Eating Disorders

Question 1

eating disorders more commonly affect which gender

Answer 1

women:men 10:1

Question 2

what are the 2 most common eating disorders

Answer 2

anorexia nervosa

bulimia nervosa

Question 3

list the 5 elements of diagnostic criteria for diagnosing anorexia nervosa

Answer 3

BMI of 17.5 or less 
self-induced weight loss with strict dieting, excessive exercise, vomiting and laxatives 
morbid fear of fatness
disturbed body image
amenorrhoea

Question 4

anorexia is the psychiatric condition which the highest mortality true/false

Answer 4

true - 50% from complications, 25% from suicide

Question 5

list some of the physical signs of anorexia

Answer 5

muscle wasting
hair loss 
lanugo hair (thin)
cold/blue peripheries 
dry skin
hypercarotenaemia

Question 6

describe the clinical test used to determine the degree of muscle wasting in someone with anorexia

Answer 6

unable to stand from a squat without using arms, weak pelvic girdle

Question 7

list the investigations for suspected eating disorder and their findings

Answer 7

WCC - low
Ca, Zn, Na and K all low - K due to vomiting
DXA scan for bone density
ECG for cardiac abnormalities such as prolonged QT

Question 8

list the cardiac complications of ED

Answer 8

hypotension, bradycardia, prolonged QT, arrhythmias

Question 9

list the dental complications of ED

Answer 9

caries in patients with self-induced vomiting

Question 10

list the neuro complications of ED

Answer 10

paraesthesia, seizures, reduced grey matter due to vitamin deficiencies

Question 11

what are the long term effects of hypokalaemia

Answer 11

renal failure

Question 12

what is Russells sign

Answer 12

calluses on the knuckles due to self-induced vomiting

Question 13

what deficiencies are commonly seen in someone with

Answer 13

B12 and folate deficiencies and anaemia

Question 14

what is the first line management for children with an eating disorder

Answer 14

family based therapy - retraining children to eat more balanced diet again with help from parents

Question 15

list other methods of managing eating disorders

Answer 15

CBT - recognises unhelpful behaviours

interpersonal therapy - focuses on relationships rather than eating disorder

Question 16

list some of the pharmacological therapies used to treat complications of eating disorders

Answer 16

oestrogen patches if amenorrhoea
vitamin D for bones
antidepressants

Question 17

what is bulimia nervosa

Answer 17

eating disorder characterised by lack of eating until binges occur, then compensatory behaviours such as self-induced vomiting or laxative use

Question 18

what are the physical signs of bulimia nervosa

Answer 18

Russells sign

parotid hypertrophy

Question 19

what is re-feeding syndrome

Answer 19

potentially fatal condition due to reduced phosphate after initiation of food after >10 days of not eating anything

Question 20

what are the signs of refeeding syndrome

Answer 20

resp/cardiac failure
hypotension
seizures
arrhythmias

Question 21

what is the treatment of re-feeding syndrome

Answer 21

thiamine and multi-vit to prevent

resuscitation

Question 22

hypophosphataemia is a sign of what condition

Answer 22

re-feeding syndrome