Eating Disorders

Question 1

What are the two main eating disorders?

Answer 1

Anorexia nervosa

Bulimia nervosa

Question 2

Give the diagnostic criteria required for anorexia nervosa

Answer 2

BMI < 17.5
Deliberate self-induced weight loss
Body image disturbance
Fear of fatness
Amenorrhoea

Question 3

What may the physical assessment of a patient with anorexia show?

Answer 3

Muscle wasting
Hair loss/lanugo hair
Cold peripheries 
Dry skin
Xanthoderma
Bradycardia
Bruising

Question 4

What may psychological assessment of an anorexic patient show?

Answer 4

Depression
OCD
Substance misuse

Question 5

Give some clinical signs of high risk anorexia

Answer 5

BMI <13
HR <40 or sBP < 80
Core temp <34
Unable to rise from squat
Cognitive impairment

Question 6

What investigations may be done for anorexic patients?

Answer 6

Haematology
Biochemistry
ECG
DEXA

Question 7

What occurs in refeeding syndrome?

Answer 7

There is depletion of already inadequate stores of nutrients as the body repairs itself

Question 8

Give some management techniques that may be used for anorexia patients

Answer 8

CBT
Dietitian
Art/drama/family therapy

Question 9

Outline the diagnostic criteria for bulimia nervosa

Answer 9

Persistent preoccupation with eating
Irresistible food cravings
Binges and effects to counter them
Fear of fatness

Question 10

Give examples of what may be seen in the physical assessment of a bulimic patient

Answer 10

Calluses on knuckles (Russell’s sign)
Parotid hypertrophy
Dental caries

Question 11

Give examples of what may be seen in the psychological assessment of a bulimic patient

Answer 11

Depression
Self-harm
Substance misuse
Impulsive personality

Question 12

Give some medical complications of bulimia nervosa

Answer 12

Hypokalaemia
Oesophageal reflux/tears
Subconjunctival haemorrhage
Missing dentition

Question 13

How can bulimia nervosa be managed?

Answer 13

CBT

SSRI