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PSYCH ROTATION > First Aid: Eating Disorders > Flashcards

First Aid: Eating Disorders Flashcards

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1
Q

What are the 2 main divisions of anorexia nervosa?

A

Restrictive type

Binge eating/purging type

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2
Q

What are characteristics of the restrictive type of anorexia nervosa?

A

Eat very little
May vigorously exercise
Withdrawn
OCD traits

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3
Q

What are characteristics of the binge eating/purging type of anorexia nervosa?

A
  • Eat in binges followed by purging, laxatives, excessive exercise and/or diuretics
  • Associated with increased incidence of major depression and substance abuse
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4
Q

What is the DSM-IV criteria for anorexia nervosa?

A
  • Body weight at least 15% below normal
  • Intense fear of gaining weight or becoming fat
  • Disturbed body image
  • Amenorrhea
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5
Q

What is lanugo?

A

fine body hair (complication of anorexia nervosa)

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6
Q

What is melanosis coli?

A

darkened area of colon 2/2 laxative abuse

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7
Q

What are other complications of anorexia nervosa?

A
  • Electrolyte imbalances (hypochloremic hyperkalemic alkalosis)
  • Hypercholesterolemia
  • Arrhythmias
  • Leukopenia
  • Osteoporosis
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8
Q

What is the gender differences with anorexia nervosa?

A

Women 10-20X more common

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9
Q

What is the prevalence of anorexia nervosa?

A

occurs in 4% of adolescents and young adults

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10
Q

When does anorexia nervosa usually start?

A

between 10 and 30

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11
Q

How might you tell the difference between someone who is thin due to anorexia nervosa versus someone who is thin due to MDD?

A
  • anorexia nervosa patients have good appetite but starve themselves (usually preoccupied with food)
  • MDD patients usually have poor appetite and have no interest in food
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12
Q

What is the differential diagnosis for anorexia nervosa?

A
  • Cancer (or other medical condition)
  • MDD
  • Bulimia
  • Somatization d/o
  • Schizophrenia
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13
Q

What is the mortality rate for anorexia nervosa?

A

10% (starvation, suicide, or electrolyte disturbance)

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14
Q

When should someone with anorexia nervosa be treated on an inpatient basis?

A

when they are 20% below ideal body weight should be hospitalized

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15
Q

What is the treatment for anorexia nervosa?

A
  • Family therapy
  • Behavioral therapy
  • Supervised weight gain programs
  • Antidepressants like paroxetine or mirtazapine (promote weight gain)
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16
Q

What are the major differences between someone with anorexia nervosa and someone with bulimia nervosa?

A

Bulimic patients:

  • usually maintain a normal body weight
  • symptoms are more ego-dystonic (distressing)
  • more likely to seek help
17
Q

What are the two types of bulimia nervosa?

A

Purging type

Nonpurging type

18
Q

What are features of the purging type of bulimia nervosa?

A

vomiting
laxatives
diuretics

19
Q

What are features of the nonpurging type of bulimia nervosa?

A

excessive exercise

fasting

20
Q

What is binge eating?

A

excessive food intake within a 2 hour period accompanied by a sense of lack of control

21
Q

What is the DSM-IV diagnostic criteria for bulimia nervosa?

A
  • Recurrent episodes of binge eating
  • Recurrent, inappropriate attempts to compensate for overeating and prevent weight gain (such as laxative abuse, vomiting, etc.)
  • The binge eating and compensatory behaviors occur at least twice a week for 3 months
  • Perception of self-worth is excessively influenced by body weight and shape
22
Q

What are common complications of bulimia nervosa?

A
  • Hypochloremic hypokalemic alkalosis
  • esophagitis
  • dental erosion
  • calloused knuckles
  • salivary gland hypertrophy
23
Q

What is the prevalence of bulimia nervosa?

A

1-3% of adolescent and young females

24
Q

What are common comorbidities of bulimia nervosa?

A
  • Mood disorders
  • Impulse control disorders
  • Alcohol abuse/dependence
25
Q

Which has a better prognosis, anorexia or bulimia?

A

bulimia nervosa

26
Q

What is the prognosis for bulimia nervosa?

A
  • 50% recover fully with treatment

- 50% have chronic course with fluctuating s/s

27
Q

What are the treatment options for bulimia nervosa?

A
  • Individual psychotherapy
  • Cognitive-behavioral therapy
  • Group therapy
  • SSRIs (first line), TCAs (second line)
28
Q

How is obesity defined?

A

being at least 20% over ideal body weight

29
Q

What is the prevalence of obesity in the USA?

A

over 50%

30
Q

Where does binge eating d/o fall in the DSM-IV?

A

under eating d/o NOS

31
Q

What is the DSM-IV criteria for binge eating disorder?

A
  • Recurrent episodes of binge eating
  • Severe distress over binge eating
  • Bingeing occurs at least 2 days a week for 6 months and is not associated with compensatory behaviors (like vomiting, laxative use, etc.)
  • 3 or more s/s are present: eating very fast, eating until uncomfortably full, eating large amounts when not hungry, eating alone due to embarrassment over eating habits, feeling disgusted, depressed or guilty after over-eating
32
Q

What therapies are used for treating binge eating disorder?

A
  • Individual psychotherapy
  • Behavioral therapy
  • Strict diet and exercise program
  • Pharmacotherapy to promote weight loss
33
Q

What are drugs used to promote weight loss?

A
  • Stimulants (phentermine and amphetamine) to suppress appetite
  • Orlistat (Xenical)
  • Sibutramine (Meridia)
34
Q

What is the MOA of orlistat?

A
  • inhibits panreatic lipase

- inhibits amount of fat absorbed from GI tract

35
Q

What is the MOA of sibutramine?

A

-inhibits reuptake of NE, serotonin, and dopamine

PSYCH ROTATION (18 decks)

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