Eating disorders

Question 1

What is bulimia?

Answer 1

Episodes of compulsive uncontrollable bingeing (excess food in under 2 hours) followed by compensatory behaviour to prevent weight gain

Question 2

Compensation in bulimia is often driven by feelings of shame/guilt about binge. What methods are often used?

Answer 2

Vomiting
Laxatives
Diuretics
Excess exercise
Fasting

Question 3

What are some signs and symptoms of bulimia

Answer 3

Normal or low BMI
Hypotension
Dental erosion
Parotid gland swelling
Russell’s sign (scarring on knuckles from induced vomiting)

Question 4

What are complications of bulimia?

Answer 4

Metabolic alkalosis
Mallory-Weiss Tear
Dehydration
GORD
Constipation
Cardiac arrhtyhmias
Prolonged QT

Question 5

How is bulimia managed?

Answer 5

SSRIS
CBT
IPT (interpersonal therapy)
psychoeducation

Question 6

What must the BMI be to be classified as anorexia nervosa?

Answer 6

Under 17.5

Question 7

What are physical signs of anorexia nervosa?

Answer 7

Low BMI
hypotension
bradycardia
Enlarged salivary glands
Lanugo hair (fine hair covering skin)
Amenorrhoea
Prolonged QT

Question 8

What would biochemical testing show in patients with anorexia nervosa?

Answer 8

Hypokalaemia
Low sex hormones
Hypercholesteroloaemia

Question 9

What is a complication of treating anorexia nervosa?

Answer 9

Refeeding syndrome:
Carbohydrate intake causes insulin to be released. Cells take up glucose but also electrolytes like phosphate, magnesium and potassium. Can lower these levels in the blood.
Hypophosphatemia
Hypomagnesaemia
Hypokalaemia

Can cause arrhythmias