University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

101

Pages:

2
Author:

Mariam A. A.

Anorexia Nervosa Definition Pathological fear of weight gain, distorted body image that leads to excessive weight loss and potentially malnutrition Epidemiology • • Peak in 10-25 years old More common in females than makes 10:1 Aetiology DSM5 • • • • • Biological (not clear) Psychological - Due to obsessive-compulsive personality traits Environmental Dieting and starvation Transitions Clinical features/signs and Symptoms • • • • • • • • • Excess weight loss Body image disturbances Insomnia Irritability Lack of emotions Hunger denial and making excuses not to eat Frequent meal skipping Eating refusal Vomiting Pathophysiology/Pathogenesis Diagnosis • • • • History Physical exam - Heart rate - Blood pressure - Temperature - Checking skin and nails for any signs BMI less than 18.5 in adults Lab tests: - Electrolyte imbalances: ✓ Low Na+, low K+, low Cl-, low phosphate, low Mg and increased HCO3(metabolic alkalosis) Low glucose levels Liver enzymes increased AST/ALT Elevated alpha-amylase in patients with recurrent vomiting Renal Function Parameters: Low creatinine levels ✓ Due to reduced muscle mass - Increased cholesterol levels ✓ Unknown mechanism ✓ Possible explanation: reactive increase in cholesterol synthesis and/or decrease in bile excretion X-rays - Check for bone density - Check for any fractures - • Treatment • • • • Psychotherapy - Cognitive behavioural therapy - Psychodynamic psychotherapy Pharmacotherapy - Antidepressants Nutritional support and education Restoring healthy weight - Dietitian Complications • • • • • • • • Harbottle et al. found that females diagnosed at the age of 15 years, have a lower life expectancy by 25 years 80% of patients with this disease have a cardiovascular illness, such as bradycardia Anaemia Osteoporosis (bone loss) In females -> absence of a period - Body does not have enough fuel to run bodily functions as usual - Body prioritises most important functions - Less energy to processes that are not absolutely vital for survival. For example, reproduction - Suppression of the part of the hypothalamus that controls hormonal fluctuations within the body In males -> decreased testosterone Depression Alcohol and substance misuse