eating/feeding disorders (2)

Question 1

which ED has the highest mortality rate?

Answer 1

anorexia nervosa

Question 2

what is the relapse rate of anorexia at 1 year

Answer 2

50%

Question 3

which disorder has an extreme fear of obesity/weight gain even though they are severely underweight

Answer 3

anorexia

Question 4

which disorder has a severe distortion of body image

Answer 4

anorexia

Question 5

describe restricting type of anorexia

Answer 5

-does not engage in binge eating or purging
-diet and fast rigorous exercise

Question 6

describe binge/purge anorexia

Answer 6

primarily only restricts but does binge/purge occasionally

Question 7

when is someone with anorexia in full remission

Answer 7

at a regular BMI

Question 8

BMI levels of mild, moderate, severe, and extreme anorexia

Answer 8

mild= >17
mod= 16-16.99
severe= 15-15.99
extreme= <15

Question 9

heart complications of anorexia

Answer 9

prolonged QT and ST-T wave (CAN LEAD TO DEATH)
bradycardia
vtac/vfib

Question 10

how is BP effected by anorexia

Answer 10

hypotension/ortho

Question 11

comorbidity with anorexia

Answer 11

depression/anxiety
compulsive behavior/OCD

Question 12

when does bulimia occur?

Answer 12

late adolescence/early adulthood

Question 13

what condition is repeated, episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time. FOLLOWED by inappropriate compensatory behaviors to rid body of excess calories

Answer 13

bulimia

Question 14

how long does episodes of bulimia need to occur to be diagnosed

Answer 14

once a week for 3 months

Question 15

compensatory mechanisms used in binging

Answer 15

-self-induced vomiting
-misuse of laxatives, diuretics, enemas
-fasting
-excessive exercise

Question 16

describe frequency of episodes that classifies mild, mod, severe, and extreme bulimia (also the same for binge eating disorder)

Answer 16

mild= 1-3 eps/week
mod= 4-7 eps/week
severe= 8-13 eps/week
extreme= 14 or more eps/week

Question 17

comorbidities with bulimia

Answer 17

MDD/bipolar, anxiety, borderline/histrionic personality, substance abuse

Question 18

describe weight fluctuation in bulimia

Answer 18

weight fluctuation common, but likely stays in normal range

Question 19

what can lead to death in bulimia

Answer 19

dehydration/electrolyte imbalances, EKG changes/arrythmias

Question 20

effects of vomiting frequently (bulimia)

Answer 20

tooth enamel erosion, dental carries, loss of dental arch, tears in esophagus

Question 21

risk factors for anorexia/bulimia?

Answer 21

UNKNOWN
-linked to chromosomes 1, 2, abd 13
-neuro-endocrine abnormalities

Question 22

what part of the brain is effected in eating disorders

Answer 22

hypothalamus

Question 23

what does the hypothalamus do in relation to eating disorders

Answer 23

-recognize when hungry
-nit hungry
-when sated

Question 24

which neurotransmitter is impaired in anorexia

Answer 24

dopamine, triggers anxiety

Question 25

which neurotransmitters are altered in bulimia

Answer 25

serotonin and norepinephrine

Question 26

which amino acid is essential to serotonin synthesis and is only available through diet

Answer 26

tryptophan

Question 27

brain differences in bulimia

Answer 27

-increased grey matter -more likely to have ADHD

Question 28

psychodynamic influences on bulimia/anorexia

Answer 28

-mother-infant disturbances -parent responds to emotional need with food -enmeshed boundaries -conflict avoidance -POWER/CONTROL OF BODY -passive father/domineering mother

Question 29

which kind of gain are where they get to avoid something

Answer 29

primary

Question 30

which kind of gain are where they get attention

Answer 30

secondary

Question 31

which kind of gain are where their areas of conflict are shifted

Answer 31

tertiary

Question 32

personality traits linked with EDs

Answer 32

perfectionism, avoidant, interceptive awareness, anxirty, intolerance of uncertainty, obsession, thought sticking, impulsive/compulsive, competitive

Question 33

which ED is repeated episodes of uncontrolled binge eating with significant distress, do not use compensatory mechanisms

Answer 33

binge eating disorder

Question 34

psychological/environment factors for binge eating disorder

Answer 34

-low self esteem / body dissatisfication -reduced coping -ACE

Question 35

which feeding disorder is the persistent eating of substances with no nutritional value (dirt, paint, paper clips)

Answer 35

pica

Question 36

why is pica dangerous

Answer 36

undigested objects can cause intestinal blocking

Question 37

which feeding disorder is where undigested food is returned to the mouth, re-chewed, re-swallowed, or spit out

Answer 37

rumination disorder

Question 38

what is rumination disorder associated with

Answer 38

intellectual development disorders and neglect

Question 39

which eating disorder is when someone with DM1 restricts insulin to lose weight

Answer 39

diabulimia (ED-DMT1)

Question 40

treatment of eating disorders

Answer 40

restore nutritional status - weight restoration program

Question 41

what is an imbalance of electrolytes / fluid shifts that can occur when a malnourished pt begins to eat normally (rapid discharge of insulin & ↓ phosphorus)

Answer 41

refeeding syndrome

Question 42

what increases the risk of refeeding syndrome

Answer 42

-rapid weight loss -abnormal EKG/low phos -diuretic, laxative, or insulin misuse

Question 43

s/sx of refeeding syndrome

Answer 43

weakness, leg swelling, difficult breathing, altered mental status, seizures, heart failure

Question 44

how must people with refeeding syndrome be fed?

Answer 44

refed slowly and supplement electrolytes

Question 45

descrube behavior modification treatment for ED

Answer 45

must perceive control of treatment, contract for privleges based on weight gain

Question 46

which practice of ED recovery uses concepts of CBT and eastern mindfulness practices

Answer 46

dialectical behavior therapy

Question 47

what are the goals of family therapy for ED

Answer 47

-educate -don't comment on body -support for feelings of guilt and stigma -support gorups -stop tertiary gains

Question 48

when should individual therapy be used for EDs

Answer 48

not normally used, only when there is an underlying psych problem

Question 49

how can "fear foods" be handled?

Answer 49

pair challenging food with non-challenging food

Question 50

meds with anorexia

Answer 50

no approved meds, no evidence of meds being beneficial for treatment