NURS 5462 OBESITY/EATING DISORDERS EXAM
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
Anorexia
Refusal to maintain minimal weight and intense fear of gaining weight. Risk factors—
female; family hx of an eating disorder; perfectionist or OCD type personality traits;
society that values thinness
1 in 10 of these folks have sudden death from starvation, cardiac arrest or suicide
Associated with MDD [65%]; social phobia; OCD Mortality is 20 percent from AN
Bulimia
—binge eating followed by compensatory methods to prevent weight gain, Binge eating
is defined as eating a large amount of food within a 2° period • Compensatory behaviors
—self induced vomiting; misuse of diuretics, laxatives or enemas; excessive exercise or
fasting; abuse of thyroid hormone replacement medications or stimulants
Those with BN
who cycle between binging and extreme food restriction have a worse prognosis than
those who just purge Most with BN are not underweight—they are of normal weight or
overweight—distinguishing it from AN
Introduction—Binge-Eating Disorder
Recurrent episodes of binge eating without compensatory use of vomiting, laxatives,
emetics or diuretics Binges are usually triggered by emotions related to work or school
, stress, fear of abandonment or loss Associated with a FH of Binge-Eating Disorder
Patient is usually of normal weight or overweight
Clinical Presentation—Anorexia
Warning signs: Substantial weight loss? • Depression or mood swings? • Preoccupation
with weight, calories and/or food? • Wear baggy clothes? • History of excessive
exercise? On exam—look for emaciation, cachexia, dry skin, lanugo hair, edema,
enlarged parotid glands
Anorexia symptoms
• Amenorrhea • Constipation • Abdominal pain • Hypothermia • Lethargy or fatigue •
Anxious • Headaches
Clinical Presentation—Bulimia Nervosa
Any significant weight loss or gain? • Depression? • Great concern for weight? • Visit to
the bathroom after meals? • Alluded to strict dieting or binging cycles? • Marked
criticism of his or her body?
• On labs—look for low K+, low Cl-, low Na++, elevated bicarbonate, metabolic alkalosis
[from vomiting], metabolic acidosis [from diarrhea if abusing laxatives], elevated
amylase
*Russel sign
BN SX
• Irregular menses • Abdominal pain • Fatigue or lethargy • Peripheral edema • Bloating
• Depression • Acid reflux • Sore throat
Clinical Presentation—Binge Eating Disorder
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
Anorexia
Refusal to maintain minimal weight and intense fear of gaining weight. Risk factors—
female; family hx of an eating disorder; perfectionist or OCD type personality traits;
society that values thinness
1 in 10 of these folks have sudden death from starvation, cardiac arrest or suicide
Associated with MDD [65%]; social phobia; OCD Mortality is 20 percent from AN
Bulimia
—binge eating followed by compensatory methods to prevent weight gain, Binge eating
is defined as eating a large amount of food within a 2° period • Compensatory behaviors
—self induced vomiting; misuse of diuretics, laxatives or enemas; excessive exercise or
fasting; abuse of thyroid hormone replacement medications or stimulants
Those with BN
who cycle between binging and extreme food restriction have a worse prognosis than
those who just purge Most with BN are not underweight—they are of normal weight or
overweight—distinguishing it from AN
Introduction—Binge-Eating Disorder
Recurrent episodes of binge eating without compensatory use of vomiting, laxatives,
emetics or diuretics Binges are usually triggered by emotions related to work or school
, stress, fear of abandonment or loss Associated with a FH of Binge-Eating Disorder
Patient is usually of normal weight or overweight
Clinical Presentation—Anorexia
Warning signs: Substantial weight loss? • Depression or mood swings? • Preoccupation
with weight, calories and/or food? • Wear baggy clothes? • History of excessive
exercise? On exam—look for emaciation, cachexia, dry skin, lanugo hair, edema,
enlarged parotid glands
Anorexia symptoms
• Amenorrhea • Constipation • Abdominal pain • Hypothermia • Lethargy or fatigue •
Anxious • Headaches
Clinical Presentation—Bulimia Nervosa
Any significant weight loss or gain? • Depression? • Great concern for weight? • Visit to
the bathroom after meals? • Alluded to strict dieting or binging cycles? • Marked
criticism of his or her body?
• On labs—look for low K+, low Cl-, low Na++, elevated bicarbonate, metabolic alkalosis
[from vomiting], metabolic acidosis [from diarrhea if abusing laxatives], elevated
amylase
*Russel sign
BN SX
• Irregular menses • Abdominal pain • Fatigue or lethargy • Peripheral edema • Bloating
• Depression • Acid reflux • Sore throat
Clinical Presentation—Binge Eating Disorder
