Eating Disorders Flashcards
(43 cards)
What are the diagnostic features of anorexia nervosa?
- persistent restriction of energy intake leading to significant low body weight
- intense fear of gaining weight/behaviour interfering with weight gain
- disturbance in way one’s body weight/shaped is experienced
What are the subtypes of anorexia nervosa and their symptoms/actions done?
- Bulimic sub-type
- bingering
- vomiting
- laxative, diuretic abuse - Restrictive sub-type
- food restriction
- exercise
What are the diagnostic features of bulimia nervosa?
- recurrent episodes of binge eating characterised by: eating large amounts in discrete time OR lack of control during eating episode
- recurrent inappropriate compensatory behaviour to prevent weight gain
- behaviours above occur at least once a week for 3 months
- self-evaluation is unduly influenced by body shape/weight
- disturbance not occurring exclusively during episodes of anorexia nervosa
What are the subtypes of anorexia nervosa and their symptoms/actions done?
- Purging sub-type
- vomiting
- laxative, diuretic abuse - Non-purging sub-type
- food restriction
- exercise
What is the ratio of females to males, affected by Anorexia nervosa?
10:1
What is the community prevalence of AN?
0.4 to 100
Which types of people are more AN present in?
Dancers, gymnasts, athletes, models
What % of BN present in young females?
0.5-1%
Which has an older age onset, AN or BN?
BN (bulimia nervosa)
What other eating disorders are there?
- ARFID (avoidant restrictive food intake disorder) - undereat, but no body image problem
- PICA (eating non-nutrients)
- OSFED (other specific feeding and eating disorders)
- UFED (unspecified eating and eating disorder)
What are some clinical examination abnormalities in bulimia nervosa?
- tooth erosion
- calluses on knuckles
- enlarged parotids
- dehydration
- irregular pulse
What features tell you that from history, one had BN?
- loss of tooth enamel
- difficulty swallowing
- abdominal pain (IBS)
- gastric dilatation and rupture (rare)
- bowel disturbance (diarrhea, constipation, piled)
- absent/irregular menstruation
What are typical features in adults that show history of weight loss?
- loss weight/height
- amenorrhoea (absence of menstruation)
- loss sex drive
- weakness
- cold tolerance
- insomnia
- cyanosis, yellow skin
- lanugo hair (for insulation)
- constipation
- fractures
- infertility
What are typical features in children/adolescents that show history of weight loss?
- Failure to grow
- Failure to develop
What are some clinical examination abnormalities in bulimia nervosa?
- Emaciation
- Failure to grow
- Failure to develop
- Muscle weakness SUSS test
- Lanugo hair
- Dehydration
- Carotenosis
- Low blood pressure
- Slow pulse
- Low core temperature
In terms of biochemistry, what are some abnormal investigations found in AN?
- Urea usually down
- Urea, creatinine up if renal - failure or dehydration
- Sodium down in dehydration or water loading
- Glucose down
- potassium down if purging
- Mg, Phosphate down if refeeding
- Creatine Kinase (CK) up
- Liver function tests (Transaminase enzymes up)
- ECG (Any abnormality, T inversion, Prolonged QTc interval (>450ms))
How do you check bone mineral density thats abnormal in AN?
- using BMD or DEXA scan
- Hip and spine use X-rays
What is ovarian ultrasound used for?
- determine healthy weight
What can you tell at diff body weights, from ovarian ultrasound?
Low weight: no internal ovarian structure, small follicles
Medium weight: some internal ovarian structure, lots of large follicles (multifollicular phase)
Normal weight: Internal structure with one large dominant follicle diameter 15-22mm
At what BMD reading does one conclude that there’s osteopaenia?
1-2.5
At what BMD reading does one conclude that there’s osteoporosis?
<2.5
Explain what is hypokalaemia?
- low potassium
- vomiting (loss acid) = alkalosis
What can result from hypokalaemia?
- cardiac arrhythmia
- death
Why is there slow gut transit time in BN?
due to laxative abuse and low potassium
