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Peds: ED
Peds: ED
16
Anatomy
Graduate
03/02/2012

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Cards

Term
mental illness with highest mortality rate:
Definition
eating disorders
Term
typical anorexic:
Definition
- straight A
- high achieving
- athletic
- middle class
Term
fastest growing increases in eating disorders are among:
Definition
- males
- minorities
Term
Anorexia Nervosa is defiend as refulsa to maintina weight greater than or equal to minimally normal weight for age and heigh or weight loss leading to maintenance below __ of expected, or failure to meet expected weight gain during period of growth, leading to weight less than __% expected. Also have intense fear of gaining weight even though underweight, disturbance in way in which one s body weight or shape is experienced, or denial of seriousness, of current low body weight, amenorrhea (of at least 3 months) in post-menarchial females.
Definition
- below 85% expected
- 85%
Term
Bulimia Nervosa dx criteria:
Definition
1. Reccurent episodes of binge eating: either more than most would eat in given amount of time or feeling out of control
2. Recurrent inappropriate compensatory behavior to prevent weight gain
3. Occurence of these practices at least 2 times/week for 3 months
4. Self evaluation unduly influenced by body shape and weight
5. The disturbance does not occur exclusively during episodes of anorexia nervosa
Term
Long term complications of Anorexia Nervosa;
Definition
- Decreased GI motility
- GER
- Difficulty digesting high caloric intake
- SMA Syndrome
- Loss of gastrocolic reflex- constipation even with stool softeners
- Osteopenia/fractures- occurs 6 onths after amenorrhea
Term
Long term complications of Bulimia nervosa:
Definition
- Esophageal rupture
- Esophagitis
- Barrett Esophagus
- Aspiration pneumonia
- Chronic metabolic acidosis or alkalosis
- Diet pills: insomina, HTN, tachycardia, palpitations, seizures, sudden death
- Cardiomyopathy
Term
Criteria for admission to hospital with eating disorder:
Definition
- Decreased urine output
- HR < 50 bmp, awake
- Hypotension, systolic less than 90
- QTC > 45 msec
- K+ < 3.2
- Cl- < 88
- Hypothermia < 96F
- Wt < 75% IBW or ongoing loss
- Orthostasis
- Esophageal tears, hematemesis
- Intractable vomiting
- Uninterruupted bing purge cycles
Term
orthostatic vital signs:
Definition
- Increased heart rate by > 20 bpm
- Decreased systolic or diastolic > 10 mmHg
- 2 minutes after standing from lying
- Syncope
Term
UA will show increased SG if pt is ___.
Definition
dehydrated
Term
UA will show __ SG if pt water loaded.
Definition
decreased
Term
Lab findings with eating disorders:
Definition
- Decreased USG
- Decreased WBC, RBC, PLT, HCT- bone marrow suppression
- Decreased TSH and thyroxine
- Decreased FSH, LH, estradiol, testosterone (shut down of hypothalamic-pituitary- gonadal axis)
- Increased BUN/Cr- renal insufficiency and chronic dehydration
- Increased AST and ALT (malnutrition)
- Increased Amylase
Term
Vomiting will cause what lab findings:
Definition
- Metabolic alkalosis
- Hypokalemia
- Low chloride
Term
DDx of weight loss with distorted body image:
Definition
- IBD
- DM
- Hyperthyroidism
- Malignancy
- Depression
- Adrenal insufficiency
- Celiac disease
Term
target weight:
Definition
90% IBW- menses return within 6 months of this

goal is 1 pound weight gain/week

increased caloric intake by 200-300 kcal every 3 days

may need 3000-3500 kcal/day

initially will have fluid retention due to decreased metabolic rate
Term
PCP role with eating disorder:
Definition
- Follow up within 2-3 days of dx
- See 2x/week if marginal weight
- With improved weight, see pt every other week, then every month, then every 6 months
- Follw electrolytes, blood pressure, and heart rate
- Daily multivitamin and calcium, 500 mg bid
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