S1B5 - Nutrition: eating disorders Flashcards
Describe the typical behaviors of a bulimic patient.
Bulimia nervosa is an eating disorder characterized by binge eating, with or without purging, often followed by abuse of laxatives, diuretics, or enemas.
Describe the defining characteristics of anorexia nervosa.
Anorexia nervosa is an eating disorder characterized by the following:
- Restriction of energy intake
- Significantly low body weight
- Intense fear of gaining weight or persistent behavior that interferes with weight gain
- Distorted view of one’s own weight, shape, or body image
- Excessive exercising
- May or may not be associated with purging
What is one commonly tested cause of pica eating disorder?
One commonly tested cause of pica is iron deficiency anemia.
A 14-year-old Caucasian female is brought to her pediatrician because she has lost a significant amount of weight. She has been doing extremely well in school, but her teachers noted she is extremely thin. She has increased her running to 6 miles a day. On examination she is noted to be extremely thin having lost greater than 20% of her weight. Which of the following other psychiatric conditions is associated with her diagnosis?
A) Bipolar disorder I
B) Dysthymic disorder
C) Schizophrenia
D) Body Dysmorphic disorder
E) Depression
Depression
Answer Explanation
The patient described has a diagnosis consistent with anorexia nervosa. It is characterized by excessive dieting and weight loss (losing >15% body weight) with abnormal eating habits, despite normal appetite. Also exhibits increased exercise and body image distortion. It commonly coexists with depression.
What is the initial treatment of severe anorexia nervosa?
Initial treatment for severe anorexia nervosa initially involves hospitalization to restore a good nutritional status.
What is the body weight of a patient with bulimia nervosa?
Body weight in bulimia nervosa is usually normal or slightly overweight.
Bulimia nervosa is most often seen in which patient population?
Bulimia nervosa is most often seen in adolescent females.
Why should a clinician avoid prescribing bupropion to a patient with bulimia nervosa?
When selecting an antidepressant for patients with bulimia nervosa, clinicians should avoid bupropion, as it is contraindicated due to a higher risk of seizures in people with bulimia nervosa.
A 15-year-old female is brought to her pediatrician because she was found vomiting after an episode of binge eating. Upon further questioning, she admits to using laxatives and diuretics. Which of the following is NOT associated with her diagnosis?
A) Dental caries
B) Swelling of parotid glands
C) Esophageal tears
D) Normal body weight
E) Matabolic acidosis
Metabolic acidosis
Answer Explanation
The patient described has bulimia nervosa, which is characterized by binge eating, followed by vomiting or abuse of laxatives, diuretics and enemas. Also associated with excessive exercising. Bulimia is also associated with esophageal varices, dental caries, swelling of parotid glands, electrolyte disturbances, menstrual irregularities, metabolic alkalosis and dorsal hand calluses from inducing vomiting (Russell’s sign). Patients with bulimia typically do not have severe weight loss. They often have normal body weight.
What is pica eating disorder?
Pica eating disorder is characterized by persistent eating of non-nutritive substances (e.g. ice) for at least one month.
Anorexia nervosa is most commonly seen in which gender?
Anorexia nervosa is seen predominantly in females.
In addition to restoring a good nutritional status in people with anorexia nervosa, what are some other treatment options?
Other treatment options for anorexia include antidepressants (e.g. mirtazapine due to weight gain side effects) and family therapy.
Name several complications of anorexia nervosa.
Anorexia nervosa is associated with several complications, including:
- Osteoporosis and metatarsal stress fractures
- Amenorrhea
- Anemia
- Electrolyte disturbances (e.g. hypokalemia, hyponatremia)
- Lanugo (fine body hair)
What other psychiatric condition is associated with anorexia nervosa?
Anorexia nervosa commonly coexists with depression.
What are the treatment options for patients with bulimia nervosa?
Treatment of bulimia nervosa may include the following:
- Cognitive Behavioral Psychotherapy (CBT)
- Dietician to provide nutritional education
- Family therapy
- Antidepressants (e.g. TCAs, SSRIs, MAOIs)
Describe the medical complications of a patient with bulimia nervosa.
Bulimia nervosa may have several complications including:
- Esophageal tears (Mallory-Weiss syndrome) and rupture (Boerhaave syndrome)
- Dental caries
- Inflammation of parotid glands
- Electrolyte disturbances (e.g. hypokalemia, hypochloremia)
- Menstrual irregularities
- Metabolic alkalosis
- Dorsal hand calluses from inducing vomiting (Russell’s sign)
