Things I Still Don't Know Flashcards
What are the two types of anorexia nervosa?
restricting type and binge eating type/purging type
what are the cardiac medical complications associated with anorexia nervosa?
bradycardia, hypotension, QT dispersion, cardiac atrophy, and mitral valve prolapse
what are the dermatologic medical complications associated with anorexia nervosa?
Xerosis, lanugo, carotenoderma, acrocyanosis, seborrheic dermatitis
what complications are associated with refeeding syndrome?
hypophosphatemia, hypokalemia, CHF, peripheral edema, rhabdomyolysis, seizures, hemolysis
what are common comorbid mood disorders associated with anorexia nervosa?
depression, anxiety: OCD***
what is needed for the minimum first line care for AN?
nutritional rehabilitation and psychotherapy
hospitalization necessary due to complications of starvation, resistance to re-feeding, suicidality
How long should hospitalization last in an AN patient?
until normal weight is achieved to reduce relapse and rehospitalization
How much weight should an inpatient AN patient gain per week?
2-3 lbs (.9-1.5 kg)
how much weight should an outpatient AN patient gain per week?
.5-1 lb (.2-.5 kg)
what is the usual initial intake of calories for an AN patient?
30-40 kcal/kg
then progressively increased to match body tolerance and weight gain goals
When should you consider pharmacotherapy in patients with AN?
consider only for patients who have been resistant to other therapies and who are willing to take medications
What medications should be avoided in patients with AN and why?
bupropion: increased seizure risk with binging and purging
and TCAs: cardiotoxicity
caution with antipsychotics and antidepressants with risk of QT prolongation
what is the only adjunctive medication shown to help with weight gain in patients with AN?
olanzapine (2.5-10 mg)
what can be prescribed to patients to help reduce anxiety associated with confronting meals?
lorazepam
how is bulimia nervosa defined?
recurrent episodes of binge eating with recurrent compensatory behavior to prevent weight gain such as vomiting, misuse of laxatives, fasting, or exercise
how long do symptoms of BN need to occur in order to be diagnosed?
both need to occur at lease once a week for 3 months
what are the electrolyte medical complications associated with BN?
dehydration, hypokalemia, hypochloremia, and metabolic alkalosis
what are the GI medical complications associated with BN?
mallory-weiss syndrome
what are the dental and skin medical complications associated with BN?
tooth enamel erosions and dental caries, scar and callus on dorsum of hand (Russel’s sign), and xerosis
what are the cardiac medical complications associated with BN?
hypotension, orthostasis, sinus tach, ECG changes, and arrhythmias
What is the most critical assessment you have to do in the treatment plan of a patient with BN?
always monitor the patients for SI
what is the best standard treatment for BN patients?
combination of nutritional rehabilitation, CBT, and pharmacotherapy
what medication should be avoided in patients with BN? Why?
bupropion: increased seizure risk with binging and purging
what is the first line pharmacotherapy for patients with BN?
fluoxetine 60 mg daily