flashcards_anorexia_nervosa

Question 1

What are the key components of psycho-education for anorexia nervosa?

Answer 1

Advice on nutrition and health.

Question 2

What comorbid psychiatric illnesses are common in anorexia nervosa?

Answer 2

Depression, OCD, and substance misuse.

Question 3

What is the realistic weekly weight gain target in nutritional management for anorexia nervosa?

Answer 3

0.5-1 kg per week.

Question 4

What are the key features of CBT-ED for anorexia nervosa?

Answer 4

Usually up to 40 sessions over 40 weeks, encourages healthy eating, addresses nutrition, cognitive restructuring, and self-esteem.

Question 5

What is the Maudsley Anorexia Nervosa Treatment in Adults (MANTRA)?

Answer 5

20 or more weekly sessions, explores main problems causing anorexia, educates about nutrition, and explores other management aspects.

Question 6

What is Specialist Supportive Clinical Management (SSCM)?

Answer 6

20 sessions with a practitioner, helps understand the cause of anorexia, focuses on what is important to the patient, and encourages developing a non-anorexic identity.

Question 7

What should be offered if the primary psychotherapies for anorexia nervosa are unacceptable?

Answer 7

Offer a different one of the three primary options or consider Eating Disorder-Focused Focal Psychodynamic Therapy (FPT).

Question 8

What is the 2nd line psychotherapy for anorexia nervosa?

Answer 8

CBT-ED, AFP-AN (adolescent-focused psychotherapy).

Question 9

What is the role of motivational interviewing in anorexia nervosa treatment?

Answer 9

Engages ambivalent patients who lack insight into their disorders.

Question 10

What is the goal of interpersonal therapy in anorexia nervosa treatment?

Answer 10

Improves social functioning and interpersonal skills, better for patients with later onset or longer duration of illness.

Question 11

When is medical treatment particularly important in anorexia nervosa?

Answer 11

If there are physical complications, rapid weight loss, or BMI < 13.5.

Question 12

When might inpatient treatment be necessary for anorexia nervosa?

Answer 12

If BMI < 13, extremely rapid weight loss, serious physical complications, high suicide risk, or if the Mental Health Act is needed for compulsory feeding.

Question 13

What are the biochemical and clinical features of refeeding syndrome?

Answer 13

Low phosphate, low magnesium, low potassium, low thiamine, salt and water retention; fatigue, weakness, confusion, high blood pressure, seizures, arrhythmia, heart failure.

Question 14

What is the 1st line treatment for children with anorexia nervosa?

Answer 14

Family Therapy, with some sessions for the whole family and some separate, usually 18-20 sessions over 1 year.

Question 15

What is the 2nd line treatment for children with anorexia nervosa?

Answer 15

Individual CBT-ED or AFP-AN if Family Therapy is unacceptable.

Question 16

What are the referral pathways for anorexia nervosa based on severity?

Answer 16

Severe: Urgent referral to CEDS (BMI < 15, rapid weight loss, evidence of system failure). Moderate: Routine referral to CEDS (BMI 15-17, no evidence of system failure). Mild: Monitor/advice/support for 8 weeks, support from BEAT, routine referral to CEDS if failure to respond (BMI > 17, no additional co-morbidity).

Question 17

What are the summary management options for adults with anorexia nervosa?

Answer 17

Individual eating disorder focused CBT (CBT-ED), Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), Specialist Supportive Clinical Management (SSCM).

Question 18

What is the summary management for children with anorexia nervosa?

Answer 18

1st line: Anorexia Focused Family Therapy. 2nd line: CBT.

Question 19

What percentage of individuals with anorexia nervosa will die from the condition?

Answer 19

Up to 10%.

Question 20

What are the key points to explain about anorexia nervosa during PACES?

Answer 20

Diagnosis is characterized by a morbid fear of fatness, reduced calorie intake, and endocrine problems based on BMI; risks include osteoporosis, infertility, cardiac problems; psychological therapy involves exploring thought processes, setting an eating plan, and weight gain targets; medical therapy if depressed (e.g., fluoxetine); support from Beat (Eating Disorder Charity).