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PHAR 557 > Eating Disorders > Flashcards

Eating Disorders Flashcards

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1
Q

T or F: There’s no specific BMI/wt req’d to be dx’ed w/ anorexia nervosa.

A

T

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2
Q

BMI assoc w/ mild anorexia nervosa (DSM-5)

A

≥ 17 kg/m^2

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3
Q

BMI assoc w/ extreme anorexia nervosa

A

BMI < 15 kg/m^2

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4
Q

Behaviour assoc w/ bulimia nervosa.

A

Binge eating + purging

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5
Q

What is the main problem with pts who suffer from anorexia nervosa?

A

they have an intense fear of gaining wt/getting fat

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6
Q

Extreme bulimia nervosa is defined as…

A

≥ 14 compensatory (purging) behaviours per week

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7
Q

Extreme bulimia nervosa is defined as…

A

≥ 14 compensatory (purging) behaviours per week

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8
Q

Which eating disorder doesn’t have specific BMIs assoc w/ it?

A

bulimia nervosa

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9
Q

Underwt BMI:

A

< 18.5 kg/m^2

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10
Q

Obese BMI:

A

> 30 kg/m^2

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11
Q

Obese BMI:

A

> 30 kg/m^2

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12
Q

What’s the deadliest psychiatric illness?

A

Anorexia nervosa

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13
Q

How do eating disorders usually begin?

A

Stressful events

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14
Q

What’re the 2 subtypes of anorexia nervosa?

A
  1. restricting type (no regular binge eating/purging during the last 3 mths), and…
  2. binge eating/purging type (regular binge eating/purging during the last 3 mths)
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15
Q

Consequences of amenorrhea in anorexic women?

A
  1. reduced BMD (osteoporosis)
  2. decreased growth velocity
  3. no libido
  4. unexpected pregnancies
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16
Q

Consequences of amenorrhea?

A
  1. reduced BMD (osteoporosis)
  2. decreased growth velocity
  3. no libido
  4. unexpected pregnancies
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17
Q

At a neurobiological level, how does anorexia nervosa cause amenorrhea?

A

Starvation/chronic stress > increased cortisol release > suppression of hypothalamic pituitary gonadal axis (and other axes too) > reduction in follicle development > reduction in estrogen release > reduction in uterine lining proliferation > reduction in periods > amenorrhea

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18
Q

T or F: Return of menstrual cycle in anorexic women is related to the amt of body fat.

A

F (it’s related to the amt of serum estrogen)

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19
Q

What body systems are negatively impacted by anorexia nervosa?

A

All of them since they depend on nutrients

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20
Q

T or F: Most CV abnormalities return to baseline with wt restoration.

A

T

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21
Q

T or F: Most CV abnormalities return to baseline with wt restoration.

A

T

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22
Q

Why is domperidone used for delayed stomach emptying, but metoclopromide is not in

A

Metoclopramide crosses the BBB > extrapyramidal sx’s

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23
Q

Is estrogen replacement tx effective for amenorrheic wom for increasing bone loss? And who?

24
Q

Is estrogen replacement tx effective for amenorrheic wom? Andy who

25
Bisphosphonates: evidence for use in anorexic women for preventing bone loss?
There's mixed evidence wrt preventing fractures in pts w/ eating disorder
26
T or F: Bisphosphonates are able to prevent bone fractures in adult women W/O anorexia.
T
27
Best way to prevent bone breakdown in the body?
Weight recovery
28
Which one is preferred: NG tube feeding or IV feeding? Why?
NG tube feeding > it's cheaper and safer
29
Refeeding syndrome - sx's?
gastric bloating, nausea, edema, diarrhea
30
When does refeeding syndrome occur?
when the malnourished pt is fed a high carb load
31
What exactly happens during a refeeding syndrome episode?
pt given carb-heavy load > body produces lg amt of insulin > rapid uptake of phosphates, Mg, K into cells > decrease in serum electrolytes + fluid retention > cardiac changes (due to hypoK) > HF > death (possibly)
32
When are cardiac issues the most likely during nutrition reintroduction to malnourished pts?
In the beginning
33
Most problematic electrolyte shift in refeeding syndrome?
K > hypoK will cause cardiac issues
34
How to avoid refeeding syndrome?
Initiate refeeding SLOWLY
35
Non-pharm tx for anorexia nervosa?
Psychotx (CBT)
36
When does pharm tx become effective for anorexia nervosa pts?
when pt gains wt
37
Pharm options for anorexia nervosa:
1. Zinc 2. antipsychotics 3. antidepressants
38
Why is Zn given to anorexia nervosa pts?
For wt gain, and to benefit mood/anxiety
39
Efficacy of Zn in anorexia nervosa?
Mixed evidence
40
Which antipsychotics are recommended in anorexia nervosa pts?
Olanzapine (2nd gen) ONLY
41
T or F: Bc olanzapine is an antipsychotic, it helps with the cognitions/obsessionality of anorexia nervosa
F It only helps w/ gaining wt (modest)
42
Olanzapine AEs (it's used for anorexia nervosa)
EPS (akathisia, acute dystonia, parkinsonism, tardive dyskinesia), antichol activity, QT prolongation
43
What kind of antidepressants are recommended in anorexia nervosa pts?
SSRIs
44
How do antideps help w/ anorexia nervosa?
They may help w/ comorbid depression and OCD AFTER wt restoration
45
T or F: SSRIs help with wt gain in anorexic pts.
F
46
T or F: TCAs are recommended in anorexic pts.
F
47
What should the focus be in anorexia nervosa tx?
The behavioural aspect (CBT)
48
T or F: Bulimic pts are often underwt
F They're often either on upper end of normal wt or overwt
49
Non-pharm tx for bulimia nervosa
CBT (most effective psychotx)
50
T or F: CBT is more effective than pharm tx for bulimia nervosa
T
51
Drugs of choice for bulimia nervosa
SSRIs
52
How do SSRIs help w/ bulimia nervosa?
They reduce binge-purge episodes (regardless of comorbid depression)
53
Most studied SSRIs for bulimia nervosa
fluoxetine, citalopram, sertraline
54
What other medication has been used for tx'ing bulimia nervosa?
Topiramate
55
What specific AE of topiramate prevents it from being normally used?
Brain fog
56
Besides the binge-eating and purging, what else should we be tx'ing in bulimic pts?
1. electrolyte abnormalities 2. constipation 3. malnutrition

PHAR 557 (36 decks)

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