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Pediatric EOR exam > Peds Eating Disorders > Flashcards

Peds Eating Disorders Flashcards

1
Q

what is the definition of body image

A

perception that a person has of their own physical self

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2
Q

what are the two main factors that influence body image

A
  • individual factors
  • environmental factors
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3
Q

what are perceptual factors of body image

A

how we see ourselves

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4
Q

what are affective factors of body image

A

how we feel about how we look

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5
Q

what are cognitive factors of body image

A

our thought and beliefs about out body

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6
Q

what are behavioral factors of body image

A

what we do in relation to how we look

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7
Q

body dissatisfaction is strongly tied to (…)

A

chronic negative perception about ones body

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8
Q

what makes body dissatisfaction different from an eating disorder?

A

morbid fear of weight gain and the thoughts are all-consuming in an eating disorder

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9
Q

what are risk factors for body dissatisfaction

A
  • female
  • teen/adolescent
  • low self esteem
  • participation on activities that focus on being thin
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10
Q

t/f eating disorders may have a possible genetic link

A

true

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11
Q

mother/sisters of anorexic patients are (…)x as likely to also have an eating disorder

A

8

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12
Q

what neurotransmitters does anorexia affect?

A

serotonin and dopamine mostly. possibly norepinephrine

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13
Q

what neurotransmitters do bulimia affect?

A

serotonin

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14
Q

people with eating disorders have a hard time recognizing what ques

A

hunger and satiety

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15
Q

what psych problems are associated with eating disorders?

A
  • OCD
  • Anxiety
  • Depression
  • body dysmorphia
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16
Q

what type of family are anorexic patients are more likely to come from?

A

rigid, controlling, and organized

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17
Q

what type of family are bulimic patients are more likely to come from?

A

chaotic, critical and conflicted

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18
Q

what type of ineffective parenting can lead to eating disorders in the future

A

feeding kids at time of anxiety rather than hunger, making it hard for them to differentiate hunger from feelings as an adult

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19
Q

how do we tell the difference between normative and abnormal dieting?

A
  • patient weight
  • patient health status
  • body perception
  • healthful or harmful diet?
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20
Q

what are the screening tools for eating disorders

A
  • SCOFF
  • ESP
  • EAT
  • PHQ
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21
Q

when does Avoidant/Restrictive Food Intake Disorder begin?

A

infancy or early childhood

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22
Q

what is the classic presentation of Avoidant/Restrictive Food Intake Disorder

A

underweight child with a BMI of 16 or less

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23
Q

diagnostic criteria of Avoidant/Restrictive Food Intake Disorder

A
  • Avoiding or restricting food intake
  • failure to meet nutritional or energy needs
  • not due to lack of resources or other medical condition
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24
Q

anorexia is (…)x more common in women

A

3 times

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25
Q

what is the peak onset of anorexia

A

early adolescence and late adolescence/early adulthood

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26
Q

what is the average age of onset for anorexia

A

18

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27
Q

classic anorexia patient

A

adolescent white female

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28
Q

what characterizes anorexia

A
  • restricted energy intake-> low body weight
  • intense fear of weight gain
  • distorted perception of weight
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29
Q

what is binge eating anorexia

A

when someone engage in small binges and purges (less frequent than bulimia)

30
Q

what is restrictive anorexia

A

anorexic tendencies with no purging behaviors

31
Q

what are abnormal food behaviors in anorexia

A
  • reduction in food intake
  • food related obsessions
  • claim distaste for food or epigastric pain
32
Q

common behavioral disturbances in anorexia

A
  • distorted perception of part or all of body
  • perfectionist
  • limited social activities
33
Q

what are the clinical findings of anorexia

A
  • depression
  • fatigue
  • bone pain
  • amenorrhea
  • GI
  • hair loss
  • russell’s sign
34
Q

what are severe clinical signs of anorexia

A
  • emaciation
  • sallow complexion
  • bradycardia
  • severe hypotension
  • osteoporosis
  • lanugo
35
Q

what is lanugo

A

fine, soft hair, especially that which covers the body

36
Q

what is Russell’s sign

A

calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time

37
Q

what is the cause of 50% of deaths in anorexic patients

A

complications of the disease

38
Q

what is included in the workup of all suspected anorexia patients?

