Dementia Flashcards
(34 cards)
Bulimia acid base?
Metabolic alkalosis - due to loss of HCL from the stomach when vomiting
When managing an anorexic patient need to screen to assess whether they need immediate admission - what to look for regarding BMI?
BMI <13
Weight loss >1kg / wk
Septic signs - cold peripheries
HR <40bpm
Suicide risk
When managing an anorexic patient need to screen to assess whether they need immediate admission - what to look for regarding peripheries?
BMI <13
Weight loss >1kg / wk
**Septic signs - cold peripheries **
HR <40bpm
Suicide risk
What disturbances may be seen in anorexia?
- electrolytes?
3
Hypercholesterolaemia
Hyperkalaemia
Hypercarotinaemia
When managing an anorexic patient need to screen to assess whether they need immediate admission - what to look for regarding observations?
BMI <13
Weight loss >1kg / wk
Septic signs - cold peripheries
HR <40bpm
Suicide risk
What will be seen on ECG of a bulimic?
Hypokalaemia due to vomiting -> 1st degree heart block, tall P-waves, flattened T waves
What is binge eating disorder?
Consume excessive amount of food in relatively short period of time.
However, unlike bulimia, there is no compensatory behaviours such as vomiting, laxatives or excessive exercise.
For diagnosis, must occur at least once per week for at least six months.
Features of:
Mild bullima?
Moderate bulima?
Severe bulimia
mild - infrequent binge+purse <2 a week -> monitor 12 weeks
mod - frequent binge + purge >2 a week -> monitor 8 weeks and refer to CEDS if needed
severe - daily purging with electrolyte imbalance -> urgent CEDs referral
Features of:
Mild bullima?
Moderate bulima?
Severe bulimia
mild - infrequent binge+purse <2 a week -> monitor 12 weeks
mod - frequent binge + purge >2 a week -> monitor 8 weeks and refer to CEDS if needed
**severe - daily purging with electrolyte imbalance -> urgent CEDs referral **
When managing an anorexic patient need to screen to assess whether they need immediate admission - what to look for regarding weight loss?
BMI <13
Weight loss >1kg / wk
Septic signs - cold peripheries
HR <40bpm
Suicide risk
When managing an anorexic patient need to screen to assess whether they need immediate admission - what to look for regarding risk?
BMI <13
Weight loss >1kg / wk
Septic signs - cold peripheries
HR <40bpm
**Suicide risk **
What is the name of the clinical sign of calluses on knuckles from forced vomiting?
Russel’s sign = bullimia
Bulimia management for adults vs children?
Clinical signs of recurrent vomiting in bulimia?
- erosion of teeth
- russel’s sign (calluses on the knuckles) from self induced vomiting
What is EDNOS?
Eating Disorder Not Otherwise Specified. Most commonly diagnosed eating disorder. Diagnosis that is often received when an individual meets many, but not all, of the criteria for anorexia or bulimia.
Do you use watchful waiting for bullimia and when?
Mild bullima?
Moderate bulima?
Severe bulimia
No watchful waiting ever
**
mild - infrequent binge+purse <2 a week -> monitor 12 weeks**
mod - frequent binge + purge >2 a week -> monitor 8 weeks and refer to CEDS if needed
severe - daily purging with electrolyte imbalance -> urgent CEDs referral
ICD 10 diagnostic criteria for bulimia?
Binging/overeating or persistent preoccupation with eating. (MAIN SYMPTOM)
Purging behaviours (excessive exercise, vomiting, laxatives, diuretics).
Psychopathology (loss of control, body image distortion, dread of fatness).
- tend to be a normal / increased weight due to the binging
What is bulimia?
Episodes of binge eating followed by intentional vomiting / laxative use / excersizing
What is the DSM 5 criteria to diagnose Anorexia? (3)
DSM-V Criteria:
Restriction of calorie intake leading to significantly low body weight.
Intense fear of gaining weight or becoming fat, even though underweight.
Disturbance in the way in which one’s body weight or shape is experienced.
calorie restriction, fear, body dysmorphia
What medication may be prescribed if there is depression with anorexia?
Fluoxetine
What physical symptoms may occur with anorexia?
Low BMI
bradycardia
lanugo hair
muscle wasting
Amenorrhea
Failure of secondary sexual characteristics
hypotension
enlarged salivary glands
Adult management of anorexia (psycho management plan)
CBT - ED
MANTRA (maudsley anorexia nervosa treatment for adults)
SSCM - specialist supportive clinical management
Adult management of anorexia - SSCM?
(Specialist Supportive Clinical Management).
Referral pathway name for patient:
- severe anorexia : (BMI<15, rapid weight loss, evidence of system failure)
CEDS
Community eating disorder services
