B5-091 Eating Disorders Flashcards
(51 cards)
recurrent episodes of binge eating
paired with
recurrent inappropriate compensatory behaviors to prevent weight gain
bulimia nervosa
- often accompanied by lack of self control
- dissociative quality during binging
- relief with purging
bulimia nervosa
vomiting, laxatives, diuretics, enemas, thyroid hormone, omit/reduce insulin dosing, fasting, excessive excercise
may accompany..
bulimia nervosa
30% of patient with bulimia nervosa go on to develop
substance abuse disorder
general constitutional symptoms of eating disorder
3
- fatigue
- significant reduction in resting energy expenditure
- abdominal pain
vital sign changes with eating disorders
- bradycardia
- hypothermia
- hypotension
CNS/psych symptoms with eating disorders
2
suicide risk
social isolation
hematologic symptoms of eating disorders
bone marrow suppression -> pancytopenia
GU symptoms with eating disorders
low estrogen and amenorrhea in females
low testosterone in men
endocrine symptoms of eating disorders
- cold intolerance
- low T4/T3 or elevated T3
MSK symptoms related to eating disorders
decreased bone density
(osteoporosis, frequent fractures)
what dermatologic abnormality might you see in a patient with an eating disorder?
lanugo
cardiac symptoms of eating disorders
4
- bradycardia
- arrythmias
- QT prolongation
- cardiomyopathy
what nutrient deficiencies are associated with eating disorders?
3
magnesium
zinc
phosphate
what GI symptoms are associated with eating disorders?
7
- weight loss
- dehydration
- constipation
- hypoglycemia
- elevated cholesterol
- AST/ALT elevation
- elevated amylase
what renal symptoms are associated with eating disorders?
peripheral edema
what clinical signs are associated with purging?
7
- parotitis
- dental erosion
- metabolic alkalosis (hypochloremia)
- hypoglycemia
- esophageal tears
- gastric rupture
- cardiac arrythmias
what electrolyte imbalances are associated with purging?
- hypokalemia
- hypochloremia
- hyponatremia
laxative abuse can cause metabolic [..]
acidosis
gold standard therapy treatment
Family Based
CBT and DBT are good backups
goals of treatment
listed in order from most to least helpful
- refeeding
- therapy
- medication - if necessary
if the symptoms are severe
the patient is unstable or refusing to eat…
need to be admitted
everyone else can be managed outpatient
life threatening condition characterized by widespread organ dysfunction related to failure to make adequate ATP
refeeding syndrome
prior to refeeding, what happens physiologically?
- prolonged under nutrition cause decreased blood glucose
- catabolism of fat and protein stores
- depeletion of intracellular electrolytes including phosphorus