B5-091 Eating Disorders Flashcards

(51 cards)

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
**during refeeding**, what happens physiologically to put patient at risk for refeeding syndrome?
1. rising glucose stimulates insulin secretion 1. phosphorus moves into cells to create ATP 1. phophorus concentrations are low from chronic undernutrition (insufficient amounts within 12-72 hours of feeding)
26
binging without purging
binge eating disorder
27
may be the prodromal phase of other eating disorders
binge-eating disorder
28
associated with anxiety, OCD
anorexia nervosa
29
* intense fear of weight gain * restriction of caloric intake with severe weight loss * at least 3 months duration * distorted perception of body image
anorexia nervosa
30
BMI <18.5 or <5th% for age
anorexia nervosa
31
* binge eating * recurrent inappropriate compensatory mechanisms * at least 1x/week for 3 months * self-evaluation unduly influenced by body shape/size
bulimia nervosa
32
may have normal/overweight BMI | 2
bulimia nervosa binge-eating disorder
33
dysfunctional dieting precedes binge eating
bulimia nervosa
34
associated with BPD and substance abuse
bulimia nervosa
35
* binge eating without compensatory mechanisms * at least 1x/week for 3 months
binge eating disorder
36
dieting follows binge eating
binge eating disorder
37
associated with bipolar, depressive, anxiety disorders
binge eating disorder
38
anorexia symptoms but weight is within/above normal range
atypical anorexia
39
absence of binge eating, only purging
purging disorder
40
* recurrent episodes of night eating * awareness and recall * causes significant distress/impairment in function
night eating syndrome
41
which deficiency is reversed as a patient begins refeeding
phosphorus | due to shift from fat to carbohydrate metabolism
42
what should be in the standard admitting orders for a patient with an eating disorder?
CBC diet history ECG electrolyte panel
43
patients who deprive themselves of calories during their teenage years are at high risk for [...] later in life
low bone density
44
chaotic feeding schedule and decisions around food frequent fad dieting
bulimia
45
highly structured day with restrictive intake/purging behaviors/exercise routines
anorexia
46
associated with OCD
anorexia
47
associated with BPD
bulimia
48
loss of acid from the stomach due to chronic vomiting can lead to
metabolic alkalosis
49
in patients who abuse laxative regularly, you may see a mild metabolic
acidosis
50
recommended treatment for Avoidant/restrictive food intake disorder
**CBT with exposure therapy and FBT** maybe SSRI
51
3 diagnostic criteria to diagnose anorexia nervosa
* persistent energy intake restriction * intense fear of gaining weight/becoming fat * disturbance in self-perceived weight or shape