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ICOM - Mental Health > Henren- Eating disorders > Flashcards

Henren- Eating disorders Flashcards

1
Q

What are the 4 major eating disorders?

A
  • Anorexia nervosa
  • Bulimia nervosa
  • Binge-eating disorder
  • Avoidant/restrictive food intake disorder (ARFID)
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2
Q

Which is the most dangerous eating disorder in which 9% of those affected die?

A

Anorexia Nervosa

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3
Q

What are 5 things that can influence an eating disorder, the main theme being shape desireability?

A

– Preferred body shape

– New “freedoms”

– Media

– Culture

– High risk populations and settings

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4
Q

What are 5 major psychological factors associated with eating disorders?

A

– Difficulty identifying feelings

– External locus of control

– Low self-esteem

– Maturation fears

– Psychodynamics = changes in our body overtime, the conscious and unconscious struggle that determine motivation and personality

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5
Q

When are 2 different ages where eating disorders peak?

A

Beginning of adolescence (puberty, secondary sex characteristics)

Later adolescence (18+, moving out)

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6
Q

What are 3 psychosocial issuses that explain etiology of eating disorders?

A
  • Assumptions and distortions
  • Family influence and conflict
  • Premorbid perfectionism and negative selfevaluation
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7
Q

• There is some evidence for a basis (GWAS, twin studies)

A

genetic

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8
Q

What is the fMRI evidence as related to after and eating disorder has started?

A

abnormal function in corticolimbic circuits involved in appetite (anterior insula)

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9
Q

fMRI evidence of abnormal function in circuits involved in appetite (anterior insula)

A

corticolimbic

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10
Q

Some/multiple neurotransmitter systems implicated after an eating disorder develops

A

multiple

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11
Q

Eating disorder influences of nutrition, metabolism, and vulnerability can be associated with the following factors:

– Set Point

– hypothalamus

– Fat cells

– deficiency

– Leptin and and CNS

– Lack of exercise

A

VMN

Dopamine

ghrelin

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12
Q

What is our bodie’s set point?

A

Our bodies have a preset weight baseline hardwired into our DNA

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13
Q

Can lack of exercise effect our set point?

A

yes

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14
Q

Below are the criteria for Anorexia Nervosa

–Refusal to maintain body weight – generally defined as BMI < for adults

– Intense of weight or fat

– body image

– Amenorrhea

– Restricting and Binge/Purging Types

A

18.5

fear

Distorted

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15
Q

The severity of Anorexia Nervosa is classified by what standard?

A

weight

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16
Q

What is the lifetime prevalence of Anorexia Nervosa?

A

0.6%

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17
Q

Onset of AN typically occurs during what age?

A

late adolescence

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18
Q

AN more common in men/women

A

women

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19
Q

AN is highly comorbid with depression, panic, , and other anxiety disorders

A

OCD

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20
Q

Please review the list of physical exam findings and symptoms of anorexia nervosa:

A
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21
Q

What is xerosis and what eating disorder is it associated with?

A

dry, rough skin

associated with Anorexia Nervosa

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22
Q

What can happen to the CNS of someone with Anorexia Nervosa?

A
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23
Q

What is the first thing to tackle for treatment of Anorexia Nervosa?

A

weight restoration, reestablish normal eating

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24
Q

What multidisciplinary team members should be involved in treatment of Anorexia Nervosa?

A
  • Medical
  • Psychological
  • Nutritional
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25
Q

What is the preferred therapy for Anorexia Nervosa?

A

family therapy

(some evidence for CBT)

26
Q

What are the 5 things included for treatment of AN?

A

• Hospitalization

• Multidisciplinary Team

  • Medical - Psychological - Nutritional

• #1 Weight restoration, reestablish normal eating

• ID Precipitants- what causes one to eat or throw up

• Psychotherapy (family therapy, some evidence for CBT)

• Minimal evidence for medications

27
Q

Are medications indicated for the treatment of anorexia nervosa?

A

minimal evidence for medications

(olanzapine can help with weight gain)

28
Q

As concerning AN, Patients often have or superficial insight into the severity of their illness

A

poor

29
Q

As concerning AN:

Toxic online cultures may perpetuate ideas about the disease

There may be pathways for involuntary treatment in some jurisdictions and situations

– restoration is key, and this may sometimes necessitate placement of an NG tube

A

unrealistic

Weight

30
Q

As concerning AN:

  • Patients with severe anorexia nervosa generally have some degree of impairment
  • When treating patients with eating disorders, interdisciplinary is crucial
  • If you have a patient who’s in recovery from an eating disorder, ask them how you can work with them to prevent and avoid interventions that may unknowingly exacerbate their illness
A

cognitive

collaboration

relapse

31
Q

What are the 5 critieria used to diagnos Bulimia Nervosa?

