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Diagnosis Management 2 > Feeding and Eating disorders > Flashcards

Feeding and Eating disorders Flashcards

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1
Q

how long does eating of nonfood items have to be present for a dx of pica

A

at least 1 month

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2
Q

what is the minimum age for pic dx

A

2

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3
Q

when does pica tend to come to clinical attention?

A

after a complication like infection or mechanical bowel issue

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4
Q

when does pica manifest

A

usually in early childhood
typically if older it is in the context of developmental disability

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5
Q

when would you make a pica dx in pregnancy

A

when symptoms are severe enough to possibly cause medical complications

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6
Q

when would anorexia be the appropriate dx over pica

A

when nonnutritive eating is done as a means of hunger control

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7
Q

what are the most common pica comorbidities

A

autism and intellectual disability

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8
Q

when would pica be associated with trichotillomania and/or excoriation disorder

A

when there is ingestion of hair and/or skin

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9
Q

definition of rumination disorder

A

repeated food regurgitation not d/t another medical/mental condition

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9
Q

when would pica be associated with avoidant/restrictive food intake disorder

A

when there is a strong sensory component to the presentation

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9
Q

how long do sx have to be present to meet criteria for rumination disorder

A

at least 1 month

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10
Q

how do infants present when attempting to regurgitate

A

straining and arching back while making sucking movements with tongue

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11
Q

features of rumination disorder in infants

A

-may gain satisfaction from behavior
-may be irritable/hungry between episodes
-may result in malnutrition
-weight loss/failure to gain common

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12
Q

what are some differential diagnoses for rumination disorder

A

GI conditions that would cause vomiting

anorexia and bulimia

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13
Q

basic definition of avoidant/restrictive food intake disorder

A

avoiding eating d/t lack of interest or sensory issues with at least 1 manifestation

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14
Q

what are possible manifestations of avoidant/restrictive food intake disorder and how many are required for dx

A

at least 1:
-significant weight loss/failure to gain
-significant nutritional deficiency
-dependence on enteral feeding or nutritional supplements
-marked interference with psychosocial functioning

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15
Q

temperamental risk factors for avoidant/restrictive food intake disorder

A

risk is increased if anxiety disorders, autism, OCD, ADHD are present

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16
Q

what are the 3 main criteria for dx of anorexia

A

-restriction of intake that results in significantly underweight
-preoccupation with thinness or fear of fatness
-disturbance in body image perception and lack of recognition of serioussness

