Liaison psych Flashcards
What are eating disorders
psychiatric conditions involving an unhealthy and distorted obsession with body image and food
Give 5 features of anorexia nervosa
- bodyweight <15% expected or BMI <17.5
- bradycardia
- hypotension
- enlarged salivary glands
- lanugo hair
- amenorrhoea
- poor insight
Give 5 behaviours/ thoughts displayed in anorexia nervosa
- restriction of energy/ calorie intake
- intense fear of gaining weight despite being underweight
- disturbed body image
- deliberate self induced weight loss
Give 3 examples of compensatory behaviour to prevent weight gain in people with eating disorders
- binge eating and/or purging
- laxatives/ diuretic/ diet pill misuse
- exercise
Give 4 physiological abnormalities that may be seen in patients with anorexia
- hypokalaemia
- Low sex hormones
- hypercholesterolaemia
- raised cortisol
- low T3
What type of anaemia is more common in people with anorexia
normocytic normochromic anaemia
How is anorexia nervosa managed
- structured eating plan with oral nutrition
- Individual ED focused CBT
- specialist supportive clinical management
- children: anorexia focused family therapy
- oral potassium supplements
Give 3 complications of anorexia
- osteopenia/ osteoporosis
- female infertility
- refeeding syndrome
When is inpatient care recommended for anorexia
for patients with a body weight <75% expected
and/or significant:
* bradycardia/ hypotension/ hypothermia
* electrolyte disturbance, hypoglycaemia
* psychiatric instability including suicidality.
What is refeeding syndrome
occurs when someone with an extended severe nutritional deficit resumes eating
State 2 factors that put a patient at higher risk of refeeding syndrome
The lower the BMI and the longer the period of malnutrition, the higher the risk
Explain the pathophysiology of refeeding syndrome
- prolonged starvation= low intracellular K+ , PO4*3- and Mg
- Refeeding -> inc insulin -> drives above + glucose into cells and Na out of cells
Give 4 symptoms of refeeding syndrome
- oedema - fluid overload
- confusion
- tachycardia
- hyperglycaemia
What is the effect of refeeding syndrome on the heart
- The left ventricle is unable to handle the fluid increase, resulting in cardiac failure
- can be fatal - ventricular fibrillation
How is refeeding syndrome managed
- referral to emergency care w continuous cardiac monitoring if severe
- slowly reintroduce food
- monitoring electrolytes
- electrolyte supplementation
