Eating disorders Flashcards

1
Q

ICD-10 diagnostic criteria for anorexia?

A
BMI; <17.5
Self-induced weight loss; strict dieting, vomiting, excessive exercise, medication 
Body image disturbance
Fear of fatness
Amenorrhoea
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2
Q

Physical assessment findings in anorexia nervosa?

A
Muscle wasting, hair loss 
Lanugo hair
Cold, blue peripheries
Dry skin 
Hypercarotenemia
Bradycardia
Hypotension 
Bruising
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3
Q

Psychological assessment in anorexia nervosa `

A

Depression
OCD
Substance misuse
Diabetes mellitus

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4
Q

Risk assessment for a high risk individual with anorexia nervosa?

A
BMI <13.0 
Wt loss >1kg/week 
Prolonged QT, HR <40, Syst. BP <80
Core temp <34
Unable to rise from squat without using arms for leverage
Cognitive impairement
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5
Q

What investigations should be performed when to aid with the diagnosis and risk assessment of anorexia nervosa?

A

Haematology
Biocehm
ECG
DXA

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6
Q

What is refeeding syndrome?

A

Caused by depletion of already inadequate stores of nutrients e.g. magnesium, potassium and phosphate which are quickly used up as the body start to repair itself

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7
Q

How can you prevent refeeding syndrome?

A

Frequent blood monitoring

Slow pace of initial refeeding

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8
Q

What is MARSIPAN?

A

Management of really sick patients with anorexia nervosa

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9
Q

What psychological management is offered for anorexia nervosa?

A
Psychological therapies; CBT
Dietitian
Medical monitoring
Art therapy/ drama therapy
Family therapy
Inpatient treatment for high risk
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10
Q

What are the implications for the MHA in anorexia?

A

Assess capacity
Assess risk
Assess reciprocity
Need for artificial feeding

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11
Q

ICD-10 diagnostic criteria for bulimia nervosa

A
Persistent preoccupation with eating
Irresistible craving for food
Binges
Attempts to counter the effects of binges; starvation, vomiting, laxatives, drug misuse
Morbid dread of fatness
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12
Q

What can be seen on physical assessment of bulimia nervosa?

A

Russell’s sign; calluses on knuckles
Parotid hypertrophy
Dental caries
U+Es

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13
Q

What can be seen on psychological assessment of bulimia nervosa?

A

Depression
Self-harm
Substance misuse
Impulse personality

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14
Q

Medical complications of bulimia nervorsa

A
Oesophageal reflux
Oesophageal tears/ rupture
Hypokalaemia
Subconjunctival haemorrhage
Dehydration 
Seizures; metabolic abnormalities
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15
Q

Management of bulimia nervosa?

A

Guided self help
CBT
SSRI

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