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Eating Disorder

Eating Disorders

QuestionAnswer
What is the definition for Eating Disorders? Disturbance in perception of body shape and weight
What are the types of eating disorders? Anorexia Nervosa, Bullimia Nervosa, Eating Disorder NOS
Under DSM IV, what are the criterias required for the diagnosis of Anorexia Nervosa? Amenorrhea (absence of at least 3 periods), refusal to maintain a minimally normal wt, afraid to gain wt, significant disturbance in perception of shape or size of his/her body
Under DSM IV, what are the criterias required for the diagnosis of Bullimia? Recurrent episodes of binge eating, Binge-eating & compensatory behavior that occur at least twice/week for 3 months, does not occur during periods of Anorexia Nervosa
Which gender has the higher prevalence of eating disorders? FEMALE
What is the significance of Anorexia Nervosa in terms of mortality? Mortality rate is 15-18%. Rate is 12x higher than death rate of all causes of death for females 15-24 yrs old
What is another significance of Anorexia Nervosa in terms of mortality? 20% of pts die prematurely from complications r/t this disorder including suicide and heart problems
A pt with eating disorder needs to stay inpatient for how long? 3 - 6 months
Which co-morbidity is eating disorder often associated with? Major Depressive Disorder
What could be a trigger for pt with eating disorder? When their weight starts to drop again
Pt with Bullimia Nervosa is also associated with which mood disorder? Bipolar
What is anti-psychotic or neuroleptic indicated for manic episodes in bipolar or schizophrenia? OLANZAPINE (ZYPREXA)
What is a major CNS side effect of Zyprexa (Olanzapine)? NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, AKATHISIA, DYSTONIA, TARDIVE DYSKINESIA
What is a major GI side effect of Zyprexa? WEIGHT GAIN
What are some predisposing factors associated with eating disorders? Genetics, neuroendocrine, Family: Enmeshed -blurred boundaries, overly demanding/controlling,dysfunctional communication, Genetics, neuroendocrine
What are some important criteria for inpatient admission associated with Anorexia Nervosa? LOW BP(<70 systolic), PULSE (<40) AND CARDIAC DYSRHYTHMIAS (hypokalemia), SUICIDAL/SELF HARM, RAPID WT LOSS(30% over 6mths)
Name some specific features associated with Anorexia Nervosa Individual wt is < 85% of normal, intense fear of becoming fat, strenuous exercising
Name some outcomes which are difficult to achieve for pt associated with Anorexia Nervosa Identify positive criteria for self-worth, develop a positive perception of own appearance, ability to acquire and use information
Name an achievable outcome for pt with Anorexia Nervosa? Improved nutritional status-reach target weight , normalize eating patterns, identify triggers, develop a relapse prevention plan
Who are the collaborative team that will be helpful to a pt with Anorexia Nervosa? Pediatrician, psychiatrist, dietician, psychiatric nurse, therapist
What are some interventions for eating disorder? Daily wt in AM in gown (not to let pt see), monitor physical status (labs, BP, P), gradually increase caloric intake to prevent hypermetabollic state, observe signs of purging
What are some effective treatment modalities for eating disorder? Cognitive behavioral therapy , dialetical behavioral therapy
Why do treatments seem difficult for pts with eating disorder? Their symptoms are ego-syntonic (inseparable part of the person), physical condition has to be treated before emotional aspect can be treated, long term tx, manipulative, defensive, resistant
What are some frequently associated feature of Bullimia? Symptoms are ego-dystonic(not part of themselves), dichotomous thinking (only see things as "all good/all bad"), impulsive, perfectionism,
What are some assessments associated with Bullimia Nervosa? Bradycardia, hypotension, dysrhytmias, cardiomyopathy, hypokalemia, hypanatremia, hoarseness, Russell's sign in throat (calluses, scars on hands)
What are some outcomes we want to see in pts with Bullimia Nervosa?
Created by: cynthiachong
 

 



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