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17
Q

what are the 2 subtypes of anorexia

A

restricting type
binge/purge type

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18
Q

what is the qualifier for anorexia restricting type

A

no binging/purging behavior for at least 3 months

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19
Q

anorexia binging/purging type

A

may purge after small amounts of food

purging typically involves vomiting, laxatives, or diuretics

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20
Q

mild anorexia

A

BMT >= 17

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21
Q

moderate anorexia

A

BMI 16-16.99

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22
Q

severe anorexia

A

BMI 15-15.99

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23
Extreme anorexia
BMI <15
24
what are some associated features of anorexia
-amenorrhea -bone mineral density loss -depressive symptoms -OCD sx
25
what behaviors are more likely to occur in anorexia binge/purge type than restricting type
more likely to be impulsive and abuse substances
26
when is anorexia onset and what is it associated with
adolescence to early adulthood usually associated with stressful life event
27
hematology labs in anorexia
leukopenia mild anemia rarely bleeding problems
28
chemistry results in anorexia
dehydration may raise BUN hypercholesterolemia elevated hepatic enzymes
29
why would someone with anorexia have an elevated bicarb level
if they were in metabolic alkalosis d/t vomiting
30
endocrine abnormalities with anorexia
low estrogen in females and low testosterone in males
31
what is the main difference between bulimia and anorexia binge/purge type
anorexia may purge after small ingestion of food and bulimia tends to maintain normal or slightly above weight
32
general definition of bulimia
recurrent episodes of binge eating with compensatory purging behaviors to avoid gaining weight
33
what constitutes a binge eating episode
-eating significantly more food than normal in a discrete time period -sense of lack of control over eating
34
how often do binge/purge episodes have to occur for a dx of bulimia
at least weekly for at least 3 months
35
mild bulimia
1-3 episodes weekly
36
moderate bulimia
4-7 episodes weekly
37
severe bulimia
8-13 episodes weekly
38
extreme bulimia
14+ episodes weekly
39
common electrolyte imbalances in bulimia
hypokalemia hypochloremia hyponatremia
40
what can cause metabolic alkalosis and metabolic acidosis in bulimia
vomiting can cause alkalosis d/t fluid loss (elevated bicarb) laxative/diuretic use can cause acidosis
41
what disorders are frequently comorbid with bulimia
personality disorders substance use disorders depression bipolar
42
basic definition of binge eating disorder
recurrent episodes of binge eating not associated with purging
43
what are characteristics of binge eating episodes in binge eating disorder and how many must be present for dx
At least 3 -eating more rapidly than usual -eating until uncomfortably full -eating large amounts when not hungry -eating alone d/t embarassment -feeling disgusted/guilty or depressed afterward
44
how often do binge eating episodes have to occur for dx of binge eating disorder
at least weekly for at least 3 months
45
mild binge eating disorder
1-3 episodes weekly
46
moderate binge eating disorder
4-7 episodes weekly
47
severe binge eating disorder
8-13 episodes weeklyx
48
treme binge eating disorder
14+ episodes weekly
49
what are the other specified feeding or eating disorders
-atypical anorexia nervosa -bulimia of low frequency or limited duration -binge eating of low frequency or limited duration -purging disorder -night eating syndrome
50
atypical anorexia
criteria for anorexia met except weight is still WNL
51
bulimia of low frequency/limited duration
criteria for bulimia met except frequency of episodes or duration of symptoms
52
binge eating disorder of low frequency/limited duration
criteria met for binge eating disorder except frequency of episodes or duration of symptoms
53
purging disorder
purging behaviors in the absence of binge eating
54
night eating syndrome
-eating large quantities after evening meal -there is awareness of eating -not better explained by another disorder
55
geophagia
when pregnant women eat clay
56
amylophagia
when pregnant women eat excessive starch
57
characteristic of regurgitation in rumination disorder
effortless and painless no nausea, retching, or disgust
58
how do you rule out pyloric stenosis when diagnosing rumination disorder
pyloric stenosis is associated with projectile vomiting and usually manifests prior to 3 months
59
treatment of rumination disorder
education/behavioral combo aversive techniques sometimes
60
common age range affected by rumination disorder
3-12 months
61
appetite loss in anorexia
usually not present until late in disease
62
odd behaviors with anorexia
will hide food around the house carry large amounts of candy somatic complaints may compulsively steal decreased interest in sex
63
what are some physical signs of anorexia
hypothermia, dependent edema, bradycardia, hypotension, and lanugo
64
when does an anorexic patient need to be hospitalized
when 20% below desired weight if 30% below likely will need treatment for 2-6 months
65
3 types of psychotherapy used for anorexia
family-based CBT dynamic psychotherapy
66
3 phases of family based psychotherapy in anorexia
1 - restoration of physical health 2 - patient gradually takes responsibility for eating decisions 3 - focus on patient's growth/development
67
first-line treatment for bulimia
CBT
68
what med is usually used to treat bulimia
fluoxetine (60-80mg) higher dose than used in depression
69
what med is contraindicated in the treatment of bulimia and why
wellbutrin because of seizure risk
70
first-line tx for binge eating disorder
CBT better results when used with SSRI
71
medication for treatment of binge eating disorder with strong evidence for reduction of episodes and weight loss
lisdexamfetamine

Diagnosis Management 2 (8 decks)

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