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Flashcards in Eating Disorder Deck (37)
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1

DSM-5 Criteria

Restriction of energy intake relative to requirements
Fear of weight gain
Severe body image disturbance

2

What does restriction of energy intake relative to requirements lead to in anorexia?

Significantly low body weight in the context of age, sex, developmental trajectory, and physical health

3

Subtypes of Anorexia Nervosa

Restricting
Binge eating/purging

4

Signs/Symptoms of Anorexia

Dry skin
Cold intolerance
Blue hands & feet
Constipation
Bloating
delayed puberty
Primary or secondary amenorrhea
Fainting
Orthostatic hypotension
Lanugo hair
Scalp hair loss
Early satiety
Weakness, fatigue
Short stature
Osteopenia
Breast atrophy
Atrphic vaginitis
Pitting edema
Cardiac murmurs
Sinus bradycardia
Hypothermia

5

DSM-5 Criteria for Bulimia: 3 of the following 5 Criteria

Eating much more rapidly than normal
Eating until uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of embarrassment
Feeling disgusted, depressed, or very guilty over overating

6

Signs/Symptoms of Bulimia

Mouth sores
Pharyngeal trauma
Dental caries
Heartburn, chest pain
Esophageal rupture
Impulsivity: stealing, ETOH abuse, drug/tobacco
Muscle cramps
Weakness
Bloody diarrhea
Bleeding or easy bruising
Irregular periods
Fainting
Swollen parotid glands
Hypotension
Russell's sign

7

Define Russell's Sign

Calluses on the back of their knuckles/hands from self induced vomiting

8

Define Binge Eating

Eating in a discrete period of time an amount of food that is larger than most people would eat in a similar period

9

DSM-5 Criteria for Eating Disorder, Not Otherwise Specified

Anorexia with regular menses
Anorexia except weight still in normal range
Bulimia except

10

Types of Inappropriate Compensatory Behavior

Self-induced vomiting
Misuse of laxatives, diuretics, or other meds
Fasting
Excessive exercise

11

Associated Psychiatric Conditions with Eating Disorders

Anxiety disorders
OCD
Personality disorders
Substance abuse

12

Pathogenesis of Eating Disorders

Combination of psychological, biological, family, genetic, environmental, and social factors

13

Screening Tools for Eating Disorders

SCOFF Questionaire
ESP

14

SCOFF Questionnaire

S: sick feel uncomfortably full
C: control (loss) over how much you eat
O: one stone (14 pounds)
F: fat when others think think
F: food dominates life

15

Important History for Eating Disorders

Maximum heigh/weight
Exercise habits: intensity, hours/week
Stress levels
Habits & behaviors: smoking, ETOH, drugs, sexual activity
Eating attitudes & behaviors
ROS

16

Anorexia Physical Exam

Vitals: orthostatic
Skin/extremity evaluation
Cardiac exam: bradycardia, arrhythmia, MVP
Abdominal exam
Neuro exam: other causes of weight loss/vomiting

17

Bulimia Physical Exam

Vitals: orthostatic
Skin/extremity evaluation
Cardiac exam: bradycardia, arrhythmia, MVP
Abdominal exam
Neuro exam: other causes of weight loss/vomiting
Parotid gland hypertrophy
Erosion of teeth enamel

18

Lab Assessment for Eating Disorders

CBC: anemia
Electrolytes
BUN/Cr
Mg, PO4, calcium
Albumin, serum protein
B-HCG
UA: specific gravity
Thyroid function tests
Serum prolactin
FSH
Bone density

19

Complications of Eating Disorders

Fluid & electrolyte imbalance
Osteopenia
Amenorrhea
Cardiac changes

20

Fluid & Electrolyte Imbalance

Hypokalemia
Hyponatremia
Hypochloremic alkalosis
Elevated BUN
Inability to concentrate urine
Decreased GFR
Ketonuria

21

Osteopenia

Most severe complications
Difficult to revers

22

Treatment of Osteopenia

Weight gain
1200-1500 mg/day of elemental calcium
Multivitamin with vit. D
Estrogen/progesterone replacement

23

What is amenorrhea caused by in anorexia?

Low FSH
Low LH

24

Cardiac Changes in Eating Disorders

MVP
Long QT
Risk of HF greatest in first 2 weeks of refeeding

25

HF during first 2 weeks of Refeeding

Reduced cardiac contractility
Refeeding edema
Slow refeeding
Repletion of K+
Avoidance of Na+ intake

26

CBT in Anorexia

Emphasizes the relationship of thoughts and feelings

27

Providers in an Interdisciplinary Care Team for Anorexia

Medical provider
Dietician with experience in eating disorders
Mental health professional

28

What are medications for in treating eating disorders?

Co-morbid conditions of depression & OCD

29

When to Hospitalize a Patient with an Eating Disorder

Severe malnutrition (

30

Nutrition in Anorexia

Regain to goal of 90-92% of IBW