Y4 - Eating Disorders

Question 1

What are the first things you should do if you diagnose an eating disorder?

Answer 1

FBC, UE - checking for nutrient deficiencies and anaemia
TFTs, LFTs
Rule out other diagnoses, e.g. hyperthyroidism, DM, Crohn’s etc.

Question 2

What are the physical complications of anorexia nervosa?

Answer 2

Hypothermia (as basal metabolic rate is reduced)
Osteoporosis (will improve if they start eating, but won’t return to previous bone density)
Oedema
Anaemia/leucopenia
Slow pulse, hypotension
Emaciation, cold extremities, lanugo
Constipation
Infertility
Thiamine deficiency (get them on IV thiamine after admission)
Refeeding syndrome

Question 3

What electrolyte abnormalities occur in anorexia nervosa?

Answer 3

Low potassium, magnesium, and phosphate

Question 4

How does AN affect the bone marrow?

Answer 4

Causes it to shut down
Leading to fewer white cells –> dampened immune system
Fewer RBCs –> anaemia
Fewer platelets –> easy bleeding

Question 5

What is refeeding syndrome?

Answer 5

After feeding a person who has not eaten in a long time, insulin is produced
Insulin drives K, Mg, phosphate into cells (but these are already in dangerously low concentrations in the blood & are hence lowered even more)

–> cardiac arrhythmias, death

Question 6

What is the literal translation of torsade de pointes?

Answer 6

Twisting of peaks

Question 7

What is torsade de pointes?

Answer 7

Polymorphic ventricular tachycardia

Prolongation of the QT interval can put an individual at risk of this

Question 8

What causes torsade de pointes?

Answer 8

Drugs, e.g. haloperidol

Electrolyte abnormalities due to malnourishment, alcoholism,