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Flashcards in Eating Disorders Deck (26):
1

two core psychopathologies of eating d/o:

disturbed eating behavior +
intense preoccupation w/weight and shape

2

mortality rate of >10%

Anorexia n.
starvation, electrolyte imbalance, suicide

3

3 features of anorexia nervosa

refusal to maintain weight
fear of gaining weight
disturbed perception of size/shape of one's body

4

binge eating w/compensatory methods to prevent weight gain

bulimia n.
less severe course than AN

5

what distinguishes AN from BN?

BN can have normal weight

6

frequent episodes of consuming lg amounts of food and feeling a lack of control over eating

binge-eating d/o

7

ratio of eating d/o among M:F

1:10

8

onset of AN/BN/dieting

co-morbidities of AN?

AN: 14-18, after 40 is rare
BN: late adolescence, early adulthood
dieting onset at puberty

depression (2/3); social phobia (1/3); OCD (1/4)

9

MZ concordance of AN

70%

10

neurochemical changes assoc w AN (NE, 5HT, CRF, cortisol, thyroid)

down NE, thyroid
up 5HT, CRF, cortisol

11

sx of AN improve after administration of what drug?

opioid antagonists

12

rigid, perfectionistic, close but troubled relationships with parents

anorexia nervosa

13

key to AN dx?

discrepancy between actual weight and perceived body image

14

AN includes abuse of which 3 meds? (LDS)

self-induced vomiting
laxatives, diuretics, stimulants

15

sequelae of AN

amenorrhea
low T
hypogonadism
mood/cognition effects

16

criteria for AN: 3 (RFD)

A. Restriction of E intake --> low body weight
B. Fear of gaining weight/becoming fat
C. Disturbance of experience of one's weight/shape

17

timeline for distinguishing restricting v. binge/purging type of AN

3 months (during this time has individual had binge/purge behavior?)

18

predictors of poor outcome for AN

duration
OLDER age of onset
prior psych hospitalizations
poor adjustment
co-morbid personality d/o

19

complications of purging

hypocalcemia
hypokalemia
met alk
ECG changes
fatty degeneration of liver
parotid gland enlargement
calluses/dental caries/esophageal tears

20

recurrent episodes of binge eating but w/o compensatory behaviors to prevent weight gain

binge eating d/o
episodes followed by embarrassment, disgust, depression or guilt

21

criteria for BN (BCDE)

A. Recurrent binge eating (eating w/in 2-hr period a larger amt of food + sense of lack of control)
B. Inapp compensatory behaviors (vomiting, laxatives, diuretics, fasting, exercise)
C. Binging and compensatory behaviors occur 2x/wk for >3mo
D. Self-evaluation influenced by shape/weight
E. Not occur excl during AN periods

22

goals of eating d/o tx

restore nutrition
modify eating behaviors
change distorted beliefs about wt/wt loss
hospitalize if depression/SI

23

Re-feeding syndrome sx
due to? how to avoid?

resp/cardiac failure, hypotension, arryth/seizures/coma/death
sudden shift from fat-->carbohydrate metabolism
cellular uptake of Pi
avoid via slow initiating w/vitamins,
electrolytes

24

psychosocial interventions for eating d/o

CBT: monitor intake, ID assoc emotions, challenge beliefs about self-image; set goals for eating and weight; behaviors are shaped via positive reinforcement

Interpersonal psychoterapy: targets relational stressors which may trigger binge episodes

25

drugs for eating d/o
1st line for BN?
which are contra-indicated?
what to give for false beliefs?
opioid blocker and app suppr for bulimia?

SSRI: fluoxetine for BN
NO TCA in AN (arryth)
NO bupropion in AN/BN (seizures)
Atypical antipsychotics for delusional beliefs

Naltrexone and ondansetron for bulimia

26

describe the Maudsley method

giving parents permission to set health expectations for anorexic child at each meal

earlier the better