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Psychiatry > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is anorexia nervosa?

A

Eating disorder characterised by:

  • failure to maintain/achieve BMI of 17.5
  • self-induces
  • distorted self image
  • fear of fatness
  • endocrine disturbances
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2
Q

What endocrine disturbance is seen in females?

A

Amenorrhoea

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3
Q

What endocrine disturbance is seen in males?

A

Loss of sexual desire /potency

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4
Q

What are biological risk factors for anorexia?

A

Female

Genetics

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5
Q

What are psychological risk factors for anorexia?

A

Sexual abuse
Personality traits of control
Alexithymia

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6
Q

What is alexithymia?

A

Inability to identify and describe emotions

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7
Q

What are social risk factors for anorexia?

A

Society that values ‘thinness’
Occupation
Family factors

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8
Q

What compensatory mehcanisms are seen in anorexia?

A 
Exercise
Microexercise
- standing not sitting
- sitting in cold
- tensing muscles
Medications
Waterloading
Chewing gum
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9
Q

What investigations should be done in suspected anorexia?

A

Weight

Bloods

  • FBC
  • U&Es
  • LFTs
  • TFTs
  • lipids
  • cortisol
  • sex hormones

VBG

ECG

DEXA scan

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10
Q

What are potential complications of anorexia?

A

Metabolic disturbances

  • hypokalaemia
  • hypercholestrolaemia
  • hypoglycaemia
  • impaired glucose tolerance
Bradycardia
Arrhythmias
Pancreatitis
Constipation
Proximal myopathy 
Osteoporosis 
Anaemia 
Hypothermia 
Lanugo hair
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11
Q

What is lanugo hair?

A

Thin, soft downy hair that appears on newborns and malnourished

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12
Q

How is anorexia managed biologically?

A

Treatment of comorbid conditions

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13
Q

How is anorexia managed psychologically?

A

Psychoeducation
CBT
Family therapy

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14
Q

How is anorexia managed socially?

A

Voluntary organisations

Self-help

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15
Q

What is the weight gain aim for outpatients with anorexia?

A

0.5kg per week

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16
Q

When is hospitalisation indicated in anorexia?

A

BMI <14

Suicidal ideation

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17
Q

What is bulimia nervosa?

A

Eating disorder characterised by:

  • recurrent overeating (binging)
  • persistent preoccupation iwht eating
  • compensatory behaviours
  • overvalue ideas about ideal body
18
Q

What is a binge?

A

Eating within a discrete period of time (2hrs) more than most people would eat during a similar period of time/circumstance

19
Q

What is the criteria for binges in bulimia?

A

At least 1x a week for 3 months

20
Q

What are biological risk factors for bulimia?

A

Female

FHx

21
Q

What are psychological risk factors for bulimia?

A

Physical abuse
Sexual abuse
Emotionally reactive personality traits

22
Q

What are social risk factors for bulimia?

A

Occupation

Life stressors

23
Q

What compensatory mechanisms are seen in bulimia?

A

Purging

  • self-induced vomiting
  • laxatives

Non-purging

  • exercise
  • fasting
24
Q

What is the VBG picture in vomiting?

A

Metabolic alkalosis + hypokalaemia

25
Q

What is the VBG picture in laxative use?

A

Metabolic acidosis

26
Q

What are complications of repeated vomiting?

A 
Arrhythymias
Hypokalaemia
Mallory-Weiss tears
Dehydration
Dental erosions
Russell's sign
27
Q

What is Russell’s sign?

A

Calluses on back o hand due to abrasion against teeth

28
Q

How is bulimia managed biologically?

A

Antideppressant - fluoxetine

Treat comorbid conditions

29
Q

How is bulimia managed psychologically?

A

Psychoeducation

CBT

30
Q

How is bulimia managed socially?

A

Food diary

Techniques to avoid bingeing

31
Q

When is inpatient treatment indicated in bulimia?

A

Suicide risk

Severe electrolyte imbalances

32
Q

What is a key complication while managing eating disorders?

A

Refeeding syndrome

33
Q

What is refeeding syndrome?

A

Potentially life threatening complications that results from feeding after period of starvation

34
Q

What causes refeeding syndrome?

A

Insulin surge

35
Q

Who is most at risk of refeeding syndrome?

A

Very low weight for height
Minimum/no intake for more than 3/4 days
Weight loss >15% in 3 months
Abnormal electrolytes before refeeding

36
Q

What are the symptoms of refeeding syndrome?

A 
Oedema
SOB
N+V
Muscle weakness
Confusion
37
Q

What are the features of refeeding syndrome?

A

Low phosphate
Low potassium
Low magnesium
Low sodium

38
Q

What is a potential complication of refeeding syndrome?

A

Heart failure

39
Q

How can refeeding syndrome be prevented?

A

Monitor bloods daily

Start refeeding at 20kcal/kg/day

40
Q

How is refeeding syndrome managed?

A

Replace electrolytes

41
Q

What is binge eating disorder?

A

Recurrent episode of binge eating without compensatory behaviour

Psychiatry (22 decks)

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