A
  • EKG
  • UA
  • serum labs
39
Q

when should you admit an anorexia patient?

A
  • unstable vitals
  • cardiac complications
  • organ failure
  • suicide
  • weight less than 70% IBW
40
Q

what is refeeding syndrome

A

metabolic alterations that may occur during nutritional repletion of starved patients

41
Q

what is the management of anorexia

A
  • multimodal approach including:
  • nutritional rehabilitation
  • psychotherapy
  • medical management
42
Q

what are the goals of anorexia treatment

A
  • medical stability
  • weight stabilization
  • heathy eating patterns
  • treat underlying psychopathology
  • prevent relapse
43
Q

t/f psych meds are first line for anorexia

A

false: psychotherapy is first line

44
Q

if psych meds are needed for anorexia treatment, what should be given?

A
  • olanzapine to help with weight gain
  • SSRI can also be used. (fluoxetine preferred d/t lower risk of relapse after restored weight)
45
Q

(…)% of anorexia patients have a good prognosis

A

50%

46
Q

(…)% of anorexia patients eventually relapse

A

35-55%

47
Q

bulimia is (…)x more common in women

A

3x

48
Q

what is the classic bulimia patient

A

adolescent white female

49
Q

what is purging bulimia

A

patients who engage in self induced vomiting or misuse of laxatives, diuretics, and enemas

50
Q

what is nonpurging bulimia

A

patients who engage in other inappropriate compensatory behaviors such as fasting, excessive exercise

51
Q

what is the typical pattern of behavior for bulimia

A
  • caloric restriction
  • binge
  • compensatory mechanism (purge)
52
Q

t/f bulimia patients have slightly more control over their condition than anorexia

A

true

53
Q

what are the clinical findings of bulimia

A
  • lethargy
  • hypotension
  • tachycardia
  • hair loss
  • GI
54
Q

what are the severe clinical findings of bulimia

A
  • dehydration
  • hypokalemia
  • hyperchloremia
  • metabolic alkalosis
55
Q

hypertrophy of what gland is related to bulimia?

A

parotid gland

56
Q

what is the workup for all suspected bulimic patients

A
  • UA
  • Serum labs
  • if severely ill: EKG
57
Q

when should you admit a bulimia patient?

A
  • unstable medical condition
  • suicidal ideation
  • refusal of treatment with potential to become unstable
58
Q

what is the management of bulimia

A
  • multimodal approach:
  • nutritional rehabilitation
  • psychotherapy
  • medical management
59
Q

what is the best form of therapy for bulimia

A

cognitive behavioral therapy

60
Q

1st line medication for bulimia

A

Fluoxetine (prozac)

61
Q

what medications are contraindicated in bulimia and other eating disorders?

A

bupropion (wellbutrin)

62
Q

what is the prognosis of bulimia

A
  • 50-70% short term reduction of symptoms
  • 28% relapse rate
63
Q

binge eating disorder is more common in which population

A

women

64
Q

what is the median age of onset for binge eating disorder

A

23

65
Q

what is binge eating disorder

A

recurrent binge eating without compensatory behaviors

66
Q

how do you rate severity of binge eating disorder

A
  • Mild: 1-3x weekly
  • Moderate: 4-7x weekly
  • Severe: 8-13x weekly
  • Extreme: 14+ weekly
67
Q

common reported symptoms with binge eating disorder

A
  • food is coping mechanism
  • shame, guilt, hopelessness
68
Q

what are the typical comorbidities of binge eating disorder

A
  • obesity
  • psychological factors.
69
Q

How do you manage binge eating disorder

A

psychotherapy

70
Q

what pharmacotherapy is available for binge eating disorder

A

Pediatric EOR exam (20 decks)

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