Eating disorders Flashcards
What are the 3 main criteria for AN
Refusal to mainain >=85% body weight
Fear of weight gain
odd self perception- self-worth determined by body weight, distorted perception of shape/weight, denies seriousness of body weight
What are the 2 types of AN
- Restricting type
2. binging/purging type
What are the characteristics of a person with AN (i.e what do they do)
- restrict calorie intake-avoid food
- smoke, chew gum
- wear baggy clothes
- diabetics may skip insulin doses
- obsessed with calories and dread weight gain
- excessive exercising esp alone e.g. running
What are the physical/biological features of AN
Appearance: emaciated, dry skin, brittle hair and nails, reduced sexual maturation, lanugo hair
CVS: bradycardia, hypotensive, orthostatic hypertension, congestive heart failure
GI: constipation, nausea, bloating
MSK: muscle wasting, osteoporosis
Metabolic: hypercholesterolaemia, hypercarotenaemia (yellow palms and soles)
Neuro: peripheral neuropathy
Amenorrhea
What is the screening tool for eating disorder
S-Do you ever make yourself sick when you feel full
C-Do you worry you’ve lost control over how much you eat
O- have you lost more than one stone in 3 months
F- Do you believe yourself to be fat when others say otherwise
F- would you say food dominates your life
What are the DSM-V criteria for Bulimia
A- recurrent binging: lack of control
B- Recurrent purging: fasting, over-exercising, vomiting, laxatives
C- Binging and purging >1wk for 3/12
D- overall self worth heavily influenced by body weight
E- symptoms not exclusive during anorexic episodes
What is the usual BMI of bulimic patients
Usually >17.5 (normal)
What are physical symptoms of bulimia
mostly those secondary to purging
- arrhythmias (hypokalaemia)
- convulsions (hyponatraemia)
- russell’s sign: calluses/cuts on knuckles
- swollen salivary glands (chipmunk face)
- eroded enamel
- tender abdomen (mallory-weiss tear)
What investigations would you undertake for a pt with eating disorder
- height, weight BMI
- Squat test (proximal myopathy)
- bloods: ESR, TFTs, FBC, U&Es, albumin, LFTs, CK, glucose
- ECG: arrhythmias, prolonged QT
What is the ideal weight restoration for AN
0.5kg/week
What is refeeding syndrome?
refeeding in a starved state results in an increase of insulin causes increased cellular uptake of glucose, K+, Mg2+ and thamine which reduced blood conc. of these to a dangerously low level. resulting in arrythmias, confusion, coma and death
