Feeding/Eating Disorders

Question 1

pt who refuses to eat due to fear of being overweight

Answer 1

anorexia nervosa

Question 2

anorexia is associated w. weight < _ % of IBW

Answer 2

85

Question 3

how is anorexia distinguished from bulimia nervosa in terms of anthopometrics (2)

Answer 3

anorexia:
BMI < 17
OR
weight < 85% IBW

Question 4

what disorder has the highest suicide rate of eating disorders

Answer 4

anorexia nervosa

Question 5

what are the 2 types of anorexia nervosa

Answer 5

binging/purging
restricting

Question 6

2 behaviors associated w. binging/purging anorexia nervosa

Answer 6

laxative/diuretic abuse
excessive exercise

Question 7

2 behaviors associated w. restrictive anorexia nervosa

Answer 7

eating very little
excessive exercising

Question 8

tx for anorexia nervosa

Answer 8

-restore nutritional state
-hospitalization
-CBT
-SSRI’s

Question 9

weight indication for hospitaization in anorexia nervosa

Answer 9

weight < 75% IBW

Question 10

t/f: SSRIs are proven effective for anorexia nervosa

Answer 10

f!

Question 11

added s.e benefit of SSRI’s for anorexia nervosa

Answer 11

weight gain

Question 12

episodes of mass eating followed by self-induced vomiting or intense exercise

Answer 12

bulimia nervosa

Question 13

4 PE findings of bulimia nervosa

Answer 13

-petechial hemorrhages on soft palate and conjunctiva
-knuckle scars
-swollen parotids
-dental erosions
-hyopotn
-tachycardia

Question 14

mc weight finding of bulimia nervosa

Answer 14

normal weight

Question 15

2 lab findings suggestive of bulimia nervosa

Answer 15

hypochloremia
hypokalemia

Question 16

purging results in what metabolic condition

Answer 16

metabolic alkalosis

Question 17

2 behaviors bulimia nervosa may share w. anorexia nervosa

Answer 17

laxative/diuretic abuse
excessive exercise

Question 18

t/f: bulimia nervosa patients are disturbed by their behavior

Answer 18

t!

Question 19

diagnostic criteria for bulimia nervosa

Answer 19

binging and compensatory behaviors at least once a week for 3 months

Question 20

tx for bulimia nervosa (3)

Answer 20

-restore nutritional status
-SSRI
-behavioral/family/group therapy

Question 21

-what SSRI is recommended for bulimia nervosa
-what is the starting dose

Answer 21

fluoxetine
60 mg po qd

higher starting dose than for dpn

Question 22

t/f: fluoxetine alone often reduces frequency of binge eating and vomiting

Answer 22

t!

Question 23

2 second line meds for bulimia nervosa

Answer 23

TCAs
MAOIs

Question 24

in pt’s w. anorexia, menstruation usually resumes when pt’s return to _ % IBW

Answer 24

90%

Question 25

personality characteristics of anorexia nervosa (4)

Answer 25

intelligent meticulous high achievers compulsive

Question 26

PE findings of anorexia (10)

Answer 26

cachexia amenorrhea loss of libido hypothermia cold intolerance bradycardia dental erosions hypotn edema hirsutism

Question 27

possible lab findings of anorexia

Answer 27

-lyte disorders (ex hypokalemia) -metabolic alkalosis -increased BUN -thrombocytopenia -leukopenia -low ESR

Question 28

ekg finding of anorexia

Answer 28

prolonged QT

Question 29

comorbidity commonly associated w. anorexia

Answer 29

depression

Question 30

t/f: medication alone is effective tx for anorexia

Answer 30

f!

Question 31

what age group is at highest risk for anorexia

Answer 31

adolescents-early 20's

Question 32

2 sports highly associated w. anorexia

Answer 32

ballet wrestling

Question 33

what 2 male populations are esp at risk for anorexia

Answer 33

homosexual wrestlers

Question 34

median age of onset for bulimia

Answer 34

20

Question 35

5 consequences of severe bulimia nervosa

Answer 35

gastric dilation esophagitis electrolyte abnl aspiration pancreatitis

Question 36

4 symptoms of bulimia nervosa

Answer 36

reflux esophagitis abdominal cramps diarrhea rectal bleeding

Question 37

2 PE findings of extreme purging

Answer 37

metabolic alkalosis lyte abnormalities

Question 38

t/f: bulimia pt's have normal labs until very late stages of the dz

Answer 38

t!

Question 39

5 FDA approved uses of fluoxetine

Answer 39

dpn OCD premenstrual dysphoric disorder panic disorder bulimia nervosa

Question 40

therapeutic effect of SSRI's may take up to _ weeks

Answer 40

4

Question 41

side effect of high initial doses of fluoxetine (20 mg or higher)

Answer 41

panic attack -> high discontinuation rate

Question 42

s.e of fluoxetine

Answer 42

HA anxiety nervousness sweating insomnia anorexia wt loss nausea diarrhea rash