Eating Disorders

Question 1

what is the main characteristic of anorexia nervosa?

Answer 1

weight loss (or failure to gain weight in children)

Question 2

what weight is suggestive of AN?

Answer 2

BMI <17.5

OR 85% weight for height in children

Question 3

what are the psychological characteristics of anorexia nervosa?

Answer 3

fear of fatness and weight gain
overvalued importance placed on weight
mood determined by weight

Question 4

what are the two subtypes of anorexia nervosa?

Answer 4

restricting

binge-purge

Question 5

what is restricting anorexia nervosa?

Answer 5

weight loss accomplished by dieting and excessive exercise

Question 6

what is binge purge anorexia?

Answer 6

still low in weight

regularly engaging in binge eating or purging behaviours

Question 7

what is bulimia nervosa?

Answer 7

recurrent binge eating followed by compensatory behaviours to avoid weight gain

Question 8

how often do episodes occur for a diagnosis of bulimia nervosa?

Answer 8

at least once a week for three months

Question 9

what can body weight be like in sufferers of bulimia nervosa?

Answer 9

normal range

may fluctuate

Question 10

what is the best predictor of a binge in bulimia nervosa?

Answer 10

a period of restricting resulting in physical hunger

Question 11

what characterises binge eating disorder?

Answer 11

recurrent episodes of excessive food consumption over short periods of time, often to the point of discomfort accompanied by feelings of guilt

Question 12

how often do episodes need to occur for a diagnosis of binge eating disorder?

Answer 12

at least once a week for three months

Question 13

what can sufferers weight be like in binge eating disorder?

Answer 13

may become obese/overweight but they do not need to be

Question 14

what can binge eating be for a patient?

Answer 14

a coping mechanism

an attempt to manage emotional stress

Question 15

what does OFSED stand for?

Answer 15

other specified feeding or eating disorder

Question 16

what is OFSED?

Answer 16

a group of disorders that do not fit the exact diagnostic criteria for other eating disorders, but mimic them in some ways

Question 17

name three examples of OFSED

Answer 17

atypical anorexia
atypical bulimia
purging disorder

Question 18

what is atypical anorexia?

Answer 18

all symptoms

weight in a normal range

Question 19

what is atypical anorexia?

Answer 19

all symptoms

weight in a normal range

Question 20

what is atypical bulimia nervosa?

Answer 20

all symptoms

binge purge cycle don’t happen as often or for as long

Question 21

what is atypical BED?

Answer 21

all symptoms

episodes less frequent and shorter

Question 22

what is purging disorder?

Answer 22

where someone purges to affect their weight but not as part of a binge purge cycle

Question 23

what is night eating syndrome?

Answer 23

when someone repeatedly eats at night after waking or eating lots after their evening meal

Question 24

what eating disorder is not about weight or the patients perceptions of weight?

Answer 24

ARFID

Question 25

what eating disorder is not about weight or the patients perceptions of weight?

Answer 25

ARFID

Question 26

what does ARFID stand for?

Answer 26

avoidant restrictive food intake disorder

Question 27

how do patients with ARFID eat?

Answer 27

restrict eating to small amounts of food avoid certain foods/food groups may be uninterested in eating

Question 28

what age group is more commonly diagnosed with ARFID?

Answer 28

childen

Question 29

what psychiatric conditions can make a diagnosis of ARFID more likely?

Answer 29

autism anxiety ADHD

Question 30

what area of the brain is first affected by starvation?

Answer 30

the forebrain this is where the self regulation system is found

Question 31

receptors for which neurotransmitters are found to be reduced in the acute stage of an eating disorder

Answer 31

serotonin | dopamine

Question 32

what are some common comorbidities in patients with eating disorders?

Answer 32

``` depression anxiety personality disorders substance abuse bipolar disorder OCD ```

Question 33

what is physical assessment used for in a patient with a suspected eating disorder?

Answer 33

establish risk of harm and need for admission NOT FOR DIAGNOSIS

Question 34

what BMI/weight loss makes a patient high risk?

Answer 34

<13 | >1kg per week

Question 35

what can often be seen when measuring BP in someone with an eating disorder?

Answer 35

orthostatic hypotension

Question 36

what test is done as part of the physical examination of a suspected eating disorder patient?

Answer 36

sit up squat stand test (SUSS)

Question 37

what sodium level is considered high risk?

Answer 37

<130 mmol/L

Question 38

what is diabetes burnout?

Answer 38

when diabetics skip insulin doses to lose weight

Question 39

what is the risk of diabetes burnout?

Answer 39

can lead to things like DKA

Question 40

what screening tool can be used to screen patients for an eating disorder?

Answer 40

sick control one fat food (SCOFF)

Question 41

what score on SCOFF indicates high probability of an ED?

Answer 41

>2

Question 42

what are the five questions asked in a SCOFF screening test?

Answer 42

``` purging behaviours? worry you've lost control over eating? lost/gained more than 1 stone in three months? believe you're fat when others disagree? thoughts and fears about food? ```

Question 43

what does MaRSIPAN stand for?

Answer 43

management of really sick patients with AN

Question 44

what is the key approach to treating a patient with AN in hospital?

Answer 44

slowly and carefully restart the feeding process

Question 45

what is the management for AN in adults?

Answer 45

CBT-ED MANTRA SSCM FPT focussed on ED's if none of these options are appropriate

Question 46

what is the management for AN in children?

Answer 46

family therapy focused on AN (FT AN)

Question 47

what is the management of BED?

Answer 47

1. guided self help 2. group CBT-ED 3. individual CBT-ED

Question 48

what is the management of bulimia nervosa in adults?

Answer 48

guided self help not appropriate/ineffective after 4 weeks, CBT-ED

Question 49

what is the management of bulimia nervosa in children?

Answer 49

family therapy focused on BN (FT-BN)

Question 50

what is the management for OFSED?

Answer 50

offer treatments recommended for the type of ED most similar to the patients symptoms

Question 51

what is the management for ARFID in young people?

Answer 51

refer to ED service/CAMHS

Question 52

what is the management for ARFID in adults?

Answer 52

refer to local ED service or community mental health team