Peds Eating Disorders

Question 1

what is the definition of body image

Answer 1

perception that a person has of their own physical self

Question 2

what are the two main factors that influence body image

Answer 2

• individual factors
• environmental factors

Question 3

what are perceptual factors of body image

Answer 3

how we see ourselves

Question 4

what are affective factors of body image

Answer 4

how we feel about how we look

Question 5

what are cognitive factors of body image

Answer 5

our thought and beliefs about out body

Question 6

what are behavioral factors of body image

Answer 6

what we do in relation to how we look

Question 7

body dissatisfaction is strongly tied to (…)

Answer 7

chronic negative perception about ones body

Question 8

what makes body dissatisfaction different from an eating disorder?

Answer 8

morbid fear of weight gain and the thoughts are all-consuming in an eating disorder

Question 9

what are risk factors for body dissatisfaction

Answer 9

• female
• teen/adolescent
• low self esteem
• participation on activities that focus on being thin

Question 10

t/f eating disorders may have a possible genetic link

Answer 10

true

Question 11

mother/sisters of anorexic patients are (…)x as likely to also have an eating disorder

Answer 11

8

Question 12

what neurotransmitters does anorexia affect?

Answer 12

serotonin and dopamine mostly. possibly norepinephrine

Question 13

what neurotransmitters do bulimia affect?

Answer 13

serotonin

Question 14

people with eating disorders have a hard time recognizing what ques

Answer 14

hunger and satiety

Question 15

what psych problems are associated with eating disorders?

Answer 15

• OCD
• Anxiety
• Depression
• body dysmorphia

Question 16

what type of family are anorexic patients are more likely to come from?

Answer 16

rigid, controlling, and organized

Question 17

what type of family are bulimic patients are more likely to come from?

Answer 17

chaotic, critical and conflicted

Question 18

what type of ineffective parenting can lead to eating disorders in the future

Answer 18

feeding kids at time of anxiety rather than hunger, making it hard for them to differentiate hunger from feelings as an adult

Question 19

how do we tell the difference between normative and abnormal dieting?

Answer 19

• patient weight
• patient health status
• body perception
• healthful or harmful diet?

Question 20

what are the screening tools for eating disorders

Answer 20

• SCOFF
• ESP
• EAT
• PHQ

Question 21

when does Avoidant/Restrictive Food Intake Disorder begin?

Answer 21

infancy or early childhood

Question 22

what is the classic presentation of Avoidant/Restrictive Food Intake Disorder

Answer 22

underweight child with a BMI of 16 or less

Question 23

diagnostic criteria of Avoidant/Restrictive Food Intake Disorder

Answer 23

• Avoiding or restricting food intake
• failure to meet nutritional or energy needs
• not due to lack of resources or other medical condition

Question 24

anorexia is (…)x more common in women

Answer 24

3 times

Question 25

what is the peak onset of anorexia

Answer 25

early adolescence and late adolescence/early adulthood

Question 26

what is the average age of onset for anorexia

Answer 26

18

Question 27

classic anorexia patient

Answer 27

adolescent white female

Question 28

what characterizes anorexia

Answer 28

* restricted energy intake-> low body weight * intense fear of weight gain * distorted perception of weight

Question 29

what is binge eating anorexia

Answer 29

when someone engage in small binges and purges (less frequent than bulimia)

Question 30

what is restrictive anorexia

Answer 30

anorexic tendencies with no purging behaviors

Question 31

what are abnormal food behaviors in anorexia

Answer 31

* reduction in food intake * food related obsessions * claim distaste for food or epigastric pain

Question 32

common behavioral disturbances in anorexia

Answer 32

* distorted perception of part or all of body * perfectionist * limited social activities

Question 33

what are the clinical findings of anorexia

Answer 33

* depression * fatigue * bone pain * amenorrhea * GI * hair loss * russell's sign

Question 34

what are severe clinical signs of anorexia

Answer 34

* emaciation * sallow complexion * bradycardia * severe hypotension * osteoporosis * lanugo

Question 35

what is lanugo

Answer 35

fine, soft hair, especially that which covers the body

Question 36

what is Russell's sign

Answer 36

calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time

Question 37

what is the cause of 50% of deaths in anorexic patients

Answer 37

complications of the disease

Question 38

what is included in the workup of all suspected anorexia patients?

