Mehl. bullet eating disorders 04-06 (1)

Question 1

M. Serum abnormalities seen in bulimic patient? acid base?

Answer 1

increased serum amylase + hypokalemic, hypochloremic metabolic alkalosis.

Question 2

M. 18F + repeated purging + BMI 17; Dx?

Answer 2

anorexia, not bulimia à if BMI low, answer is anorexia.

Question 3

M. 18F + anorexia; what electrolyte disturbance is most likely?

Answer 3

hypokalemia

Question 4

M. 18F + anorexia + BMI of 14 + reintroduced to foods; what electrolyte must we notably look out for?

Answer 4

hypophosphatemia (refeeding syndrome).

Question 5

M. 26M + lost in the woods for three weeks + BMI 27 + reintroduced to foods; what electrolyte must we
notably look out for?

Answer 5

hypophosphatemia (refeeding syndrome).

Question 6

M. Amenorrhea in patient with anorexia; why?

Answer 6

decreased GnRH pulsation -> decreased LH + FSH; Q
wants “ decr. FHS, decr. estrogen” as the answer;

in contrast, premature ovarian failure, Turner syndrome,
and menopause have “­ incr. FHS, decr.estrogen” as the answer.

Question 7

M. Anorexia in patient with edema; mechanism for edema?

Answer 7

decreased serum albumin (yes, this is straight from the Psych NBME, no idea why).

Question 8

M.