Psychological Aspects of GI disease

Question 1

Which psychological issues may present as GI disease?

Answer 1

Stress
Anxiety
Depression
Somatisation
Eating disorders

Question 2

Which drugs can affect the GI system?

Answer 2

Opiates
Amphetamines
Cocaine
Anticholinergics
Antidepressants

Question 3

How is malnutrition risk assessed?

Answer 3

MUST score

Question 4

What factors are considered for MUST scoring?

Answer 4

BMI
Weight Loss
Eaten anything in last 5 days?

Question 5

How does refeeding syndrome occur?

Answer 5

Rise of insulin
Rapid ATP generation
Phosphate moves into cells
Hypophosphataemia develops

Question 6

What factors put a patient at high risk of refeeding problems?

Answer 6

BMI < 16
Unintentional weight loss >15% (3-6mo)
10 days no eating
Low K, P, Mg

Question 7

What factors put a patient at moderate risk of refeeding problems?

Answer 7

BMI < 18.5
Unintentional weight loss >10% (3-6mo)
5 days no eating
History of alcohol/IVDA

Question 8

How are patients at high risk of refeeding syndrome treated?

Answer 8

Correct fluid depletion
Thiamine 30mins before food
Feed slowly
Gradually increase
Replace electrolytes

Question 9

What are the major types of eating disorders?

Answer 9

Binge Eating disorder
Bulimia nervosa
Anorexia nervosa