Eating disorders

Question 1

medical complication in anorexia nervosa

Answer 1

• Cardiac: Bradycardia, hypotension, QT dispersion, cardiac atrophy and mitral valve prolapse
• Gynecologic: Amenorrhea and decreased libido
• Endocrine: osteoporosis, hypothermia, euthyroid and hypoglycemia
• GI: Gastroparesis and Constipation
• Electrolyte: Dehydration, hypokalemia, hypophosphatemia, and hypomagnesemia
• Pulmonary: respiratory muscle atrophy and dyspnea
• Hematologic: anemia, leukopenia and thrombocytopenia
• Neurologic: Brain atrophy
• Derm: Xerosis, carotenoderma, acrocyanosis, seborrheic dermatitis
• Re-feeding syndrome: DO NOT rehydrate or feed pts beyond current capacity. SERIOUS COMPLICATION

Question 2

What are the mood disorder comorbidites with Anorexia nervosa

Answer 2

• Anxiety: OBSESSIVE COMPULSIVE DISORDER

- impulse control disorders

Question 3

What are the personality trait comorbidities with Anorexia Nervosa?

Answer 3

• Obsessive Compulsive
• Avoidant
• Dependent
• Narcissistic
• paranoid
• Borderline

Question 4

what are needed at minimum for first line care of Anorexia Nervosa

Answer 4

-nutritional rehabilitation and psychotherapy

Question 5

how long should hospitalization last for anorexia nervosa

Answer 5

until normal weight is achieved to reduce relapse and re hospitalization

Question 6

what is initial intake when treating Anorexia nervosa

Answer 6

30-40 kcal/kg

Question 7

what medication should be avoided in pts with anorexia nervosa and why?

Answer 7

• Bupropion: seizures . . also avoid in Bullemia

- TCAs: cardiotoxicity

Question 8

Medical complications in Bullemia Nervosa?

Answer 8

• Electrolyte: Dehydration, hypokalemia, hypchloremia, metabolic alkalosis
• Cardiac: Hypotension, orthostasis, sinus tachycardia, ECG changes, and arrhythmias
• GI: MALLORY-WEISS syndrome or esophageal rupture, parotid and submandibular gland hypertrophy, abdominal pain and bloating and constipation
• Dental and skin: Tooth enamel erosions and dental caries, scar and callus on dorsum of hand (Russel’s sign), Xerosis

Question 9

what is the best standard treatment for bullemia nervosa

Answer 9

• nutritional rehab
• CBT psychotherapy (treatment of choice)
• pharmacotherapy

Question 10

first line pharmacotherapy for Bullemia nervosa

Answer 10

-Fluoxetine

Question 11

what is the only medication approved to treat moderate to severe binge eating disorder in adults?

Answer 11

• Vyvanse (lisdexamfetamine)

- also indicated for ADHD