Psychiatry: Eating Disorders Flashcards
(41 cards)
What is Anorexia Nervosa
Excessive Diet and exercise leading to low body weight
intense fear of gaining weight
distorted perception of body weight
What BMI is classified as Anorexia Nervosa
<18.5
What causes increased mortality in Anorexia Nervosa
Malnutrition
What are the 2 major subtypes of Anorexia Nervosa
Restricting
-low caloric intake
-excessive exercise
Binge-purging
What disorders often co-occur with Anorexia Nervosa
Depression
Anxiety
OCD
PTSD
Substance abuse
How does Anorexia Nervosa impact reproductive hormones
Dec GnRH
-Dec LH/FSH
-amenorrhea
Functional Hypothalamic Amenorrhea
How does Anorexia Nervosa impact Thyroid Hormone
“Sick Euthyroid” pattern
-low T3
-High rT3
-norm/high TSH/T4
How does Anorexia Nervosa impact electrolytes
Hyponatremia
low Creatinine
What causes Hyponatremia in Anorexia Nervosa
Low solute intake
“Tea and Toast diet”
Why is Creatinine low in Anorexia Nervosa
Decreased Muscle Mass
What electrolyte abnormality if purging is present in Anorexia Nervosa
Hypokalemia
How does Anorexia Nervosa impact bones
Decreases bone density
-low estrogen
-high cortisol
Osteopenia
Osteoporosis
What hematological effects result from Anorexia Nervosa
BM Suppression
-Anemia
-Leukopenia
-Thrombocytopenia
What are the cardiac effects of Anorexia Nervosa
Decreased Muscle
-cardiomyopathy
-arrhythmias
What is considered a mild low BMI in anorexia Nervosa
17 to 18.5
What is considered a moderate low BMI in anorexia Nervosa
16 to 16.99
What is considered a severely low BMI in anorexia nervosa
15 to 15.99
What is considered an extremely low BMI in anorexia nervosa
<15
What is seen on Physical Exam in Anorexia Nervosa
Bradycardia
Hypotension
Dec Bowel Sounds
Dry, scaly skin (xerosis)
Hair loss
Lanugo hair growth
-soft, fine hair
What are the treatment options for Anorexia Nervosa
Nutritional Rehab
Psychotherapy
Olanzapine
Hospitalize
What are the indications to hospitalize a patient with anorexia nervosa
Very low body weight
Hemodynamically unstable
Volume depletion
refusal to eat
What do you have to be careful to avoid when treating Anorexia Nervosa
Refeeding syndrome
What is the hallmark of Refeeding Syndrome
Hypophosphatemia
-low PO4 from intake
-glucose inc insulin
-insulin inc metabolism
-PO4 is uptaken by cells
-further dec PO4
-loss of ATP
-Cardiac/Resp Failure
What do most fatalities result from in Refeeding Syndrome
Cardiac
-poor contractility
-low Stroke volume
-HF
-Arrhytmias
