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Feeding/Eating Disorder Flashcards

0
Q

What are the 3 common dx in childhood?

A

PICA
Rumination disorder
Avoidant/Restrictive food intake disorder

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1
Q

What is eating disorder?

A

extreme attitudes and behaviors about wt and food –> create serious emotional and physical probs with LIFE THREATENING consequences

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2
Q

What is PICA?

A

childhood dx
NON nutritive substances for 1 mo
mental retardation

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3
Q

Rumination disorder?

A

childhood
regurgitation and rechewing food for 1 mo
mental retardation

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4
Q

Avoidant/Restrictive food intake disorder?

A

disinterest in eating d/t o aversive consequences (pesticides, etc)
childhood dz

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5
Q

3 primary feeding and eating disorders (FEDs)?

A

1) anorexia nervosa
2) bulimia nervosa
3) binge-eating disorder

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6
Q

Anorexia nervosa and bulimia nervosa?

A

extreme fear and apprehension about wt gain

strong sociocultural origins - traumatic event –> control what you eat

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7
Q

Binge-eating disorder?

A

lack of control feelings and distress

shame and feeling out control

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8
Q

Spectrum of anorexia, bulimia, and binge eating?

A

Anorexia —> bulimia —> binge eating

control —> less control –> NO CONTROL

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9
Q

Anorexia and Bulimia nervosa - onset and duration?

A

onset:
- happens in younger and younger populations (86%: 20yo)
- social phenomenon
duration:
- LIFE LONG DISEASE

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10
Q

FEDs - incidence and tx cost?

A

FEDs tx is NOT included in Affordable Care Act

many are dx but NOT tx - can be costly (inpt vs outpt)

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11
Q

Anorexia nervosa - 2 subtypes?

A

1) restricting type

2) binge-eating/purging type

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12
Q

Anorexia nervosa?

A

restriction of ENERGY INTAKE w/ significantly LOW WT (unlike bulimia)
intense FEAR of gaining wt (anger/irritability)
disturbance in perception of body size and DENIAL of thinness

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13
Q

Restricting type?

A

subtype of anorexia nervosa

NO binge/purging in 3 mo (dieting, fasting , exercise)

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14
Q

Binge-eating/purging type?

A

subtype of anorexia nervosa

positive binge eating/purging/BOTH in 3 mo (vomiting, laxatives, diuretics, enemas)

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15
Q

Anorexia nervosa BMI?

A

mild: >17
mod: 16-17
severe: 15-16
extreme: hospitalization

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16
Q

Anorexia vs bulimia?

A

anorexia is more chronic and resistant to tx than bulimia

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17
Q

Anorexia - gender?

A

female to male: 10:1

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18
Q

Anorexia - timeline?

A

around age 13/early adolescence:

-puberty and development of secondary sex traits

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19
Q

Anorexia - PE?

A 
lanugo (fine unpigmented hair - like baby hair)
loss of muscle mass
loss of hair
tooth and bone decay
emotional instability
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20
Q

Anorexia - sx?

A 
insomnia
anemia
diarrhea
bradycardia
ulcers
delayed gastric emptying (body is trying to suck nutrients out of everything and anything)
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21
Q

Bulimia nervosa?

A

1) recurrent episodes of binging:
- eating in discrete time period of EXCESSIVE AMOUNT OF FOOD
- sense of lack of control
2) binge eat –> compensatory behavior*** (using laxatives, enemas)
3) occurs 1x/wk for 3 mo
4) self-evaluation excessively based on BODY SHAPE and wt

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22
Q

Bulimia nervosa - subtypes?

A

1) purging

2) non purging

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23
Q

Bulimia nervosa - purging?

