Diagnoses - Eating disorders Flashcards
(32 cards)
Episodes of unrestrained eating w/o compensatory behaviors of bulimia. Dx? (5x)
BINGE-EATING DISORDER
Metabolic abnormality commonly found w anorexia nervosa/purging subtype? (4x)
DECREASED SERUM POTASSIUM
Dehydrated bulimic w/ BP 100/60 and orthostasis HR 60. Stat lab test: (3x)
POTASSIUM
What med has shown some efficacy in reducing binging and purging in bulimia nervosa? (x3)
FLUOXETINE
A plastic surgeon asks the psychiatrist to evaluate a 15 yo pt who is requesting rhinoplasty. The surgeon is willing to perform the operation but is concerned by the pt’s young age. The pt is with her parents. The pt explains “I broke my nose playing hockey 2 years ago and it has bothered me ever since” On exam, her nose is noticeable asymmetrical. Patient shows no obvious psychological distress other than concern for her appearance. Pt states “I just want to look normal again”. Parents report child has had poor self esteem since the injury and they are hoping the operation will help her self confidence. Which of the following is the most likely psychological outcome for this pt following cosmetic surgery? (x2)
AN IMPROVEMENT IN QUALITY OF LIFE
Complication of anorexia nervosa LEAST likely to resolve after restoring weight is? (2x)
OSTEOPOROSIS
A diagnosis of anorexia nervosa requires that the patient has maintained a weight below what percentage of a minimally normal weight for age and height? (2x)
85%
Pt with significant medical hx admitted to inpatient psych unit. Labs show: low K and Cl, elevated HCO3 and amylase, and normal lipase. Dx: (2x)
BULIMIA NERVOSA, PURGING TYPE
23 y/o pt w/ excessive preoccupation with body shape. Pt is in no apparent distress, but admits to binge eating episodes followed by purging twice weekly for past 6 months, Body weight: normal. Dx: (x2)
BULIMIA NERVOSA
Enlarged parotid glands in a pt being treated for anorexia nervosa would suggest which of the following? (2x)
SELF-INDUCED VOMITING
During the acute initial refeeding phase of tx for pt w/ severe anorexia nervosa, which is most helpful focus of psychotherapeutic interventions with the pt? (2x)
COACHING, SUPPORT, AND POSITIVE BEHAVIORAL REINFORCEMENT
Risk factor for developing bulimia?
CHILDHOOD SEXUAL ABUSE
During the acute initial refeeding phase of treatment for a patient with severe anorexia nervosa, which of the following is the most helpful focus of psychotherapeutic interventions with the patient?
COACHING, SUPPORT, AND POSITIVE BEHAVIORAL REINFORCEMENT
What differentiates bulimia from binge eating disorder?
HISTORY OF LAXATIVE ABUSE
13 yo seen for therapy has lost weight and is now 20th %ile for weight and 60th %ile for hight. Decided to eat healthy, wants to lose 5-10 lbs, spending time researching food. Diagnosis?
ANOREXIA NERVOSA
Abdominal pain, diarrhea, hypokalemia, weight loss, steatorrhea, skin pigmentation. Possible laxative abuse. Measure:
PHENOLPHTHALEIN (over the counter laxative)
Patient with anorexia nervosa is admitted to inpatient unit and has begun treatment with high caloric oral feedings; 2 days after admission an EKG shows ventricular tachycardia. Which tests would best determines the likely cause of arrhythmia?
PHOSPHATE
The primary focus of behavior therapy in the treatment of anorexia nervosa is to :
RESTORE WEIGHT
Bulimia is comorbid with:
MDD
Frequently a medical sx/sign in pts with anorexia:
REPRODUCTIVE HORMONE DYSFUNCTION
What electrolyte abnormality is most seen in bulimics?
HYPOCHLOREMIC ALKALOSIS WITH HYPOKALEMIA
32 y/o pt reveals a long-standing preoccupation with the shape of her mouth and teeth, though she says that her friends and spouse have assured her that her feelings are inappropriate. Pt reports that she often spends an hour cleaning her teeth, so that the abnormality will be less noticeable. At times she avoids social contact, fearing that people will silently criticize the appearance of her mouth. She has no other obsessions on cleaning rituals. Best dx for pt’s long-standing preoccupation?
BODY DYSMORPHIC DISORDER
25-year-old pt with no previous psych history has a new preoccupation with imagined defects in appearance, which is a cause of excessive concern. The pt has a normal medical workup and, other than the distress over appearance, the pt does not have other psych sx. Which of the following meds is most appropriate?
FLUOXETINE
In overcoming the resistance to treatment often encountered with patients who have anorexia nervosa, what is it most useful for the psychiatrist to emphasize?
EMPHASIZE HOW TREATMENT WILL ALLOW THE PATIENT TO FOCUS ENERGY ON OTHER MATTERS.
