enuresis
urinary continence was never established
secondary enuresis
incontinence after an established period of continence
diagnostic criteria for encopresis
repeated bowel incontinence at least monthly x3 months not attributable to medication or a medical condition
age for dx of encopresis
chronological/developmental age at least 4
specifiers for encopresis
-with constipation and overflow incontinence
-without constipation and overflow incontinence
encopresis with constipation and overflow incontinence
stools are poorly formed and there may be intermittent or continuous leakage
is encopresis involuntary or intentional
can be either
encopresis most commonly affects who
ages 4-6 and those who experience abuse/neglect
