eating disorders

Question 1

Biological factors that may contribute to an eating disorder

Answer 1

family history, history of dieting, T1DM, genetics

Question 2

Psychological factors that may contribute to an eating disorder

Answer 2

low self esteem, relationship with self, feelings of inadequacy, depression/anxiety/fear/loneliness

Question 3

Social factors that contribute to an eating disorder

Answer 3

cultural norms, body dissatisfaction drive for “perceived ideal body type”, history of trauma, weight stigma/bullying

Question 4

Emotional/behavioral signs of an eating disorder

Answer 4

weight loss/dieting/control food, food rituals, social withdrawal, frequent dieting/body checking, extreme mood swings

Question 5

Physical signs of an eating disorder

Answer 5

weight fluctuations, GI complaints, dizziness upon standing, difficulty concentrating/sleeping, issues with dental/skin/hair/nails

Question 6

M or F: more prevalent of anorexia

Answer 6

females

Question 7

65% cases of anorexia also have

Answer 7

depression

Question 8

two types of anorexia

Answer 8

restricting type

binge-eating/purging type

Question 9

Tye of anorexia where weightloss is through dieting, fasting, and/or exercise

Answer 9

restricting type

Question 10

weight loss may be contributed to recurrent episodes of binge eating/purging

Answer 10

binge eating/purging type of anorexia

Question 11

Food symptoms of anorexia

Answer 11

dieting even though thin
peculiar behavior about food
pretend to eat/lie about eating
strange/secrete food rituals

Question 12

Appearance and behavior symptoms of anorexia

Answer 12

dramatic weight loss, feeling fat (even though underweight), fixated or obsessed with body image, critical about appearance, excessive exercise, anxiety about gaining weight, primary life focus is on weight loss and diet, withdrawal from friends

Question 13

Signs and symptoms of anorexia

Answer 13

emaciation, cold intolerance, constipation, amenorrhea, bradycardia, hypotension, hypothermia, loss of body fat, dry/scaly skin, increase in lanugo, parotid enlargement, edema, osteoporosis

Question 14

What will you see on CBC of anorexic patient?

Answer 14

leukopenia

Question 15

what will you see on EKG for anorexic patient?

Answer 15

ST T wave changes secondary to electrolyte abnormalities

Question 16

treatment for anorexia

Answer 16

may need hospitalization, psychotherapy

Question 17

What criteria would you hospitalize an anorexic patient?

Answer 17

< 20% weight for height, need to restore nutritional state

Question 18

what is the caloric goal for an anorexic patient?

Answer 18

1500 - 2000

Question 19

Meds that can cause weight gain and may benefit an anorexic patient

Answer 19

cyproheptadine, amitryptyline, fluoxetine

Question 20

Disorder characterized by recurrent and frequent binge eating combined with inappropraite ways of stopping weight gain

Answer 20

bulimia nervosa

Question 21

Psychological symptoms that may be associated with bulimia nervosa

Answer 21

depression, anxiety, irritability, obsession with eating/food/body shape/weight, low self esteem, sensititve to comments relating to food/weight/body shape/exercise

Question 22

behavior of patient with bulimia nervosa

Answer 22

eating in private, repetitive or obsession relating to body shape or weight, excessive exercising, trips to bathroom following meals, use of laxatives/emetics/diuretics/diet pills

Question 23

signs and symptoms of bulimia nervosa

Answer 23

poor dentition, calluses on the back of hands, parotid gland enlargement, heartburn, amenorrhea

Question 24

4 tests you want to order for a patient presenting with bulimia nervosa

Answer 24

CBC, CMP, TSH, albumin

Question 25

first line treatment for bulimia nervosa

Answer 25

CBT psychotherapy

Question 26

pharmacotherapy that is FDA approved to treat bulimia nervosa

Answer 26

SSRI → fluoxetine

Question 27

disorder characterized by patient eating an abnormally large amount of food over short period of time → does NOT compensate in any way after binge eating

Answer 27

binge eating disorder

Question 28

What is the most common eating disorder?

Answer 28

binge eating disorder

Question 29

what personality style is more prone to binge eating disorder?

Answer 29

impulsive, extroverted

Question 30

Binge eating may be a coping mechanism for

Answer 30

depression, stress, anxiety

Question 31

what are some consequences of binge eating disorder?

Answer 31

MSK problems, HTN, hyperlipidemia, diabetes

Question 32

Two criteria for binge eating

Answer 32

eating abnormally large amount of food within certain time period and sense of lack of self control during episode

Question 33

What are binge eating episodes associated with?

Answer 33

eating faster than normal eating until feel uncomfortably full eating large amounts of food when not hungry eating alone feeling disgusted with self/depressed or guilty after

Question 34

According to DSM5 what is the frequency and length to be considered binge eating?

Answer 34

once a week for 3 month

Question 35

signs and symptoms of binge eating disorder

Answer 35

obesity, frequent weight cycling, insomnia/early menarche/neck,should,lower back pain/ chronic muscle pain/metabolic disorders

Question 36

Most common treatment for binge eating

Answer 36

CBT psychotherapy

Question 37

pharmacotherapy for binge eating

Answer 37

SSRI, weight loss med

Question 38

characterized by persistent failure to meet nutritional or energy needs by: significant weightloss, or failure to achieve expected weight, nutritional deficiency, dependence on enteral feedings or nutritional supplements, marked interference with psychosocial functioning

Answer 38

avoidant-restrictive food intake disorder

Question 39

How does avoidant-restrictive food intake disorder differ from anorexia?

Answer 39

patient does not have distress over body shape/size or fear fatness

Question 40

Patient shows food refusal, food selectivity, eating too little, food avoidance, and delayed self feeding - they may have?

Answer 40

avoidant-restrictive food intake disorder

Question 41

signs and symptoms of avoidant restrictive food intake disorder

Answer 41

weight loss, dress in layers, constipation, abdominal pain, cold intolerance, vague GI issues

Question 42

for avoidant restrictive food intake disorder in a child - what do you want to rule out or double check?

Answer 42

rule out medical causes and check that food is available for the child

Question 43

If a child doesn’t grow out of avoidant restrictive food intake disorder, what can you do?

Answer 43

CBT psychotherapy

Question 44

Criteria is met for anorexia nervosa but the weight is not below normal

Answer 44

atypical anorexia nervosa

Question 45

criteria for bulimia nervosa is met but there are less frequent occurences

Answer 45

subthreshold bulimia nervosa

Question 46

criteria for binge eating disorder is met but occurs at lower frequency

Answer 46

subthreshold binge eating disorder

Question 47

Disorder where the patient purges without binge eating

Answer 47

purging disorder

Question 48

excessive nighttime food consumption

Answer 48

night eating syndrome

Question 49

preoccupation with imagined defect in appearnce that causes clinically significant distress or impairment in important areas of functioning

Answer 49

body dysmorphic disorder

Question 50

What does body dysmorphic disorder fall under?

Answer 50

obsessive compulsive related disorders

Question 51

treatment for body dysmorphic disorder

Answer 51

SSRI, treat comorbid conditions