Intro/Eating DOs Lectures

Question 1

True or False…

PCPs are the sole contact for more than half of all patients with mental illness

Answer 1

True

Question 2

Biggest 3 mental health issues seen in primary care?

Answer 2

Depression

Anxiety

Substance abuse

Question 3

MC psych issue?

Answer 3

Major depressive disorder

Question 4

~37,000 people in US die from ________ each year

Answer 4

Suicide

Question 5

>____% of pts who commit suicide had contact with their PCP within year of death

Answer 5

75%

Question 6

After starting psych pt on medication, how soon should you follow up?

Answer 6

Within 2-4 weeks

Question 7

If no response to psych med within ______ weeks, consider referral

Answer 7

6-8 weeks

Question 8

broad concept that prohibits professionals from revealing information about a client to anyone (some exceptions)

Answer 8

Confidentiality

Question 9

narrower concept that describes specific types of information may not be disclosed in a legal setting

Answer 9

Privilege

Question 10

Up to __% of healthcare providers are victims of violence sometime during their careers

Answer 10

50%

Question 11

There is an increased reuptake of _______ in anorexics and bulimics

(this decreases appetite)

Answer 11

Serotonin

Question 12

There is an increased release in serotonin during….

Answer 12

Binging

Question 13

Peptide Tyrosine Tyrosine (PYY) (aka satiety peptide)

this is _______ in gut of anorexics and bulimics

Answer 13

increased!

(results in decreased appetite)

Question 14

What do CCK levels look like in anorexics?

Answer 14

Increased!

(results in decrease appetite)

Question 15

Hunger hormone

dysfunctional in binge eaters

Answer 15

Ghrelin

Question 16

1. Genetic/neurochemical
2. Sociological
3. Psychological

Answer 16

All impact/influence eating disorders

Question 17

Overall sense of anxiety
Difficulty coping with stress
Awkwardness with interpersonal relationships
Low self esteem
Lack of assertiveness
Unable to express emotions

Answer 17

Personality traits assciated with eating disorders

Question 18

Prevalence of eating disorders is highest in….

Answer 18

Adolescent and young adult women

(medain age 18-21 yo)

Question 19

Median age for women with eating disorders?

Answer 19

18-21 yo

Question 20

Women account for what percentage of eating disorders?

Answer 20

90-95%

Question 21

2 types of anorexia?

Answer 21

1. Restrictive
2. Binge eating/purging

Question 22

What is the prevalence of:

Anorexia?
Bulimia?
Binge eating?

Answer 22

Anorexia: 0.6%

Bulimia: 1.0%

Binge eating disorder: 2.8%

Question 23

Eat 26 Test

SCOFF Self Test

…2 screening tools for?

Answer 23

Eating disorders

Question 24

Persistent restriction of energy intake leading to significantly low body weight

either an intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain

Disturbance in the way one’s body weight or shape is experienced

Answer 24

Anorexia

Question 25

**Weight loss** is most obvious clue \*emaciated person believes they are overweight and tries to lose more weight

Answer 25

Anorexia

Question 26

True or false... The 2 types of anorexia (restrictive and binging/purging) can be seen in the same person

Answer 26

True

Question 27

unable to refrain from binge eating and purging Often self destructive tendencies Often impulsive, dramatic, emotional personalities Frequently abuse alcohol and drugs, stimulants, or laxatives Evident by continued weight loss

Answer 27

Binge/purge type of anorexia

Question 28

Can limit to 300-600 calories a day Limited food selection Obsessive and compulsive symptoms regarding food, eating habits, and exercise

Answer 28

Restrictive type anorexia

Question 29

BMI over 17 is associated with what severity of anorexia?

Answer 29

Mild

Question 30

BMI of 16-16.99 is associated with what severity of anorexia?

Answer 30

Moderate

Question 31

BMI of 15 to 15.99 is what severity of anorexia? BMI under 15 is what severity?

Answer 31

15-15.99= **Severe** Under 15= **Extreme**

Question 32

Is severity of anorexia only based upon BMI?

