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18 Cards in this Set
- Front
- Back
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What do the following conditions have in common?
Sexually transmitted disease Online pornography obsession Domestic abuse Constipation Job loss or academic failure Eating disorders |
SHAME
Patients rarely tell you they have an eating disorder. Patients may say they are depressed, anxious, or complain of GI problems. They may say nothing, but you can observe a change in affect or cognition, or body-checking or avoidant behavior. Their parents or significant others may tell you, and/or force them to see you |
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inability to maintain body weight at or above a minimally normal weight for age and height.
Intense fear of gaining weight or becoming fat, even though underweight. |
Anorexia Nervosa
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Recurrent episodes of binge eating.
Recurrent inappropriate compensatory behavior in order to prevent weight gain…(exercise, diet pills, etc) The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months |
Bulimia Nervosa
Self-evaluation is unduly influenced by body shape and weight. The disturbance does not occur exclusively during episodes of anorexia nervosa |
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: recurrent episodes of binge eating in the absence if the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa
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Binge-eating disorder
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usual onset of anorexia?
bullimia? binge eating disorder? |
arex: Usual onset in adolescence (14-18)
bulimia: Usual onset of late adolescence through early adulthood bed: affects individuals of all ages |
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flip to see risk factors for eating disorders..objective
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Certain sports: ballet, figure skating, gymnastics, wrestling, track
First-degree family members with an eating disorder (13x greater risk) Type 1 Diabetes mellitus, especially with onset in adolescence History of physical or sexual abuse Comorbidity with affective & anxiety disorders, especially Obsessive Compulsive Disorder |
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what is the female athlete triad?
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Disordered eating
Amenorrhea Osteoporosis |
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how is diabetes a risk factor for eating disorders?
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Increased risk of AN among adolescent females with DM1
DM management can exacerbate ED Perfectionism, focus on #s, focus on body & food Insulin restriction is a purge equivalent Among adults with DM2, bulimia is more common than anorexia Success requires close collaboration of multidisciplinary team Exchanges instead of carb-counting No food records |
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3. Explain the biopsychosocial etiology of eating disorders
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Genetic predisposition
Serotonin NIMH genetics study Psychological vulnerability (ie, risk avoidant temperament) Relational dynamics Cultural phenomenon |
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what was the Key's study, what did it show?
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36 healthy young men, caloric intake reduced to ½ of their usual intake for 6 months
Developed food preoccupation and feeding rituals, food-related hoarding behavior, depression… |
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brittle hair and dry skin
cachexia lanugo hypoactive bowel sounds hyper- or hyporeflexia cognitive impairment hypothermia hypotension bradycardia physical findings of what? |
anorexia nervosa
hypothermia hypotension bradycardia require hospitalization |
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eroded dental enamel
painless parotid gland enlargement Russell’s sign Hypoactive bowel sounds Peripheral edema physical findings of what? |
Bullemia Nervosa
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what are the Medical Complications of AN, BN, ad BED?
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AN: complications result from malnutrition
BN & purging AN: complications result from mechanism of purging BED: complications result from obesity cardiovascular disease (CAD, hypertension), dyslipidemia, Diabetes mellitus, obesity-related hypoventilation syndrome and obstuctive sleep apnea, pressure sores, osteoarthritis |
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when discussing eating disoders, what is key to remember, especially with anorexia?
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high Mortality rate
Common complaints related to GI & CNS functions, and dermatologic effects |
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if a person is vomiting a lot what would Cl lvls be like?
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decreased
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tx for AN?
BN tx goal? BED? |
AN: Nutritional rehabilitation--full weight restoration.
BN: goal of treatment for BN is normalization of eating behavior BED:complete abstinence from binge-eating and modest weight loss (5-10%) |
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when a pt is diagnosed w/ anorexia, what test should you run after a year?
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DEXA
Treatment Weight restoration, smoking cessation Calcium +/- Vitamin D Calcium & Vitamin D plus alendronate compared favorably to placebo |
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What is refeeding syndrome?
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Typically develops on day 4
Not just seen in anorexia, but in rapid refeeding from any malnourished state Hypophosphatemia followed by fluid shifts and other serum electrolyte deficits Mortality due to heart failure, pulmonary edema |
