Clinical Approach to Eating Disorders and Refeeding Syndrome (Cooley) Flashcards

1
Q

What are the main eating disorder types?

A

1) Anorexia Nervosa
2) Bulimia Nervosa
3) Binge Eating Disorder

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2
Q

What is a major risk factor for Bulimia and Anorexia Nervosa?

A

Suicide

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3
Q

Restriction of energy intake relative to requirements, leading to a significantly low body weight weight for age, sex and development is characteristic of?

A

Anorexia Nervosa

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4
Q

Anorexia Nervosa patients have an intense fear of gaining weight or becoming fat despite?

A

Being underweight

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5
Q

3 months of no binging or purging (no self-induced vomiting or use of laxatives) describes what type of Anorexia Nervosa?

How is this type accomplished?

A

1) Restricting Type

2) Excessive exercising, fasting, dieting

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6
Q

3 months of binging and purging behaviors describes what type of Anorexia Nervosa?

How is this type accomplished?

A

1) Binge-eating/purging type

2) Self-induced vomiting and misuse of laxatives

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7
Q

In regards to Anorexia Nervosa, what is the re-feeding syndrome?

A

A serous complication due to rehydrating or feeding patients beyond their current capacity

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8
Q

How do you avoid Refeeding syndrome?

A

1) Limit the amount of calories and fluid provided in the early stages of refeeding
2) Avoid rapid increases in daily amount ingested
3) Closely monitor labs during first few weeks

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9
Q

What disorder is commonly a comorbidity of Anorexia Nervosa?

A

Obsessive compulsive disorder

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10
Q

How long should hospitalization last when treating Anorexia Nervosa?

A

Until normal weight is achieved

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11
Q

In the nutritional rehabilitation of Anorexia Nervosa, how many pounds gained per week is the goal for inpatients?

For outpatients?

A

1) 2-3 pounds

2) 0.5 to 1 pound

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12
Q

Why do you want to avoid bupropion with Anorexia Nervosa patients?

Why do you want to avoid antipsychotics and antidepressants?

A

1) Increases seizure risk with binging and purging

2) Risk of QT prolongation

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13
Q

Olanzapine is the only adjunctive medication show to help with?

How can lorazepam help?

A

1) Weight gain

2) Reduce anxiety associated with confronting meals

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14
Q

Recurrent episodes of binge eating followed by recurrent inappropriate compensatory behavior to prevent weight gain is characteristic of?

A

Bulimia Nervosa

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15
Q

How can patients present in terms of appearance which differs from Anorexia Nervosa?

A

Patients can vary between normal body weight, slightly underweight, overweight, or obese

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16
Q

What behaviors are used to counteract the weight gain from binge-eating with Bulimia Nervosa?

A

Purging

17
Q

Do Bulimia Nervosa patients care more about losing weight or not gaining weight?

A

Not gaining weight

18
Q

What is the treatment of choice for Bulimia Nervosa?

A

CBT Psychotherapy

19
Q

Similar to Anorexia Nervosa, what drug should be avoided in Bulimia Nervosa due to its increased seizure risk with binging and purging?

A

Bupropion

20
Q

What is the first line pharmacotherapy used for Bulimia Nervosa?

A

Fluoxetine

21
Q

What disorder is characterized by at least three of the following: Eating large amounts of food when not hungry, eating rapidly, feeling uncomfortably full after eating, eating alone due to embarrassment over amount consumed, feelings of guilt/depression/disgust after eating?

A

Binge Eating Disorder

22
Q

How does Binge Eating Disorder differ from Bulimia Nervosa?

A

No inappropriate compensatory behaviors are used

23
Q

What is the first line treatment for Binge Eating Disorder?

A

CBT psychotherapy

24
Q

In the pharmacologic treatment of Binge Eating Disorder what is Vyvanse (lisdexamfetamine dimesylate)?

A

The only medication approved to treat moderate to severe Binge Eating Disorder in adults