Eating Disorders Flashcards
(34 cards)
Define Anorexia Nervosa
Eating disorder characterised by deliberate weight loss, intense fear of fatness, distorted body image and endocrine disturbances
Give four predisposing risk factors for Anorexia Nervosa
Family History
Female
Sexual Abuse
Perfectionism
Give precipitating risk factors for anorexia nervosa
adolescence and puberty
criticism regarding eating, body shape or weight
occupational or recreational pressure to be slim
Give three perpetuating risk factors for Anorexia Nervosa
Starvation causes neuroendocrine changes that perpetuate anorexia
Perfectionism
Western Society
Describe the ICD10 diagnosis of Anorexia Nervosa
Present for at least 3 months in the absence of recurrent binge eating
- Fear of weight gain
- Endocrine disturbance resulting in amenorrhoea/Impotence
- Emaciated (BMI<17.5)
- Deliberate Weight Loss
- Distorted Body Image
Give four physical symptoms of Anorexia Nervosa
Fatigue
Hypothermia
Bradycardia
Lanugo Hair
Describe the expected Appearance, Speech, Mood and Thought of an anorexic patient
- Appearance - Thin, Weak, Slow, Anxious
- Speech - Slow, Slurred
- Mood - Euthymic or Low
- Thoughts - Preoccupation with food/weight/appearance
- Perception - no hallucinations
- cognition - normal or poor if physically unwell
- insight - poor
Describe the typical blood results of an Anorexic Patient
- Increased Urea and Creatinine
- Low Electrolytes (Mg, K, PHO3, Cl)
- Low Albumin
- Low Thyroid Hormones
- High Cholesterol
- High Cortisol
- Low glucose
Other than bloods, Name three other investigations for Anorexic Patients
- VBG (Alkalosis - Vomiting, Acidosis - Laxatives)
- DEXA - rule out osteoporosis
- ECG (Bradycardia or Long QT)
Name three complications that people with Anorexia Nervosa are at increased risk of
- Pancreatitis
- Hepatitis
- Cardiac Failure
- Osteoporosis
- Renal failure and renal stones
Describe the Biological Management of Anorexia Nervosa
SSRIs for Comorbid Depression
Aim for weight gain of 0.5-1kg/week if inpatient, or 0.5kg/week if outpatient
Treat medical complications ie electrolyte disturbance
Name 5 Psychological interventions for Anorexia Nervosa
- Psychoeducation about Nutrition
- CBT
- Cognitive analytic therapy
- Interpersonal Psychotherapy
- Family Therapy (ANFFT)
what are 2 social interventions to help AN patients?
voluntary organisations
self-help groups
What is Refeeding Syndrome?
Downregulation of enzymes causes metabolic abnormalities if feeding is started at a rate too quick
changes in phosphate, magnesium and potassium
caused by a large insulin surge following increased food intake
Causes Fluid Imbalance, Hypokalaemia, Hypophosphataemia, Decreased Muscle Activity
what can occur as a result of phosphate depletion relating to refeeding syndrome?
cardiac failure
How can Refeeding Syndrome be prevented?
Start feeding at 1200kcal and increase every 5 days
measure serum electrolytes prior to feeding and monitor refeeding bloods daily
monitor for signs such as tachycardia and oedema
how is BMI calculated
weight / height2
Define Bulimia Nervosa
Eating disorder characterised by repeated episodes of uncontrolled binge eating followed by compensatory weight loss behaviours and overvalued ideas regarding ideal shape and weight
Describe the aetiological cycle of Bulimia Nervosa
1) Sense of compulsion to eat
2) Binge eating
3) Fear of Fatness
4) Compensatory Weight Loss Behaviours
Patients often have a history of childhood obesity
risk factors for bulimia nervosa - predisposing, precipitating, perpetuating and biological, psychological and social
What are the two types of Bulimia Nervosa?
Purging - the patient uses self induced vomiting/laxatives/diuretics after eating
Non Purging - less common, excess exercise or fasting
Describe the ICD10 criteria of Bulimia Nervosa
(acronym Bulimia Patients Fear Obesity)
- *B**ehaviours to prevent weight gain
- *P**reoccupation with eating
- *F**ear of fatness
- *O**vereating (At least 2 episodes a week for 3 months)
other than the ICD10 criteria for bulimia nervosa, what are some other features?
normal weight - usually the potential for weight gain from binging is counteracted by the weight loss/purging behaviours
depressed and low self esteem
irregular periods
signs of dehydration
consequences of repeated vomiting and hypokalaemia
Give 5 consequences of repeated vomiting
Hypokalaemia
Mallory Weiss Tear
Dental Erosions
Russell’s Sign
Aspiration Pneumonitis
