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Clin Med III - Psych, Genetics > Eating Disorders > Flashcards

Eating Disorders Flashcards

(43 cards)

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1
Q

Define anorexia nervosa

A

RID

  • Refuse to maintain normal wt
  • Intense fear of gaining weight
  • Distorted view of body
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2
Q

Epidemiology of anorexia nervosa

A
  • Females

- Bimodal: 12-15 yo and 17-21 yo

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3
Q

MC age of onset for anorexia nervosa

A

14-18 yo

rare before puberty or after 40

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4
Q

Etiologies of eating disorders

A
  • Biological
  • Cultural
  • Genetic
  • Psychological
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5
Q

Comorbidities of anorexia nervosa

A
  • Anxiety disorders (60-65%)
  • Mood disorders (36-68%)
  • Substance abuse (23-35%)
  • Personality disorders (23-35%)
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6
Q

How do anorexia nervosa patients present?

A
  • Underweight
  • Unreliable history
  • Complaint is more for somatic or psych distress than wt loss
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7
Q

Clinical s/s of anorexia nervosa

A
  • Obsessed with weighing, measuring body parts, looking in mirror
  • Hoard food, will not eat in front of others, plays with food, hides food in napkins
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8
Q

What is Russell’s sign?

A

Calluses on the knuckles (from inducing gag reflex at back of throat)

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9
Q

Possible PE findings of anorexia nervosa

A
  • Russell’s sign
  • Muscle wasting
  • Lanugo (fine soft hair)
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10
Q

Treatment of anorexia nervosa

A
  • Acute intensive intervention (rehydrate, correct electrolytes)
  • Restore weight slowly (2-3 lb/wk for hospitalized, 0.5-1 outpatient)
  • Psychotherapy
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11
Q

How to restore weight in anorexia nervosa patients? Target weight?

A
  • 2-3 lb/wk for hospitalized pts
  • 0.5-1 lb/wk for outpatients
  • Female target weight: when normal menstruation returns
  • Male target weight: testicular function returns
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12
Q

What is the most effective treatment for anorexia nervosa patients in maintaining weight and healthy eating?

A

Psychotherapy (recommended for 1-2 yrs after weight has been restored)

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13
Q

Pharm treatment of anorexia nervosa

A
  • Antidepressants
  • SGAs
  • BZDs
  • Olanzapine (may help wt gain)
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14
Q

Prognosis of anorexia nervosa treatment

A
  • 45% pts have overall good outcome

- 50% continue to experience difficulties w/eating behavior and psych problems

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15
Q

What are poor prognostic indicators in anorexia nervosa?

A
  • Presence of bulimia
  • Laxative use
  • Severe wt loss
  • Low socioeconomic status
  • Denial
  • Drug use
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16
Q

What are favorable prognostic indicators in anorexia nervosa?

A
  • Early onset
  • Higher socioeconomic status
  • Less severe wt loss
  • Less denial
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17
Q

Which eating disorders may a patient maintain normal body weight?

A

Bulimia nervosa

Binge eating disorder

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18
Q

Define bulimia nervosa

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A

Binge eating combined with inappropriate ways of preventing wt gain

19
Q

Define binge eating

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A
  • As much as 3,000 cals in one sitting
  • Lack of control
  • Foods one would normally avoid
  • Secretive
20
Q

Types of bulimia nervosa

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A
  • Purging (MC): vomiting

- Non-purging: fasting, excessive exercise, overuse meds

21
Q

Epidemiology of bulimia nervosa

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A
  • Females (98-100%)

- Binge eating on its own is fairly common

22
Q

Average age of onset of bulimia

23
Q

Comorbidities of bulimia nervosa

Study These Flashcards
A
  • Mood disorders (24-88%)
  • Anxiety
  • Substance abuse (30%)
  • Personality disorder (20%, MC borderline)
24
Q

How to differentiate anorexia from bulimia?

Study These Flashcards
A

More severe wt loss and amenorrhea in anorexia

25
How to differentiate MDD from bulimia?
MDD may overeat in winter time but there are no compensatory behaviors
26
When is inpatient hospitalization indicated in bulimia?
- Electrolyte disturbances or medical complication - Depression w/SI - Those who have not responded to outpatient tx
27
What psychotherapy shows the best results for uncomplicated bulimia not requiring hospitalization?
Residential programs (40 hr/wk)
28
What is the only FDA approved treatment of bulimia?
Fluoxetine 60 mg/d
29
What med should be avoided in bulimia and anorexia treatment?
Bupropion (associated with increased seizures)
30
Alternative pharm treatments for bulimia
- Topiramate - Ondansetron - Bright light therapy
31
Prognosis of bulimia
Higher rates of partial and full recovery compared with anorexia
32
Poor prognostic indicators of bulimia
- History of substance abuse - Longer duration of disorder at presentation - SI or hx of suicide attempts
33
Define binge eating disorder (BED)
Recurrent binge eating WITHOUT regular compensatory measures
34
What is the MC eating disorder in the US?
Binge eating disorder
35
Epidemiology of BED
- Females 60%, males 40% | - Equal in all races/ethnicities
36
Average age of onset for BED
Typically begins in adolescence but can begin later in life too
37
Etiology of BED
- None specifically - Familial disorder possibly - Cultural component
38
How to differentiate obesity from BED?
- Obesity: no success w/psych tx | - BED: psych comorbidities are higher
39
Treatment of BED
- Outpatient psychotherapy - SSRIs or Venlafaxine - Sibutramine (wt loss agent) - Topiramate
40
Prognosis of BED
- Little info available - Remission rates are higher than with anorexia or bulimia - Crossover to anorexia or bulimia is UNCOMMON
41
Define pica
Persistent eating of non-food items over a period of at least 1 month that is severe enough to warrant intervention
42
How old must a patient be to be diagnosed with pica?
At least 2 yo | eating must be developmentally inappropriate and not a part of cultural/social norms
43
Define rumination disorder
- Repeated regurgitation of food that has already been swallowed - Over a period of at least 1 month, not a/w a medical disorder

Clin Med III - Psych, Genetics (9 decks)

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