Feeding and Elimination disorders Flashcards by Amy Collins

diagnostic criteria for pica

-eating nonfood items for at least 1 month
-inappropriate to developmental level
-not part of culture

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how old does someone have to be before they can be dx with pica

at least 2

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what are some things that can be associated with the development of pica

lack of food availability
vitamin deficiencies

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pica manifestation during pregnancy

may manifest when specific cravings occur but is only diagnosed if severe enough to cause possible medical complications

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most common pica comorbidities

autism
intellectual disability

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what other disorders might pica be associated with

-trichotillomania
-excoriation disorder
-avoidant/restrictive food disorder

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what should be included in pica assessment

possible GI complications
poisoning
infection
nutritional deficiency

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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

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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

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how is rumination disorder manifested in infants

may strain and arch back while making sucking movements with tongue to promote regurgitation

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diagnostic criteria for avoidant/restrictive food intake disorder

-feeding/eating disturbance presenting with at least one additional manifestation

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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

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tempermental risk factors for avoidant/restrictive food intake disorder

presence of comorbid anxiety, autism, OCD, ADHD

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environmental risk factors for avoidant/restrictive food intake disorder

family anxiety
mother’s with eating disorders

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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

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type specifiers for anorexia

restricting type
binge eating/purging type

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severity specifiers for anorexia

mild: BMI17 or higher
moderate: BMI 16-16.99
severe: BMI 15-15.99
profound: BMI <15

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physical sx r/t starvation that may be associated with anorexia

amenorrhea
VS instability
irreversible bone mineral density loss

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typical onset of anorexia

adolescence

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hematological lab abnormalities in anorexia

-leukopenia
-mild anemia
-bleeding problems (rare)

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serum chemistry abnormalities with anorexia

-elevated BUN d/t dehydration
-hypercholesterolemia
-elevated hepatic enzymes
-hypomagnesemia
-hypokalemia from vomiting
-metabolic alkalosis or acidosis

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endocrine lab abnormalities with anorexia

low normal T4
decreased T3
low estrogen in females
low testosterone in males

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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