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17 Cards in this Set

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What is the criteria for Anorexia Nervosa?
Body weight less than 85% of expected
Intense fear of gaining weight of becoming fat
Disturbance in the way in which one's body weight or shape is experienced
postmenarchal and amenorrheic females
However, the two essentials are underweight and amenorrhea!@
What types of Anorexia are there?
Restricting type: Person has restricted whta they eat
Binge-eating/purging type: regularly engaging in binge eating or purging behavior
Remember - Anorexia = underweight + Amenorrhea irrespective of process
What are the predisposing factors for Anorexia?
History of sexual abuse
Problems expressing aggression and a recently stressful life situation
Personality profile: Best and the brightest, perfectionist, peacemakers, family of body health conscious freaks!
What are comorbid conditions associated with anorexia Nervosa
Mood disorders (50-75%)
Lifetime history of OCD (25%)
Personality Disorder (40-75%)
Outcome of Anorexia Nervosa?
Death rate 5-18%
Most frequent cause of death is cardiac arrhythmia with sudden cardiac death
What is the criteria for Bulimia Nervosa?
BINGE EATING - Eating in a discrete period of time (within any 2 hour period), an amount of food way bigger than most peeps. (A giving in period after starvation)
Following binges is inappropriate compensations:
Self-induced vomiting, laxatives, diuretics, enemas...
Fasting
Excessive exercise (uh-oh! Really I'm just trying to get buff!)
What is the time frame for bing eating in Bulimia?
on average 2x a week for 3 months
What types of Bulimia are there?
Purging type: self induced vomiting or the misuse of laxatives, diuretics, or enemas
Nonpurging type: other inappropriate compensatory behaviors, such as fasting or excessive exercise
Little Hint: Often bulimics are not underweight looking
What is the course and predisposing factors of Bulimia? (vegeta's bulimia?)
Mid adolescence with a chronic intermittent course
Typically family history of obesity
What are some emphasized medical complications of anorexia or bulimia?
Cardiac Arrhythmias, hypokalemia, hyponatremia, leukopenia
Signs and symptoms of anorexia:
Regression of secondary sexual characteristics (phew!)
Orthostatic hypotension - Fainting
Lowered core body temperature
and other stuff....
What are some signs and symptoms of purging?
Nausea
spontaneous (nonvolitional) reflex vomiting of any food
Persistent lancinating epigastric pain
Flatulence
Eroded dentition
Russell's sign - cuts on back hand from being scraped on teeth while pugilisticating(not a word)
Lab findings of those that purge 3x/day?
low WBCAnemia
Diminished RBC mass
Macrocytic RBC indices
Hypochloremia
Hyperphosphatemia
Low protein
Hypomagnesemia
and a partridge in a pear tree
Treatment for anorexia and bulimia? (Besides shoving food down their throat and taping their mouth shut?)
Inpatient facility - close monitoring
partial hospitalization - daytime monitoring
Outpatient management - fuck em
Medical management process for anorexia and bulimia?
Weight restoration (slow refeeding due to possible cardiac overload)
Correction of electrolyte abnormalities
Monitor for attempts to purge
TreatmentsBesides regular medical management for anorexia or bulimia?
Cognitive-Behavioral Therapy - bad bad don't do this... spank spank!
Family therapy - may be less beneficial for those over 18 due to return to family which will inhibit progress
Pharmacotherapy - no medications specifically for anorexia or bulimia however may treat comorbid conditions
What drugs should be avoided in comorbid treatment of anorexia or bulimia?
Avoid TCAs because TCAs carry a risk of cardiac arrhythmias which in an eating disorder patient is even higher risk
Avoid Buproprion (wellbutrin) due to the lower seizure threshold of eating disorder patients