Psychological Aspects of GI Disease/Eating Disorders

Question 1

What is dyspepsia?

Answer 1

Indigestion

Question 2

What can opiates do to appetite?

Answer 2

Suppress it

Question 3

What can drinking heavily cause?

Answer 3

Acute gastritis

Question 4

What are the metabolic causes of Anorexia, Nausea or Vomiting?

Answer 4

Diabetic ketoacidosis
Renal tubular acidosis
Hypercalcaemia
Adrenocortical insufficiency
Other rare causes of acidosis or alkalosis

Question 5

What is porphyria?

Answer 5

Abnormal metabolism of haemoglobin so porphyrins are excreted in urine causing it to become darker

Question 6

What does vomiting early usually signify?

Answer 6

Functional symptoms

Question 7

When would people with pyloric problems vomit?

Answer 7

A few hours after eating

Question 8

What investigations should be done?

Answer 8

Full Blood Count
Biochemical profile – Blood glucose
Pregnancy Test
Urinalysis/ Culture 
Chest X-Ray
Abdominal film (AXR)
Ultrasound Scan (USS) – Endoscopy (UGIE)

Question 9

How is the nutritional risk assessed?

Answer 9

1. BMI –

Question 10

What is refeeding syndrome?

Answer 10

Carbohydrate overload that they are not used to will cause an adrenalin spike (Raises Insulin, rapid generation of ATP, phosphate moves into cell causing Hypophosphataemia to develop – Electrolyte imbalance

Question 11

What are the consequences of refeeding syndrome? (9)

Answer 11

Rhabdomyolysis – Destruction of striated muscle cells
Respiratory failure
Cardiac failure
Leucocyte dysfunction
Hypotension
Arrhythmias
Seizures
Coma
Sudden death

Question 12

What are functional disorders like?

Answer 12

Software problem - Even though you can’t see them, does that mean they aren’t there?

Question 13

What is visceral sensitivity?

Answer 13

General increase in pain sensation experienced in internal organs

Question 14

What is anorexia nervosa?

Answer 14

Refusal to maintain body weight at or above a minimally normal weight for age and height
Comes with an intense fear of gaining weight or becoming fat, even though underweight

Question 15

What is the minimum diagnostic criteria for Anorexia Nervosa?

Answer 15

15% of minimum normal weight must have been lost

Menstruation is absent

Question 16

What characterises Bulimia Nervosa? (5)

Answer 16

Recurrent episodes of being-eating whilst:

1. Eating in a discrete period of time, e.g. a 2-hour period, an amount of food that is definitely larger than most people would eat during a similar period of time and similar circumstances
2. A sense of lack of control during the episode
3. Recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, other medications or enemas
4. The binge-eating and compensatory behaviours occur on average at least twice a week for 3 months 5. Self-evaluation is unduly influenced by body weight and shape.