Tutorial 5- Self harm and eating disorders Flashcards
What is the BMI indications for anorexia?
17.5 (25% below normal) and below
What are the symptoms of anorexia?
Hair loss Soft hair on body Cold intolerance Loss of energy Amenorrhoea Muscle loss
What is the key sing of bulimia?
Bulimia = binging!
What are specific signs of bulimia?
Dental problems
Russell’s sign (knuckle calluses from induced vomiting)
What do you need to watch out for during eating disorders?
Electrolyte disturbances, particularly potassium
Why do children develop eating disorders?
Can stem from a loss of control in their life (parents moving away, financial problems)
How do you treat someone with an eating disorder?
Psychological therapies (family therapy works well in younger people) SSRI's can be given (mainly anorexia) Re-feed if they are severely starved brain doesn't function and so must feed using a nasogastric tube
What happens during re-feeding syndrome?
When the body is starved their is an imbalance in electrolytes particularly potassium, magnesium and phosphorus. If you give too much food too quickly these ions can lead to seizures, MI and comas.
To treat refeeding syndrome NICE has some good guidelines
Can you section someone with an eating disorder under the mental health act
Yes if they are severely starved, this is because their decision making will be impaired.
What is the clinical term for someone losing joy in things they once enjoyed??
Anhedonia
Who is at the highest risk of killing themselves?
People who are:
Isolated Suffering with a mental health disorder Have a suicide plan Men (particularly older men) suffering with drug and alcohol problems Impulsive
How do you treat someone who has tried to commit suicide?
Start on antidepressants (will take 2 weeks to work, make sure they cant overdose on it)
Put them, somewhere safe, don’t leave on their own (in young people try not to admit)
CBT, family therapy
Social work if there are serious risk (school in children)
What did I learn about describing behaviour in the mental state examination
Fidgeting
Eye contact
Rapport with Dr (full/partial/none)
What did I learn about describing speech in the mental state examination
Rate
Tone
Volume
What did I learn about describing Mood in the mental state examination
Subjectively- how the patient describes
Objectively- how the Dr describes
Mood not just about elated or low, can also be aggressive anxious, nervous etc