Answer 38

* EKG * UA * serum labs

Question 39

when should you admit an anorexia patient?

Answer 39

* unstable vitals * cardiac complications * organ failure * suicide * weight less than 70% IBW

Question 40

what is refeeding syndrome

Answer 40

metabolic alterations that may occur during nutritional repletion of starved patients

Question 41

what is the management of anorexia

Answer 41

* multimodal approach including: * nutritional rehabilitation * psychotherapy * medical management

Question 42

what are the goals of anorexia treatment

Answer 42

* medical stability * weight stabilization * heathy eating patterns * treat underlying psychopathology * prevent relapse

Question 43

t/f psych meds are first line for anorexia

Answer 43

false: psychotherapy is first line

Question 44

if psych meds are needed for anorexia treatment, what should be given?

Answer 44

* olanzapine to help with weight gain * SSRI can also be used. (fluoxetine preferred d/t lower risk of relapse after restored weight)

Question 45

(...)% of anorexia patients have a good prognosis

Answer 45

50%

Question 46

(...)% of anorexia patients eventually relapse

Answer 46

35-55%

Question 47

bulimia is (...)x more common in women

Answer 47

3x

Question 48

what is the classic bulimia patient

Answer 48

adolescent white female

Question 49

what is purging bulimia

Answer 49

patients who engage in self induced vomiting or misuse of laxatives, diuretics, and enemas

Question 50

what is nonpurging bulimia

Answer 50

patients who engage in other inappropriate compensatory behaviors such as fasting, excessive exercise

Question 51

what is the typical pattern of behavior for bulimia

Answer 51

* caloric restriction * binge * compensatory mechanism (purge)

Question 52

t/f bulimia patients have slightly more control over their condition than anorexia

Answer 52

true

Question 53

what are the clinical findings of bulimia

Answer 53

* lethargy * hypotension * tachycardia * hair loss * GI

Question 54

what are the severe clinical findings of bulimia

Answer 54

* dehydration * hypokalemia * hyperchloremia * metabolic alkalosis

Question 55

hypertrophy of what gland is related to bulimia?

Answer 55

parotid gland

Question 56

what is the workup for all suspected bulimic patients

Answer 56

* UA * Serum labs * if severely ill: EKG

Question 57

when should you admit a bulimia patient?

Answer 57

* unstable medical condition * suicidal ideation * refusal of treatment with potential to become unstable

Question 58

what is the management of bulimia

Answer 58

* multimodal approach: * nutritional rehabilitation * psychotherapy * medical management

Question 59

what is the best form of therapy for bulimia

Answer 59

cognitive behavioral therapy

Question 60

1st line medication for bulimia

Answer 60

Fluoxetine (prozac)

Question 61

what medications are contraindicated in bulimia and other eating disorders?

Answer 61

bupropion (wellbutrin)

Question 62

what is the prognosis of bulimia

Answer 62

* 50-70% short term reduction of symptoms * 28% relapse rate

Question 63

binge eating disorder is more common in which population

Answer 63

women

Question 64

what is the median age of onset for binge eating disorder

Answer 64

23

Question 65

what is binge eating disorder

Answer 65

recurrent binge eating without compensatory behaviors

Question 66

how do you rate severity of binge eating disorder

Answer 66

* Mild: 1-3x weekly * **Moderate: 4-7x weekly** * Severe: 8-13x weekly * **Extreme: 14+ weekly**

Question 67

common reported symptoms with binge eating disorder

Answer 67

* food is coping mechanism * shame, guilt, hopelessness

Question 68

what are the typical comorbidities of binge eating disorder

Answer 68

* obesity * psychological factors.

Question 69

How do you manage binge eating disorder

Answer 69

psychotherapy

Question 70

what pharmacotherapy is available for binge eating disorder

Answer 70