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Year 4 Psych- A > Eating disorders > Flashcards

Eating disorders Flashcards

1
Q

Bulimia nervosa definition including ICD-11 and DSM-V Criteria

A
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2
Q

biochemical features of bulimia

A

Hypokalaemia: ECG will show too
Low sex hormone levels (FSH, LH, oestrogen and testosterone)
Raised growth hormone and cortisol levels
Hypercholesterolaemia
metabolic alkalosis in ABG in some cases

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3
Q

psychological symptoms of bulimia

A
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4
Q

physical symptoms of bulimia

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5
Q

differential diagnoses of bulimia

A
  • Anorexia Nervosa (AN)
  • Kleine-Levin Syndrome: Characterized by hypersomnia, hypersexuality, and hyperphagia.
  • Kluver-Bucy Syndrome: Involves compulsive eating, associated with bilateral medial temporal lobe lesions.
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6
Q

management of bulimia

A

If bulimia-nervosa-focused guided self-help is unacceptable, contraindicated, or ineffective after 4 weeks of treatment, NICE recommend that we consider individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

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7
Q

anorexia nervosa definition: DMS-5 criteria

A

BMI adults (<18.5 – mild risk AN, <15 – moderate risk, <13 – high risk)

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8
Q

anorexia nervosa risk factors

A
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9
Q

anorexia nervosa features: history and examination

A
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10
Q

investigations in anorexia nervosa

A

Blood results:
Deranged electrolytes - typically low calcium, magnesium, phosphate and potassium
Low sex hormone levels (FSH, LH, oestrogen and testosterone)
Leukopenia
Raised growth hormone and cortisol levels (stress hormones)
Hypercholesterolaemia
Metabolic alkalosis, either due to vomiting or use of diuretics

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11
Q

Management of anorexia nervosa

A

If patients are very unwell the MARSIPAN checklist should be used to guide management.

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12
Q

Anorexia nervosa complications

A
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13
Q

positive and negative prognosis factors in anorexia nervosa

A
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14
Q

What should be asked about for PC of an eating disorder?

A

duration

precipitants (puberty, sudden weight loss, a switch to veganism/vegetarianism)

behaviours and frequency (restricting, binging, vomiting, exercising, laxative use, compulsions, routines)

cognitions (weight gain fear, body perception, any body parts they don’t like)

ideal weight (if you had a magic wand, highest and lowest weights in the past)

motivation for change (what’s stopping them from recovering, why do they stick with it?)

biological symptoms (libido)

also consider:

  • evidence for impulsivity -> self-harm, gambling
  • evidence for psychosis
  • evidence for anxiety
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15
Q

What should be asked about for family history of an eating disorder?

A

family attitude to food and eating - any pressure to finish food as a child

parent’s dieting history

mother and father’s shape

family psych history

role in family and relationships

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16
Q

What should be asked about for personal history of an eating disorder?

A

shape as a child

fussy as a child

effect of puberty

schooling

peer pressure

pregnancies

are they still functioning

17
Q

What should be asked about for PMH of an eating disorder?

A

medical admissions

complications with eating disorder e.g. osteoporosis, amenorrhoea, and infertility

WATCH OUT FOR DIABETES

18
Q

What should be asked about for social history of an eating disorder?

A

do you like cooking (anorexics tend to love it)

do you shop for food

do you have friends or hobbies

do you eat out (anorexics tend to hate this)

19
Q

What do you look for in physical examination of a patient with an eating disorder?

A

parotitis (from vomiting)

dry skin (reduced essential oils)

their size, dress and energy level

back of teeth

20
Q

What investigations should be done for a patient with an eating disorder?

A

weight and height

blood tests (FBC, thyroid function, liver function) particularly interested in phosphate and potassium

ECG

bone density

21
Q

Binge eating disorder presentation

A
22
Q

Avoidant-Restrictive Food Intake Disorder (ARFID)
definition/presentation

A
23
Q

Biological risk factors for eating disorder

A
24
Q

Psychological risk factors of eating disorders

A
25
Q

sociocultural risk factors of eating disorders

A
26
Q

physiological abnormalities in anorexia nervosa

A

Physiological abnormalities
hypokalaemia
low FSH, LH, oestrogens and testosterone
raised cortisol and growth hormone
impaired glucose tolerance
hypercholesterolaemia
hypercarotinaemia
low T3

Anorexia features
most things low
G’s and C’s raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

Year 4 Psych- A (20 decks)

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