Eating Disorders Flashcards
What is the diagnostic criteria for anorexia nervosa
Body mass index of 17.5 or less
Self-induced weight loss - strict diet, excessive exercise, vomiting etc
Body image disturbance -calling themselves overweight when clearly not
Fear of fatness
Amenorrhea
What are some of the physical signs of anorexia nervosa
Muscle wasting, hair loss Lanugo hair - fine and downy Cold, blue peripheries Dry skin Hypercarotenaemia - yellow skin due to high carotene in blood Bradycardia, hypotension Bruising
What metabolic condition is commonly associated with anorexia nervosa
Diabetes mellitus
What psychological conditions are commonly seen in anorexia nervosa
Depression
OCD
Substance misuse
What are the signs of a high risk case in anorexia nervosa
BMI under 13 or weight loss of over 1kg per week
Prolonged QT, HR<40 or systolic BP <80
Core temperature under 34C
Unable to rise from squat without using arms
Cognitive impairment
What is a sit up squat stand test
Sit up - patient lies on floor and sits up without using their hands (if possible)
Squat stand - patient squats down and rises without using their hands (if possible)
Scored based on ability to get up without hands
What investigations would you do for anorexia nervosa
Haematology
Biochemistry
ECG - looks for QT and bradycardia
DXA - bone density scan
What is refeeding syndrome
This is when you overload a malnourished person with nutrients and electrolytes causing a massive shift
There is a sudden depletion of the already inadequate nutrient stores as the body tries to repair itself
How do you prevent refeeding syndrome
Slow pace of initial refeeding
Frequent blood monitoring
How can you manage anorexia nervosa
Psychological therapies – CBT Dietitian Medical monitoring Art therapy/drama therapy Family therapy Inpatient treatment for high risk It is a multidisciplinary input
What is the diagnostic criteria for bulimia nervosa
Persistent preoccupation with eating Irresistible craving for food
Binges
Attempts to counter the effects of binges (starvation, vomiting, laxatives, drug misuse)
Morbid dread of fatness
List some of the physical signs of bulimia nervosa
Calluses on knuckles (Russell’s sign)
Parotid hypertrophy
Dental caries
Which psychological conditions are common in bulimia nervosa
Depression
Self harm
Substance misuse
Impulsive personality
List some of the medical complications of bulimia nervosa
Oesophageal reflux Oesophageal tears/rupture Hypokalaemia Subconjunctival haemorrhage Dehydration Seizures – metabolic abnormalities
How can you treat bulimia nervosa
Guided self-help
CBT
SSRI
