Eating Disorders

Question 1

The main difference between Anorexia (AN) and Bulimia (BN) is that in ____ patients are always underweight

Answer 1

AN

Question 2

____ pubertal development is associated with development of an ED

Answer 2

early

Question 3

A drive to excel in _____ is associated with development of an ED

Answer 3

sport

Question 4

In AN, there is a consistent lack of ____ of the seriousness of low body weight

Answer 4

recognition

Question 5

2 subtypes of AN:

Answer 5

Restricting

binging/purging

Question 6

In the ______ type of AN, the individual has not engaged in binging/purging behavior and loses weight through dieting or excessive excercise

Answer 6

restricting

Question 7

In the binge eating/purging type of AN, the patient has engaged in recurrent episodes of binging/purging and importantly is _____

Answer 7

underweight

Question 8

There is often a sense of loss of _____ in patients during binge eating with bulimia nervosa

Answer 8

control

Question 9

Patients with ______ disorder often eat alone because of feeling embarrassed about how much they are eating

Answer 9

binge-eating

Question 10

Patients with binge-eating disorder are typically _____, but feel intense _____ while eating

Answer 10

overweight

distress/disgust/guilt

Question 11

What are menstrual periods like in patients with ED

Answer 11

ammenorrhea or irregular

Question 12

GERD is often seen in patients with these 2 eating disorder subtypes:

Answer 12

BN

AN with binging/purging

Question 13

Substance abuse is very often comorbid in patients with _____

Answer 13

bulimia nervosa

Question 14

Other presenting symptoms of ED:

Answer 14

cold intolerance
constipation
dizziness/syncope
fatigue
dry skin
palpitation

Question 15

AN physical findings:
acrocyanosis is due to ______ of blood vessels
Heart rate is typically described as ______

Answer 15

constriction

bradycardic

Question 16

AN patients often have _____, which is overly fine hair

Answer 16

lanugo

Question 17

In patients with AN, breasts are typically ____. There is ____ affect and salivary glands are _____ from starvation

Answer 17

atrophic
flat
enlarged

Question 18

In AN there is edema of the extremities after _____

Answer 18

rehydrating/renourishment

Question 19

BN physical findings:

salivary gland _____ from vomiting, acid causing mouth ____ and dental enamel _____

Answer 19

enlargement

sores, erosions

Question 20

What is russell sign and what is it seen in?

Answer 20

callouses on fingers; seen in BN

Question 21

Edema of the extremities in BN is due to ______

Answer 21

stopping diuretics–>increase aldosterone–>increase Na and water retention

Question 22

What is a mallory weiss tear and what do you see it in?

Answer 22

tear of esophageal sphincter; seen in BN

Question 23

In AN, ____chromic, _____cytic anemia can be seen with moderate leuko_____

Answer 23

normo-; normo-

-penia

Question 24

AN patients have ____ blood sugar and ____ cholesterol and liver enzymes

Answer 24

low, elevated

Question 25

_____natremia may be seen in patients with AN. Some patients may have a _____ specific gravity from drinking a lot of H2O

Answer 25

hypo

low

Question 26

In BN and AN with binging/purging ____kalemia and ____chloremia may be seen with metabolic alkalosis secondary to ____

Answer 26

hypo-, hypo-

vomiting

Question 27

In BN and AN w/ binging and purging, _____kalemia may be seen with metabolic acidosis from ______ (from ____ abuse)

Answer 27

hypo
diarrhea
laxative

Question 28

Vomiting causes loss of HCl and resorption of _____, leading to metabolic ______

Answer 28

bicarbonate

alkalosis

Question 29

Diarrhea causes loss of _____, leading to metabolic _____

Answer 29

HCO3-

acidosis

Question 30

Elevated _____ _____ from the salivary gland is seen in BN

Answer 30

serum amylase

Question 31

The _____ is a test that screens for depression

Answer 31

PHQ9

Question 32

Long term mortality is highest in ____ relative to any other psych disorder

Answer 32

AN

Question 33

A high ESR with low weight (is/is not) indicative of an ED

Answer 33

not; probably inflammatory bowel disease

Question 34

The mainstays of treatment of AN are:

Answer 34

NUTRITIONAL REHAB

CBT

Question 35

Criteria for hospitalization with an ED:
HR less than _____
temperature less than _____ C
Systolic bp less than _____

Answer 35

40
35
70

Question 36

Criteria for hospitalization with an ED:
Serum K less than ____
Phosphate less than ___
long _____ interval

Answer 36

2.5
1
QT

Question 37

____ at doses of ____ per day has been approved for treatment of BN

Answer 37

Prozac

60 mg

Question 38

Olanzapine may be helpful for some patients with AN. It promotes ____ and decreases ______

Answer 38

weight gain

obsessive thinking

Question 39

Medications that prolong the _____ interval should be avoided in ED

Answer 39

QT

Question 40

______ is contra-indicated in treatment of ED because of increased risk of seizures

Answer 40

Wellbutrin

Question 41

Re-feeding syndrome:

During AN, the stores of ____ are depleted

Answer 41

phosphate

Question 42

Refeeding syndrome 1:

feeding causes a release of ____–>triggers cellular uptake of ___, ___, ____

Answer 42

insulin

Phophate, K+, Mg2+

Question 43

Refeeding syndrome 2:
Insulin causes cells to produce ___, further depleting stores of Phosphate, K, and Mg. Lack of these intermediates causes tissue ____, myocardial ____, and ____ failure

Answer 43

ATP
hypoxia
dysfunction
respiratory

Question 44

____phophatemia, _____kalemia, and _____magnesaemia are clinical components of refeeding syndrome.

Answer 44

hypo-; hypo-; hypo-