Feeding/Eating Disorders Flashcards
pt who refuses to eat due to fear of being overweight
anorexia nervosa
anorexia is associated w. weight < _ % of IBW
85
how is anorexia distinguished from bulimia nervosa in terms of anthopometrics (2)
anorexia:
BMI < 17
OR
weight < 85% IBW
what disorder has the highest suicide rate of eating disorders
anorexia nervosa
what are the 2 types of anorexia nervosa
binging/purging
restricting
2 behaviors associated w. binging/purging anorexia nervosa
laxative/diuretic abuse
excessive exercise
2 behaviors associated w. restrictive anorexia nervosa
eating very little
excessive exercising
tx for anorexia nervosa
-restore nutritional state
-hospitalization
-CBT
-SSRI’s
weight indication for hospitaization in anorexia nervosa
weight < 75% IBW
t/f: SSRIs are proven effective for anorexia nervosa
f!
added s.e benefit of SSRI’s for anorexia nervosa
weight gain
episodes of mass eating followed by self-induced vomiting or intense exercise
bulimia nervosa
4 PE findings of bulimia nervosa
-petechial hemorrhages on soft palate and conjunctiva
-knuckle scars
-swollen parotids
-dental erosions
-hyopotn
-tachycardia
mc weight finding of bulimia nervosa
normal weight
2 lab findings suggestive of bulimia nervosa
hypochloremia
hypokalemia
purging results in what metabolic condition
metabolic alkalosis
2 behaviors bulimia nervosa may share w. anorexia nervosa
laxative/diuretic abuse
excessive exercise
t/f: bulimia nervosa patients are disturbed by their behavior
t!
diagnostic criteria for bulimia nervosa
binging and compensatory behaviors at least once a week for 3 months
tx for bulimia nervosa (3)
-restore nutritional status
-SSRI
-behavioral/family/group therapy
-what SSRI is recommended for bulimia nervosa
-what is the starting dose
fluoxetine
60 mg po qd
higher starting dose than for dpn
t/f: fluoxetine alone often reduces frequency of binge eating and vomiting
t!
2 second line meds for bulimia nervosa
TCAs
MAOIs
in pt’s w. anorexia, menstruation usually resumes when pt’s return to _ % IBW
90%
personality characteristics of anorexia nervosa (4)
intelligent
meticulous
high achievers
compulsive
PE findings of anorexia (10)
cachexia
amenorrhea
loss of libido
hypothermia
cold intolerance
bradycardia
dental erosions
hypotn
edema
hirsutism
possible lab findings of anorexia
-lyte disorders (ex hypokalemia)
-metabolic alkalosis
-increased BUN
-thrombocytopenia
-leukopenia
-low ESR
ekg finding of anorexia
prolonged QT
comorbidity commonly associated w. anorexia
depression
t/f: medication alone is effective tx for anorexia
f!
what age group is at highest risk for anorexia
adolescents-early 20’s
2 sports highly associated w. anorexia
ballet
wrestling
what 2 male populations are esp at risk for anorexia
homosexual
wrestlers
median age of onset for bulimia
20
5 consequences of severe bulimia nervosa
gastric dilation
esophagitis
electrolyte abnl
aspiration
pancreatitis
4 symptoms of bulimia nervosa
reflux esophagitis
abdominal cramps
diarrhea
rectal bleeding
2 PE findings of extreme purging
metabolic alkalosis
lyte abnormalities
t/f: bulimia pt’s have normal labs until very late stages of the dz
t!
5 FDA approved uses of fluoxetine
dpn
OCD
premenstrual dysphoric disorder
panic disorder
bulimia nervosa
therapeutic effect of SSRI’s may take up to _ weeks
4
side effect of high initial doses of fluoxetine (20 mg or higher)
panic attack -> high discontinuation rate
s.e of fluoxetine
HA
anxiety
nervousness
sweating
insomnia
anorexia
wt loss
nausea
diarrhea
rash