A

subtype of bulimia

self-induced vomiting OR misuse of: laxatives, diuretics, enema

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24
Bulimia nervosa - nonpurging?
exercise and eating
25
Bulimia nervosa - frequency of episodes?
mild: 1-3/wk mod: 4-7/wk severe: 8-13/wk extreme: 14+/wk
26
Bulimia nervosa - population?
16-19yo female > male 5-10% college women
27
Bulimia nervosa- prognosis?
untreated: chronic | 50-75% can fully recover
28
Vomiting sx?
Low K high bicarbonate arrhythmia acid-base imbalance
29
Laxative abuse?
``` low K low HCO3 renal injury arrhythmia constipation acid base imbalance ```
30
Russell's sign?
signs of vomiting
31
Oral complications of bulminia?
``` teeth become translucent enamel loss teeth are shortened pulp exposed palatal hematoma ```
32
Buliminia nervosa - PE?
oral complications sialadenosis russell's signs
33
Sialadenosis?
PE of bulimina | bilateral parotid gland enlargement
34
Compensatory strategies - Buliminia?
``` exercise strict diet diet pills fasting vomiting diuretics laxatives ```
35
How does culture play a role in eating disorders?
past: not able to afford food --> fat? RICH now: TOO MUCH FOOD --> thin? RICH and self control
36
Binge eating disorder?
NEW - DSM5 recurrent episodes of binging characterized by: -eating in discrete time period an excessive amount of food (like Buliminia but NOT purging) -sense of lack of control
37
Binge eating disorder - dx?
``` at least 3; 1x/wk for 3 mo: more rapid eating eating until uncomfortably full eat large amounts when not hungry eat alone b/c they feel embarrassment feel gross w/ self, depressed, very guilty ```
38
Binge eating - cx?
emotions dysregulation (sadness, stress, worry)
39
Binge eating - aftermath?
feelings/mood alteration | emotions in response to consuming large amount of food
40
Binge eating - episodes?
mild: 1-3/wk mod: 4-7/wk severe: 7-13/wk extreme: 14+/wk
41
Binge eating cycle?
crave food --> strict rigid diet --> shame dperessed --> guiilt, self loathing --> "ive failed, fck it all" --> break rules and eat --> crave food, etc
42
Other specified feeding or eating disorders (5)?
1) atypical anorexia nervosa 2) bulimia nervosa of low freq and/or limited duration 3) binge eating disorder of low freq and/or limited duration 4) purging disorder 5) night eating syndrome
43
Other specified feeding or eating disorders-Atypical anorexia nervosa?
ALL anorexia criterai EXCEPT wt is normal
44
Other specified feeding or eating disorders-Bulimia nervosa?
ALL bulimia critera EXCEPT binge/purg <3 mo
45
Other specified feeding or eating disorders-Binge eating disorder?
all BED criteria except binge <3mo
46
Other specified feeding or eating disorders-Purging disorder?
recurrent purging for wt or shape w/o binge eating
47
Other specified feeding or eating disorders-Night eating syndrome?
recurrent eating after waking or excessive eating after evening meal w/ awareness and recall of eating dinner
48
Unspecified feeding or eating disorder?
sx of FED but does NOT meet criteria for anything can be used to "shift"/bridging to another dz clinician cannot get a clear hx of the pt - ie) ER
49
DDx and Comorbid dx?
``` Superior mesenteric artery sx MDD OCD BDD (body dysmorphic disorder) somatoform disorder ```
50
Body dysmorphic disorder (BDD)?
ALWAYS includes debilitating or excessive fear of judgment by others social anxiety social phobia preoccupation w/ PERCEIVED DEFECT or flaws in physical appearance repetitive behaviors or mental acts at some point d/t concern ANXIETY DISORDER
51
Somatoform disorder?
food avoidance SECONDARY to GI sx
52
Diabulimia?
manipulating insulin to lose wt
53
Diabulimia population?
diabetes | 15-30yo
54
Diabulimia - complication?
vision loss depression kidney failure heart damage
55
Exercise dependence/addiction?
primary exercise dependence | secondary exercise dependence
56
Exercise dependence/addiction - primary?
exercise is the primary disorder | NO disordered eating behaviors ID'd
57
Exercise dependence- secondary?
primary dx is AN, B< ED, NOS longer hospitalization predicts QUICKER relapse
58
Problematic exercise?
rigidity routine exercise is TOP priority exercise despite sickness, injury, etc
59
Problematic exercise - effects?
overuse injuries social isolation and impaired relationship anxiety sleep disturbance
60
Healthy exericse?
REST DAY exercise buddy increase variety moderation approach
61
Men and eating disorders?
Anorexia: wt loss and fear of wt gain Bulimia and binge: binging +/- purging increased risk for depressions, anxiety, and substance disorders
62
Men and eating disorder - what to watch out for?
compensatory strategies social norms positive feedback for exercise: don't eat and just exercise CULTURE - men are suppose to be macho, not skinny and weak
63
Muscle dysmorphia/Bigorexia?
preoccupation w/ appearance, musculature ignore information that body image i NOT consistent w/reality cx: depression or feeling of disgust
64
Muscle dysmorphia/Bigorexia - predisposing factors?
``` being bullied family disharmony perfectionism -OCD stress culture ```
65
Men vs women?
``` men: less likely to seek help for emotional prob delaying tx = reduce tx effectiveness focus on more muscular shape compulsive exercise and dieting exercise; nonpurging more substance abuse women: higher drive for thinness importance of SHAPE compensatory behaviors ```
66
Sexual orientation?
lesbian women: don't care about shape | gay men: care about shape
67
RF for feeding and eating disorders?
``` early prob eating behaviors early pubertal maturation HIGH % of body fat poor body image: abuse hx - sexual abuse w/ bulimia NOT anorexia **EARLY, EARLY, EARLY ```
68
Factors to FEDs?
social networking | pro-anorexia groups: dieting tips, thinspiration
69
At risk groups?
gymnast dancers gay/lesbians business
70
Potential AN, BN traits?
premorbid --> persistent sx after tx --> behaviors are exaggerated by malnutrition
71
SCOFF quesionnaire?
-do you make yourself SICK -do you worry you lost CONTROL -in past 3 mo, have you lost OVER 6.5kg/15lbs -do you believe ourself to FAT -would you say FOOD dominates your life 2+ = AN/BN
72
Increased risk of additional psychiatric dx?
depression depression tx OCD
73
Tx eating disorder?
``` CBT DBT addiction model Maudsley method interpersonal psychotherapy meds admit ```
74
Checking the mirror? Skin picking?
Body dysmorphic Disorder
75
BDD - w/ muscle dysmorphia?
muscles are too big/small
76
BDD dx?
need constant reassurance from others 1+hr daily dedicated to defect repeated dermatologic or cosmetic referral for correction of the defect NO lab test
77
BDD - screening?
MMSE MOOD: depressed, irritable, anxious THOUGHT process: perseveration on perceived defect THOUGH content: thoughts about perceived defect become delusional EXCEPT for time and energy spent on perceived defet
78
BDD tx?
medications - SSRI, TCA have consistent tx w same provider refer

Behavioral Med (17 decks)

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