Eating disorders flashcards
9 high-yield MRCP Part 1 cards from the Intellect Medicos Psychiatry course. Try to answer each question before you open it — then study them properly with spaced repetition, which brings each card back just before you would forget it.
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Below what BMI does ICD-10 set the weight criterion for anorexia nervosa?
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17.5 kg/m² (or weight more than 15% below expected).
Why? Other criteria: self-induced weight loss, distorted body image, morbid fear of fatness and amenorrhoea in women.
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Which electrolyte abnormality is the hallmark of refeeding syndrome?
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Hypophosphataemia.
Why? Feeding triggers insulin release, which drives phosphate (with potassium and magnesium) into cells. This can cause arrhythmias, heart failure and muscle weakness.
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What is the first-line psychological treatment for anorexia nervosa in adults, and in children and young people?
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Adults: eating-disorder-focused CBT (CBT-ED). Children and young people: anorexia-focused family therapy.
Why? NICE NG69 recommends these. MANTRA or specialist supportive clinical management are alternatives for adults.
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What is the first-line treatment for bulimia nervosa in adults?
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Bulimia-focused guided self-help; if that fails, individual eating-disorder-focused CBT (CBT-ED).
Why? Psychological treatment is the mainstay.
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Which acid–base and potassium disturbance is typical of bulimia with repeated self-induced vomiting?
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Hypokalaemic (hypochloraemic) metabolic alkalosis.
Why? Vomiting loses gastric acid (HCl), and volume depletion drives renal potassium loss.
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Which hormone pattern explains amenorrhoea in anorexia nervosa?
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Low LH, FSH and oestrogen: hypogonadotrophic hypogonadism.
Why? Starvation suppresses hypothalamic GnRH release. Low oestrogen also contributes to osteoporosis.
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Which two hormones are typically raised in anorexia nervosa?
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Growth hormone and cortisol.
Why? Starvation is a physiological stress. The 'Gs and Cs' that rise also include cholesterol, carotene and salivary gland (parotid) size.
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Name two criteria that on their own put a patient at high risk of refeeding syndrome (NICE).
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Any two of: BMI under 16; unintentional weight loss over 15% in 3–6 months; little or no intake for over 10 days; low potassium, phosphate or magnesium before feeding.
Why? These patients need a cautious feeding start with thiamine and B vitamins, and close electrolyte monitoring and replacement.
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A patient binges and self-induces vomiting. Which feature best separates anorexia nervosa (binge–purge type) from bulimia nervosa?
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Body weight: BMI below 17.5 points to anorexia; in bulimia weight is usually normal or near normal.
Why? Amenorrhoea and endocrine changes are common in anorexia but less common in bulimia.