Answer 32

NO..also reflected by symptoms and degree of functional disability

Question 33

Recurrent episodes of binge eating characterized by: 1. Eating, in a discreet period of time, an amount of food that is larger than what most individuals would eat in a similar period of time 2. Sense of lack of control over eating during the episode

Answer 33

Bulimia

Question 34

Includes recurrent inappropriate behavior in order to prevent weight gain such as.... Purging (self induced vomiting) Laxatives, diuretics, fasting, excessive exercise

Answer 34

Bulimia

Question 35

For bulimia... The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for........

Answer 35

3 months

Question 36

Is bulimia associated with anorexia?

Answer 36

No

Question 37

Felling of **lack of control while eating** Regularly engages in inappropriate compensatory behavior to prevent weight gain (vomiting, laxatives, etc) **typically normal weight!!**

Answer 37

Bulimia (often diagnosed later in life, good at hiding behavior)

Question 38

The severity of bulimia is based upon....

Answer 38

Number of compensatory behaviors done per week

Question 39

What severity of bulimia is: 1-3 epsiodes of inappropriate compensatory behaviors a week

Answer 39

Mild

Question 40

What severity of bulimia is: 4-7 epsiodes of inappropriate compensatory behaviors a week

Answer 40

Moderate

Question 41

What severity of bulimia is: 8-13 epsiodes of inappropriate compensatory behaviors a week

Answer 41

Severe

Question 42

What severity of bulimia is: 14 or more epsiodes of inappropriate compensatory behaviors a week

Answer 42

Extreme

Question 43

Eating disorder Osteoporosis Amenorrhea

Answer 43

Female athlete triad

Question 44

1. Nutritional (disordered eating) 2. Endocrine (amenorrhea, diminished hormones) 3. Musculoskeletal (loss of Ca from bones)

Answer 44

Female athlete triad

Question 45

Electrolyte abnormalities (hypokalemia) Enamel erosion Russell's sign

Answer 45

Medical complications of **self induced vomiting**

Question 46

Hypochloremic metabolic acidosis can be caused by _______ and \_\_\_\_\_\_

Answer 46

**Vomiting** and **diuretics**

Question 47

Hyperchloremic metabolic acidosis Rectal prolapse Hemorrhoids

Answer 47

Medical complicatons of **over using laxatives**

Question 48

Sores on knuckles from self induced vomiting

Answer 48

Russell's sign | (sign of bulimia)

Question 49

Urine (ketones, pH, specific gravity, hydration) Ht, wt, BMI (remove baggy clothes) Temp Orthostatics EKG CBC, CMP, Amylase, Lipase, Phosphorus, Thyroid screening

Answer 49

Labs to get if suspicious of eating DO

Question 50

Mostly seen in females up to 30-40% of obsese ppl may meet this criteria

Answer 50

Binge eating DO

Question 51

Recurrent episodes of binge eating characterized by both of the following: Eating in a discreet period of time an amount of food larger than what most would eat A sense of a lack of control over eating during the episode **NO compensatory behavior, so they gain weight**

Answer 51

Binge eating disorder

Question 52

The binge eating episodes are associated with 3 or more of the following Eating very rapidly Until uncomfortably full Large amounts when not hungry Eating alone due to embarrassment over the amount Feeling disgusted with oneself, depressed, or very guilty afterward **at least once a week for 3 months NOT associated with bulimia or anorexia**

Answer 52

Binge eating disorder

Question 53

What is the severity of binge eating disorder based upon?

Answer 53

Number of binges per week

Question 54

1-2 binges a week = ? 4-7 binges a week = ? 8-13 binges a week= ? 14 + binges a week= ?

Answer 54

1-2= mild 4-7= moderate 8-13= severe 14+= extreme

Question 55

Cornerstone treatment for eating disorders?

Answer 55

Cognitive behavioral therapy (CBT)

Question 56

True or False.. some studies show there may be benefit from SSRIs wth anorexia and bulimia

Answer 56

true

Question 57

With anorexia, the lifetime prevalance of major depression is?

Answer 57

50%

Question 58

What percent of ppl with anorexia never achieve a normal weight?

Answer 58

25%