Eating disorders

Question 1

What is anorexia nervosa?

Answer 1

intense fear of gaining weight, significantly lower weight

Question 2

What is bulimia nervosa?

Answer 2

recurrent episodes of binge eating then recurrent compensatory behaviour to prevent weight gain (vomit)

Question 3

How long to get diagnosed with bulimia?

Answer 3

1x a week for 3 months

Question 4

What is binge eating disorder?

Answer 4

binge eating with no compensatory behaviour (vomit)
MUST have 3 of :
eating rapidly
uncomfortably full
eatingg when not hungry
feeling guilty

Question 5

IS AN or BN more connected to genetics?

Answer 5

AN

Question 6

What does starvation do to the body?

Answer 6

increased cortisol causing HPA suppression which causes low hormones (amenorrhea and low libido
not a lot of tryptophan to make serotonin

Question 7

What trigger most commonly causes HPA suppression?

Answer 7

stress

Question 8

Which gender gets more eating disorders?

Answer 8

females

Question 9

Which eating disorder has higher rates of mortality?

Answer 9

anorexia

Question 10

What are the consequences from long term anorexia?

Answer 10

starvation, cardiac arrest, suicide

Question 11

Do hospitalized pregnant women. or bulimic have higher heart attack risk?

Answer 11

bulimia

Question 12

What mental disorder is common with eating disorders?

Answer 12

Anxiety, mood substance use

Question 13

What is the general principle of treatment of eating disorders?

Answer 13

it is a coping mechanism so fix underlying and offer treatment for the symptoms

Question 14

What happens if no estrogen?

Answer 14

osteoporosis, lowered growth, low libido, unexpected pregnancies

Question 15

What event is a common relapse for eating disorders?

Answer 15

pregnancy

Question 16

How can eating disorders effect pregnancy?

Answer 16

poor wight, miscarriage, nutrient deficiency, post partum depression

Question 17

When will periods return?

Answer 17

in 6 months of achieving body weight of around 90%

Question 18

What cardio complications can occur from AN?

Answer 18

prolonged QTc
Cardiac atrophy
bradycardia
arrhythmia
hypotension

Question 19

At what QTc are you at risk of TDP?

Answer 19

> 470

Question 20

What causes the arrhythmia in AN?

Answer 20

Low K

Question 21

Will cardiac issues resolve?

Answer 21

with weight restoration yes
BUT
irreversible myocarditis with emetine toxicity

Question 22

What does chronic ipecac use do?

Answer 22

induces vomitting
irreversible myocarditis

Question 23

How can we lower refeeding risk?

Answer 23

refeed slow
phosphorus supplement
hospital

Question 24

How can we treat gastroparesis?

Answer 24

Domperidone and metoclopramide

Question 25

Why is domperidone better than metoclopramide?

Answer 25

doesn't cross BBB= no EPS

Question 26

Risks of domperidone?

Answer 26

QTc prolonging

Question 27

How does domperidone work?

Answer 27

peripheral dopamine antagonist

Question 28

What can we do for constipation?

Answer 28

Peg to retrain if need bowel taper use sennosides

Question 29

Any risk with sennosides?

Answer 29

be abused to Lose weight

Question 30

What would show dehydration in eating disorders?

Answer 30

high BUN

Question 31

What effects on liver does eating disorders cause?

Answer 31

low albumin, high high INR, LFT increase

Question 32

Would you have metabolic acidosis or alkalosis if vomiting?

Answer 32

Alkalosis

Question 33

Would you have metabolic acidosis or alkalosis if abusing laxative?

Answer 33

acidosis

Question 34

When is most bone built?

Answer 34

adolescent

Question 35

Which eating disorder has highest risk of OP?

Answer 35

AN

Question 36

Does estrogen replacement help with bones?

Answer 36

NOPE does not increase BMD

Question 37

Do calcium and vitamin d supplementation help?

Answer 37

probably Calcium 1200-1500mg and Vitamin D 1000 IU/day

Question 38

Do bisphosphanates work?

Answer 38

no in teenagers no studies for adults but can extrapolate

Question 39

What is the best way to recover BMD?

Answer 39

weight recovery duh

Question 40

How long does it take BMD to increase after restoring weight?

Answer 40

1-2 years

Question 41

Is BMD always recoverable?

Answer 41

FU no

Question 42

How to begin refeeding?

Answer 42

30-40kcal/kg/day then to 70-100

Question 43

Which is better IV or NG to feed?

Answer 43

NG

Question 44

What electrolytes must we monitor when feeding?

Answer 44

PO4, MG, K, NA, Ca daily for first 5 days

Question 45

What is refeeding syndrome?

Answer 45

bloating, nausea, electrolytes rush into cells, retains fluid which causes more work for the heart, and this is bad

Question 46

What electrolyte is crucial for the function of the heart?

Answer 46

PO4 as this is used in ATP

Question 47

Non pharm for AN?

Answer 47

CBT

Question 48

What is zinc used for?

Answer 48

zinc deficiency exhibit similar to AN

Question 49

Does zinc help with BMI resting?

Answer 49

oof who knows perhaps??

Question 50

Do antipsychotics help in AN?

Answer 50

only olanzapine showed weight increase BUT not benefit on eating disorder mentally

Question 51

Risks with antipsychotics?

Answer 51

EPS, QTc, tardive

Question 52

DO TCA help?

Answer 52

no

Question 53

Do SSRI help?

Answer 53

help with comorbid conditions AFTER weight is restored

Question 54

Does bupropion help?

Answer 54

NO, seizure risk

Question 55

What are signs of bulimia?

Answer 55

dental caries, esophagus damage, parotid gland enlargement

Question 56

What is usually the weight of a bulimic person?

Answer 56

upper end of normal or slightly overweight

Question 57

Best psychotherapy for bulimia?

Answer 57

CBT

Question 58

Is CBT better than drugs for bulimia?

Answer 58

OBV

Question 59

AT what % weight does menses restart?

Answer 59

90% of normal

Question 60

What drugs are good for bulimia?

Answer 60

SSRI- lower binge-purge episodes

Question 61

Do you need to have depression in order to use SSRI's for bulimia?

Answer 61

NO. Benefit regardless

Question 62

What SSRIs are good for bulimia and which has the indication?

Answer 62

FLUOXETINE-indication citalopram sertraline

Question 63

Does topiramate help with bulimia?

Answer 63

it does decrease episodes BUT side effects brutal- brain fog