Eating Disorders

Question 1

to have AN you have to have a BMI of ___

Answer 1

17.5 or less

Question 2

diagnostic features of AN?

Answer 2

self induced weight loss
body image disturbance
fear of fatness eg weighing themselves
amenorrhea

Question 3

how do patients with AN try to induce their weight loss?

Answer 3

strict dieting eg weighing food
vomiting
excessive exercise
medication eg laxitives/slimming pills

Question 4

physical signs of AN?

Answer 4

muscle wasting
hair loss
lanugo hair
cold/blue peripheries
dry skin
hypercarotenaemia
bradycardia
hypotension
bruising

Question 5

psychological comorbidities of AN?

Answer 5

depression
OCD
substance misuse
diabetes eg not taking insulin

Question 6

substance misuse is more common in anorexia/bulimia?

Answer 6

bulimia

Question 7

patients with a BMI under __ should be managed as inpatients?

Answer 7

13

Question 8

when would you admit a patient who has a normal BMI

Answer 8

if theyre losing weight rapidly eg 1kg a week

Question 9

cardiac complications of AN?

Answer 9

long QT

hypotension

Question 10

a patient with a core temperature of __ should be managed as an inpatient

Answer 10

34

Question 11

what movement test can be done to look for anorexia?

Answer 11

lie down and sit up without using your hands

squat-stand test without using hands

Question 12

investigations for AN?

Answer 12

FBC - WCC low
biochem - U+Es, K+ (vomiting?), Na (if waterloading), LFTs
ECG- bradycardia
DXA- osteoporosis?

Question 13

why do patients with AN drink alot of water?

Answer 13

to make them look heavier

to curb hunger pangs

Question 14

what is broken down first and last when you starve?

Answer 14

use up spare fat stores then muscle then organs of your body for nutrients

Question 15

osteoporosis is common in AN T or F

Answer 15

F, usually osteopenia

Question 16

what sports should be avoided in young patients with or who have recovered from AN; why is this?

Answer 16

traumatic sports eg skiing, horseriding

their bone density won’t go back to normal as they’ve missed the crucial period for growth

Question 17

patients will deteriorate when first refed T or F

Answer 17

T

Question 18

what is refeeding syndrome?

Answer 18

depletion of inadequate stores of nutrients which are quickly used up s the body starts to repair itself

Question 19

how should you monitor refeeding syndrome?

Answer 19

monitor with regular bloods

Question 20

ion levels will be __ in refeeding syndrome

Answer 20

low

Question 21

how are patients with AN fed as an inpatient?

Answer 21

NG tube

Question 22

psychological Tx of AN?

Answer 22

CBT
dietician
medical monitoring
art/drama/family therapy

Question 23

what therapy has proven to be the best therapy for adolescents?

Answer 23

family therapy

Question 24

diagnostic features of bulimia

Answer 24

persistent preoccupation with eating
irresistable craving for food
binges
attempts to counter binges
morbid dread of fatness

Question 25

how can patients with bulimia counter their binges?

Answer 25

starvation vomiting laxatives drug misuse

Question 26

physical signs of bulimia?

Answer 26

calluses on knuckles from putting fingers down their throats parotid hypertrophy dental caries bad dentition

Question 27

comorbidities of bulimia?

Answer 27

depression self harm substance misuse impulsive rather than obsessional personality

Question 28

complications of bulimia?

Answer 28

``` oesophageal reflux mallory-weiss tear hypokalaemia subconjunctival haemorrhage dehydration seizures ```

Question 29

main electrolyte disturbance in bulimia?

Answer 29

hypokalaemia

Question 30

Tx of bulimia?

Answer 30

guided self help CBT SSRI

Question 31

there is loss of interest in food in AN T or F

Answer 31

F, they still have interest in food but dont eat because they have a morbid dread of food

Question 32

male equivalent of amenorrhea as a category in ICD 10?

Answer 32

sexual dysfunction