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20 Cards in this Set
- Front
- Back
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What has the highest mortality
rate of any psychiatric disorder? |
Anorexia Nervosa
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When is the peak onset of an eating disorder?
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14-18 years old
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Anorexia vs. Bulemia
Who is more likely to get treatment? |
33% anorexia patients get treatment
6% bulemia patients get treatment |
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What are the demographics associated with eating disorders?
(age, academics, Socioeconomics) |
Occurs most often in late adolescence to young
adults in high academic achievers and higher socioeconomic groups |
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Low Body weight (15% below normal BMI or 85% of expected body weight)
• Intense fear of gaining weight • Body Image distortion • **Amenorrhea** (at least 3 consecutive cycles) • Sub types: – Restrictive type (limiting caloric intake) – Binge eating/purging type |
Anorexia Nervosa
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Recurrent binge eating (large quantities and lacking control)
• Recurrent compensatory behavior (eg., selfinduced vomiting, over-exercise, enemas, laxatives) • Above 2 both occur together 3 consecutive months • Self image highly influenced by shape and weight • Does not occur in setting of anorexia*** • Subtypes: – Purging – nonpurging |
Bulemia Nervosa
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What is the most common eating disorder?
**EXAM** |
***Eating Disorder NOS***
• Aberrant eating patterns and weight management that do not meet criteria for anorexia or bulimia. • Criteria met for Anorexia but has menses or weight normal *** • Met for bulimia but happens less than 2x weekly or less than 3 months duration • Chewing and spitting out food • Binging w/o compensation |
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What sign/symptom has a 90% prevalence in eating disorders?
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Vomiting 90%
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What is Russell's sign?
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Scaring on back of hand from self induced vomiting
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Neuroendocrine effects of Anorexia and Bulemia
-Cortisol -Thyroid Hormones - Estrogen, LH, FSH **** |
Cortisol = increased
Thyroid hormones usually all decreased including TSH but TSH can be variable Estrogen, Progesterone and LH/FSH all lowered (Amenorrhea) |
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- metabolic disturbances that
occur as a result of reinstitution of nutrition to patients who are starved or malnourished • Refeeding process requires phosphates, magnesium and potassium • Can cause Hepatitis • Close monitoring of blood biochemistry is therefore necessary in the early refeeding period. • Energy intake should remain only 50-70% that of normally required for the first 3–5 days |
Refeeding Syndrome
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If a patient has been starving, what should there energy intake be for the first 3-5 days?
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Energy intake should remain only 50-70% that
of normally required for the first 3–5 days (Avoid Refeeding Syndrome) |
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What neuroendocrine level MUST be checked in all Anorexia and Bulemia patients?
**EXAM** |
Thyroid Hormones and TSH!!
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What is the most common psychiatric disorder to accompany eating disorders?
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Major Depression (MDD)
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Anorexia Vs. Bulemia
-cold intolerance -lack of sexual interest |
Anorexia
(Bulemia has no cold intolerance and normalsex interest) |
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Anorexia Vs. Bulemia
-Hypokalemia is only lab symptom |
Bulemia
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Anorexia Vs. Bulemia
-Hypokalemia -Metabolic Acidosis -Increased Serum Urea -Decresead thyroid hormones** |
Anorexia
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What are the most common causes of fatality for Anorexia and Bulemia?
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**Anorexia = hypophosphatemia
(W/ re-feeding can lead to Resp. & Heart Failure) **Bulemia = hypokalemia assoc. w/ purging |
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A patient has a BMI less than 17.5 ... What do you do?
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HOSPITALIZE
Consider **Family Intervention** |
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When should you hospitalize a bulemic patient?
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if they have medical issues secondary to their disorder
(electrolytes, esophageal scrarring) |