A

– Recurrent binge eating and lack of control

– Inappropriate compensatory behaviors

– Self-evaluation and body shape

– Not Anorexia Nervosa

– Purging and Non-Purging Types

32
Q

What are some of the innapropriate compensatory behaviors used in order to prevent weight gain with bulimia nervosa?

A

vomiting, laxatives, diuretics, fasting, excessive exercise, medications

33
Q

How is the severity of bulimia nervosa measured and by what standard:

A

innappropriate compensatory behaviors per week

34
Q

BN is more/less lethal than AN?

A

less

35
Q

Which medications can be used to treat BN and which type of therapy?

A

SSRIs

CBT

36
Q

Review the medical sequelae of BN:

A
37
Q

What are some metabolic consequences of BN?

A

Hypokalemia

hypochloremia

metabolic acidosis

38
Q

What are 4 GI issues that can occur due to BN?

A

Pancreatitis

GERD

consipation

Mallory-Weiss tears (tear in lower esophagus)

39
Q

What esophageal tear can occur with Bulimia Nervosa?

A

Mallory-Weiss tears (tear of tissue of the lower esophagus)

40
Q

Prognosis of AN

  • 40% recover; 30% improve; % no improvement
  • Overall mortality is 5-18%
  • All-cause mortality in anorexia is 4-14x higher than the general population
  • ~60% due causes
  • ~25% due to
  • Anorexia is among the most deadly of all disorders
A

20

cardiovascular

suicide

psychiatric

41
Q

Prognosis of Bulimia Nervosa:

  • Overall better than AN
  • 50-90%
  • % continue long term
A

improve

30

42
Q

An episode of binge eating is characterized by which 2 characteristics?

A
  1. Eating far more than others in a discrete amount of time
  2. A sense of lack of control during episode
43
Q

Review the other criteria for binge eating (without compensatory techniques):

A
44
Q

How is binge eating (without compensatory techniques) specified by severity?

A

of binge eating episodes per week

45
Q

What is the most common eating disorder?

A

Binge eating (without compensatory behaviors)

46
Q

What % of patients who seek medical care for obesity have a binge eating disorder?

A

25%

47
Q

Binge eating is more common in men/women?

A

women

48
Q

What is the medication of choice for binge eating and what is the best type of therapy?

A

SSRIs

CBT

49
Q

What is ARFID?

A

avoidant/restrictive food intake disorder (ARFID)

50
Q

ARFID is an eating or feeding disturbance associated with which 4 criteria:

A
51
Q

ARFID is/is not better explained by lack of food or cultural practices

A

is not

52
Q

ARFID does not occur exclusively with which 2 eating disorders?

A

anorexia nervosa

bulimia nervosa

53
Q

In ARFID, there is/ is no disturbance in the way in which one’s body weight or shape is experienced

A

is no

54
Q

In ARFID, the eating disturbance is/ is not attributable to a concurrent medical condition or not better explained by another mental health disorder, or with another disorder (ASD) warrants additional clinical attention

A

is not

55
Q

Clinically, patients of ARFID are often underweight/overweight?

A

underweight

56
Q

What is the simple 5 question questionnaire that screens for eating disorders?

A

SCOFF

  • Do you make yourself Sick because you feel uncomfortably full?
  • Do you worry you have lost Control over how much you eat?
  • Have you recently lost more than One stone (14 pounds or 6.35 kg) in a three-month period?
  • Do you believe yourself to be Fat when others say you are too thin?
  • Would you say that Food dominates your life?
57
Q

Does the patient have a BMI <18.5? Differentiating between which 2 eating disorders?

A

Anorexia Nervosa or ARFID (avoidant/restrictive food intake disorder)

58
Q

How do we differentiate between AN and ARFID if patient has BMI less than 18.5?

A

Does the patient also have negative body cognitions? = AN

59
Q

How to distinguish between BN and Binge eating disorder if BMI over 18.5?

A

– Is the patient purging? —> Probably BN

60
Q

Review the question and correct and incorrect answers regarding AN?

  1. As you gather further history, which symptoms would support the diagnosis of anorexia nervosa?
A
61
Q

Review the question and correct and incorrect answers regarding AN?

  1. The most appropriate steps in the management of the patient once the diagnosis of anorexia nervosa is confirmed includes:
A

most importantly = restore weight

62
Q
A

ICOM - Mental Health (24 decks)

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