Eating Disorder Flashcards

1
Q

Sequence of events

A

Open question
Timeline
Ideas- why do you/your family and friends think you have a problem with food. Do you worry about your weight?
Effect on life- how do you feel, what effect has your eating had on your life?

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2
Q

Symptom analysis

A

Daily routine- what do you eat in a day. Do you eat with others. Is routine fixed
Fear of fatness- how would you feel if you gained weight
Weight- do you have a target weight, would you mind if I asked how much you weight?, do you make yourself deliberately sick or use laxatives
Maladaptive behaviours- do you exercise too much? Do you use appetite suppressants or water tablets (furosemide)

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3
Q

SCOFF Questionnaire

A

Sick- do you make yourself sick because you are full
Control- do you worry you have lost control over what you eat
One stone- have you lost more than a stone in the last 3 months
Feel fat- do you feel fat even when others say you are thin
Food dominates- does food dominate your life

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4
Q

Systems review

A

Any physical problems?
Amenorrhoea
Quick top to toe- FWARJRNL, energy, bowels, hair, chest pain or palpitations

Psychosis- auditory hallucinations/ visual hallucinations/ altered sensations/ delusions of thought and control
Mania- energy levels/ have people said you are hyper/ spending habits/ libido
Depression- mood/anhedonia/ sleep/ future
Others- memory loss/ anxiety/ insight

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5
Q

Risk

A

Self
Others
Suicidal intent
Previous

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6
Q

Patients perspective

A

Concerns
Expectations
Insight

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7
Q

PMH

A

Medical or psychiatric disorders
Diabetes? Coeliac?

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8
Q

DH

A

OTC regulars allergies
Taking any drugs to help with weight loss- do you know how dangerous they can be?

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9
Q

FH

A

Medical or psychiatric disorders

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10
Q

SH

A

Job- what does it involve. Impact on job (or school)
Home situation- occupants and difficulties
How is mood affecting home life
Support from family or friends
Smoke alcohol recreational drugs
Have you been looking after yourself and the home eg. showering and cleaning

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11
Q

Important point

A

Need rapport- don’t ask how much they weigh straight away
Could be a thin person asking how to lose more weight or someone conplaining of weight loss
Always consider whether it could be an organic cause

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12
Q

Always remember

A

Anyone that presents with a friend or loved one, ask if they are happy for them to stay in with you for the consultation

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13
Q

Anorexia nervosa

A

Distorted body image
Food dominates

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14
Q

Bulimia nervosa

A

Unlike anorexia,usually normal or overweight
Bing eating
Compensatory behaviour to account for the binge eg. Inducing vomiting (look at knuckles), extreme dieting or exercise
Teeth erosion, sore throat and reflux due to purging

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15
Q

Binge eating

A

Recurrent food binges with loss of control over how much is eaten
Similar to bulimia but no compensatory behaviour
Normal or overweight

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16
Q

Investigations

A

Physical exam MSE Observations
Bloods- FBC UE LFT TFT glucose magnesium B12 folate bone profile
ECG
MRI if worried about other cause
coeliac screen

17
Q

Mania

A

Tell DVLA can’t drive