Lecture 62 - Eating Disorders

Question 1

_______ is an eating disorder in which patients eat non-nutritive materials like dirt or paper for at least ____ month(s).

Answer 1

Pica

1 month

Question 2

________ disorder, which is more common among children than adults, is typically associated with intellectual disability but is NOT associated with GI condition and does NOT occur during the course of other eating disorders.

Answer 2

Rumination Disorder

Question 3

Avoidant/Restrictive Food Intake Disorder is characterized by a lack of interest in food bc of _______ characteristics of the food. It typically arises in children, and diagnosis requires the child is not meeting nutritional needs bc of the disorder.

Answer 3

Sensory Characteristics

Question 4

Anorexia Nervosa occurs in tandem with _____ _____ disorder.

Answer 4

Body Dismorphic Disorder

Question 5

Bulimia Nervosa is characterized by binging and purging, but keep in mind purging can be something other than vomiting (e.g. taking laxitives or exercising excessively). Disgnosis requires a frequency of at least ____ episode(s) per week for ____ month(s).

Answer 5

1 episode per week

3 months

Question 6

Binge-eating disorder diagnosis requires a frequency of _____ episode(s) per week for ______ month(s) (same as bulimia nervosa), and is NOT associated with recurrent _______ behavior as is seen in bulimia and anorexia.

Answer 6

1 episode per week

3 months

Recurrent Compenssatory behavior

Question 7

Anorexia is associated with which socioeconomic class?

Answer 7

Middle-upper socioeconomic class

Question 8

Anorexia often occurs in tandem with MDD or dysthymia, Anxiety disorders, and OCD. Which is more frequently observed among anorexic patients?

Answer 8

MDD or dysthymia (50-75%) > Anxiety disorders (40%) > OCD (30%).

Keep in mind Anorexia Nervosa has the HIGHEST mortality rate of any DSM dx.

Question 9

Lanugo is a characteristic finding of Anorexia nervosa. What is it?

Answer 9

It is increased growth of fine body hair, especially on the face.

Question 10

_____ syndrome occurs when caloric intake is increased too rapidly after a period of starvation. It can lead to arrythmias, confusion, coma, and convulsions due to a shift in ______ and ______ balance. It usually occurs within ___ days of starting to feed.

Answer 10

Refeeding syndrome

Electrolytes

Fluid

4 days

Question 11

Antidepressants and Low-dose Antipsychotics (olanzapine and quetiapine) are used to treat Anorexia. Which are assciated with weight gain and increased appetite?

Keep in mind _____ (14mg/day) has been shown to accelerate increases in BMI.

Answer 11

Antipsychotis are associated with weight gain and increased appetite.

Zinc (14mg/day)

Question 12

______ therapy is an effective psychotherapy treatment for eating disorders in Adolescents, but not so much for adults.

______ ______ therapy is good for preventing relapse.

Answer 12

Family therapy

Cognitive Behavioral therapy (CBT)

Question 13

______ nervosa is associated with Perfectionism while ______ nervosa is associated with Impulsive behaviors and mood disorders.

Answer 13

Anorexia Nervosa

Bulimia Nervosa

Question 14

50% of those with _______ (anorexia or bulimia?) go on to develop ______ (anorexia or bulimia?).

Answer 14

Anorexia

Bulimia

Question 15

Patients with Bulimia most commonly compensate with Vomiting. Some abuse Syrup of _____, which induces vomiting, but it can also cause myocardial damage. Also look for patients to present with Hypo______ (this ion is lost in vomitus and urinary excretion, the latter due to postemetic bicarbonaturia).

Answer 15

Syrup of Ipecac

Hypokalemia

Question 16

Russel’s sign is a characteristic finding in patients with Bulimia. What is it?

Answer 16

Bruising or marks in particular places suggestive of vomiting (e.g. knucles used to brace while vomiting)

Question 17

Patients with Bulimia may have elevated _______ and Vasopressin secondary to dehydration. Rapidly rehydrating a patient like this may lead to salt retention and edema.

Answer 17

Aldosterone

Question 18

________ (Prozac) is the only SSRI approved for treatment of eating disorders. Keep in mind this is the SSRI with the longest half-life. Which is the one with the shortest half-life?

Answer 18

Fluoxetine (Prozac)

Fluvoxamine has the shortest half-life of SSRIs

Question 19

Unlike Anorexia and Bulimia Nervosa, ______-_____ disorder does NOT show any difference in prevalance between ethnic groups.

Is crossover from this to other eating disorders likely?

Answer 19

Bing-Eating Disorder (BED)

NO!

Question 20

Lack of _____ increases Ghrelin and decreases Leptin. How would this affect hunger?

Answer 20

Lack of Sleep

This would cause an increase in hunger from both the increased Ghrelin AND decreased Leptin.

Question 21

Preschool children of which ethnicity tend to have the highest prevalence of Obesity?

Answer 21

Hispanic