B5-091 Eating Disorders Flashcards

1
Q

recurrent episodes of binge eating
paired with
recurrent inappropriate compensatory behaviors to prevent weight gain

A

bulimia nervosa

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2
Q
  • often accompanied by lack of self control
  • dissociative quality during binging
  • relief with purging
A

bulimia nervosa

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3
Q

vomiting, laxatives, diuretics, enemas, thyroid hormone, omit/reduce insulin dosing, fasting, excessive excercise

may accompany..

A

bulimia nervosa

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4
Q

30% of patient with bulimia nervosa go on to develop

A

substance abuse disorder

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5
Q

general constitutional symptoms of eating disorder

3

A
  • fatigue
  • significant reduction in resting energy expenditure
  • abdominal pain
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6
Q

vital sign changes with eating disorders

A
  • bradycardia
  • hypothermia
  • hypotension
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7
Q

CNS/psych symptoms with eating disorders

2

A

suicide risk
social isolation

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8
Q

hematologic symptoms of eating disorders

A

bone marrow suppression -> pancytopenia

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9
Q

GU symptoms with eating disorders

A

low estrogen and amenorrhea in females
low testosterone in men

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10
Q

endocrine symptoms of eating disorders

A
  • cold intolerance
  • low T4/T3 or elevated T3
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11
Q

MSK symptoms related to eating disorders

A

decreased bone density

(osteoporosis, frequent fractures)

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12
Q

what dermatologic abnormality might you see in a patient with an eating disorder?

A

lanugo

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13
Q

cardiac symptoms of eating disorders

4

A
  • bradycardia
  • arrythmias
  • QT prolongation
  • cardiomyopathy
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14
Q

what nutrient deficiencies are associated with eating disorders?

3

A

magnesium
zinc
phosphate

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15
Q

what GI symptoms are associated with eating disorders?

7

A
  • weight loss
  • dehydration
  • constipation
  • hypoglycemia
  • elevated cholesterol
  • AST/ALT elevation
  • elevated amylase
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16
Q

what renal symptoms are associated with eating disorders?

A

peripheral edema

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17
Q

what clinical signs are associated with purging?

7

A
  • parotitis
  • dental erosion
  • metabolic alkalosis (hypochloremia)
  • hypoglycemia
  • esophageal tears
  • gastric rupture
  • cardiac arrythmias
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18
Q

what electrolyte imbalances are associated with purging?

A
  • hypokalemia
  • hypochloremia
  • hyponatremia
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19
Q

laxative abuse can cause metabolic [..]

A

acidosis

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20
Q

gold standard therapy treatment

A

Family Based

CBT and DBT are good backups

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21
Q

goals of treatment

listed in order from most to least helpful

A
  1. refeeding
  2. therapy
  3. medication - if necessary
22
Q

if the symptoms are severe
the patient is unstable or refusing to eat…

A

need to be admitted

everyone else can be managed outpatient

23
Q

life threatening condition characterized by widespread organ dysfunction related to failure to make adequate ATP

A

refeeding syndrome

24
Q

prior to refeeding, what happens physiologically?

A
  1. prolonged under nutrition cause decreased blood glucose
  2. catabolism of fat and protein stores
  3. depeletion of intracellular electrolytes including phosphorus
25
Q

during refeeding, what happens physiologically to put patient at risk for refeeding syndrome?

A
  1. rising glucose stimulates insulin secretion
  2. phosphorus moves into cells to create ATP
  3. phophorus concentrations are low from chronic undernutrition
    (insufficient amounts within 12-72 hours of feeding)
26
Q

binging without purging

A

binge eating disorder

27
Q

may be the prodromal phase of other eating disorders

A

binge-eating disorder

28
Q

associated with anxiety, OCD

A

anorexia nervosa

29
Q
  • intense fear of weight gain
  • restriction of caloric intake with severe weight loss
  • at least 3 months duration
  • distorted perception of body image
A

anorexia nervosa

30
Q

BMI <18.5 or <5th% for age

A

anorexia nervosa

31
Q
  • binge eating
  • recurrent inappropriate compensatory mechanisms
  • at least 1x/week for 3 months
  • self-evaluation unduly influenced by body shape/size
A

bulimia nervosa

32
Q

may have normal/overweight BMI

2

A

bulimia nervosa
binge-eating disorder

33
Q

dysfunctional dieting precedes binge eating

A

bulimia nervosa

34
Q

associated with BPD and substance abuse

A

bulimia nervosa

35
Q
  • binge eating without compensatory mechanisms
  • at least 1x/week for 3 months
A

binge eating disorder

36
Q

dieting follows binge eating

A

binge eating disorder

37
Q

associated with bipolar, depressive, anxiety disorders

A

binge eating disorder

38
Q

anorexia symptoms but weight is within/above normal range

A

atypical anorexia

39
Q

absence of binge eating, only purging

A

purging disorder

40
Q
  • recurrent episodes of night eating
  • awareness and recall
  • causes significant distress/impairment in function
A

night eating syndrome

41
Q

which deficiency is reversed as a patient begins refeeding

A

phosphorus

due to shift from fat to carbohydrate metabolism

42
Q

what should be in the standard admitting orders for a patient with an eating disorder?

A

CBC
diet history
ECG
electrolyte panel

43
Q

patients who deprive themselves of calories during their teenage years are at high risk for […] later in life

A

low bone density

44
Q

chaotic feeding schedule and decisions around food
frequent fad dieting

A

bulimia

45
Q

highly structured day with restrictive intake/purging behaviors/exercise routines

A

anorexia

46
Q

associated with OCD

A

anorexia

47
Q

associated with BPD

A

bulimia

48
Q

loss of acid from the stomach due to chronic vomiting can lead to

A

metabolic alkalosis

49
Q

in patients who abuse laxative regularly, you may see a mild metabolic

A

acidosis

50
Q

recommended treatment for Avoidant/restrictive food intake disorder

A

CBT with exposure therapy and FBT
maybe SSRI

51
Q

3 diagnostic criteria to diagnose anorexia nervosa

A
  • persistent energy intake restriction
  • intense fear of gaining weight/becoming fat
  • disturbance in self-perceived weight or shape