description of health issues
current health risks
mental effects
behavior effects
treatment
100
Anorexia is associated with these cardiac findings * Bonus for EKG findings in severe cases
bradycardia (<60bpm) hypotension (<90 systolic), orthostatic hypotension
with extremely low K (< 2.5)- EKG shows falt or inverted T waves, ST segment depression, prominent U waves.
100
Binge eating do occurs in ___% of medically obese patients
25%
100
This disorder can cause the individual to think he/she is constantly overweight
Anorexia
100
People with this disorder are often shameful of behaviors (ego-dystonic)
Bulimia
100
Usually the first step to recovering from an eating disorder is what
Admitting you have one
200
Name 3 physical findings associated with Bulimia Nervosa
Calluses on hands, salivary gland hypertrophy, erosion of dental enamel (perimylolysis) dental caries, facial petechiae, perioral irritation, edema, adominal bloating, cardiac arrythmai, recall prolapse, hemorrhoids, oral ulcer, hematemesis
200
Bulima and anorexia mostly affect this age group
teens and 20s
200
Grief, disgust, and self-hatred about their eating behaviors are some of the many psychological effects of this eating disorder
binge-eating
200
8% of these cases begin with involuntary weight loss
Anorexia Nervosa
200
FDA approved medication for Binge eating do
Vyvanse (lisdexamfetamine) 2015
- SSRIs (reasonably effective), SNRIs, atomoxetine (reduced BE frequency), topiramate and zonisamide and orlistat
300
Low levels of this (highly sensitive) and high levels of this electrolyte indicates purging behavior *Bonus.
low potassium (<3.6), high bicarbonate (>30meq/L) - (pure dietary hypokalemia relatively rare)- indicates self induced vomiting or diuretic abuse. Pearl - Low serum bicarbonate related to laxative abuse.
300
This GI condition occurs in almost all AN-R? What meds to use and what to avoid?
Constipation: treat with adequate water, low fiber, polyethylene glycol. Avoid stimulant laxatives senna, cascara or bisocodyl potential for abuse and damage to colonic nerve cells and refractory constipation (cathartic colon syndrome).
300
Which subset of patients with AN feels the most stigma from self, society and other AN peers? What new DSMV specifier exists primarily in this group?
males (3.6:1 F:M)- reverse AN, muscle dysmorphia and Body Dysmorphic do
300
Binge eaters usually eat normally around others and do this when alone
gorging
300
These medications have been approved for treatment of AN
none: largest trials have been done on fluoxetine 60mg vs placebo showed not effective at preventing relapse or depression.
AAP showed lack of weight gain. Small studies with abilify which show help in reduction of distorted thinking.
400
Refeeding syndrome involves these electrolyte abnormalities and potentially this life threatening condition and should be a high level of concern when 30% below IBW
hypophosphatemia (newly synthesized tissues steal phos from ATP prevents cardiac contractility-CHF) hypokalemia (glucose increases insulin drives electrolytes intercellularly- C-BIG-K) , cardiovascular collapse (increased circulatory blood volume combined with reduced heart mass)
400
Delayed emptying of the stomach_________: in AN-R after 10-20% weight loss occurs and presents with LUQ pain vomiting, abdominal distention and gastric dilation- whats the tmt?
Gastroparesis; improves with feeding and avoidance of legumes and excessive fiber, may switch to liquid food supplement TID (750-1000 cal) for first 2 weeks and earlier in meal, divide intake into 3 meals and a snack
400
Individuals with this type of eating disorder develop addictions to cope with their problem
Bulimia
400
Anorexic people tend to engage in a lot of secret behavior: Name two to look out for.
exercise, hiding weights in clothes during weight checks, drinking extra fluid, wearing multiple layers of clothes
400
The only FDA approved medication for Bulimia Nervosa
fluoxetine- 60mg not 20mg reduced number of binging and vomiting episodes-ridiculous drop out rate 83% for tmt group
500
Syndrome that occurs after chronic purging- resulting in low K, metabolic alkylosis, volume depletion, upregulation of serum aldosterone. Bonus-What is the tmt?
Pseudo-Bartter's Syndrome- purging results in low KCL, because of dehydration- stimulates aldosterone- worsens -metabolic alkalosis and tells kidneys to dump more K- tmt stop purging- slow 50-75ml/hr NaCl fluids (avoids edema and central pontine myelitis (Na <120))
500
Significant weight loss puts you at high risk of this syndrome-which leads to inability to keep stomach contents down without NJ placement and eventual weight restoration
SMA (Superior Mesenteric Artery) Syndrome
500
People with eating disorders are also usually coupled with this type of mental health disorder
depression
500
Why besides loss of calories is exercise limited in AN?
risk of fall and fracture, risk of sudden cardiac death, dizziness upon standing
500
What makes therapy so difficult particularly in AN- how do you overcome this in therapy
disorder is ego-syntonic- increasing motivation by externalizing the eating do and engaging in treatment