What is the diagnostic criteria for Bulimia Nervosa?
- Recurrent binges
(binge = <2 hr periods of eating a lot AND sense of loss of control) - Recurrent compensatory behaviors (purging)
(vomit, exercise, diuretics, laxatives, enemas, fasting) - Binges and compensatory behaviors at least once a week for 3 months
- Self evaluation is unduly influenced by body and weight.
What is Russell’s sign in Bulimia Nervosa?
Scratches or cuts on back of the hands resulting form teeth scraping while inducing vomit.
What electrolyte and acid/base disturbance is classic for Bulimia?
Hypokalemic, hyperchloremic alkalosis.
What is the diagnostic criteria for Anorexia Nervosa?
- Restriction of energy intake relative to requirement leading to low body weight (BMI <18.5)
- Intense fear of gaining weight
- Disturbance of body image.
What are the two subtypes of AN?
Restricting type: No binging or purging present for 3 months.
Binging/purging type: Binging or purging present for 3 months.
AN has two peak ages of incidences which are?
12-14
AND
18
What psychiatric illness has the highest mortality rate?
Anorexia Nervosa (bc medical complications and suicide)
What are the 6 main RF for developing Anorexia Nervosa?
- White woman
- Early feeding problems as a child
- Maternal depression during childhood
- Fam hx of ED
- Perfectionism
- Being praised for weight loss.
What is Russel’s sign?
lesion on knuckles due to self induced vomiting.
Purging via laxative abuse and vomiting cause different metabolic and acid/base disturbances…what happen in each situation?
Laxative = Hyperkalemic, hyponatremic, Metabolic Acidosis
Vomiting = hypochloremic, hypokalemic metabolic Alkalosis.
