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Part II ISQ Club - Eating disorders

36 posts in this topic

Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

This is the last 'Part II ISQ-Club' post for Spring 2004. Bye!

1. Self-induced vomiting and deliberate self harm are associated in adolescent girls

2. Peptic ulceration is a recognised complication of bulimia nervosa

3. Bulimia is associated with increased mortality

4. In treatment of anorexic patients with severe weight loss, initial weight gain is associated by cognitive improvement

5. Shoplifting is associated with bulimia nervosa

6. The Eating Disorders Inventory is a self-reported questionnaire

7. Amenorrhoea is seen in bulimia nervosa

8. Hypothyroidism is associated with hirsutism

9. Anorexia nervosa of latter onset have a higher mortality than earlier onset

10. Anorexia can be prevented by education in schools, activities and peer focus group discussions

11. T4 levels are raised in anorexia nervosa

12. Peripheral CCK release reduces satiety

13. Approximately 30% of women experience the blues after pregnancy

14. Feeling muddled is a common symptom of post-pregnancy blues

15. Adolescent girls who intentionally self harm have a history of parental criticism immediately preceding the episode.

16. The effect of cortisol is more than that of DHEA in adolescent depression

17. Pseudocyesis is associated with social isolation

18. Self neglect in the elderly (Diogenes syndrome) is likely to be caused by delusions

19. Self neglect in the elderly (Diogenes syndrome) is generally thought to be burnt-out personality disorder

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Eating disorders inventory is a self-report questionnaire - TRUE

although....it consists of statements rather than questions...am I being too precise here? or is there a difference between an inventory and a questionnaire?

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Pseudocyesis is associated with social isolation - TRUE

Int J Psychiatry Med 1990;20(1):97-108 (6 cases where social isolation is one of several common features)

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5. Shoplifting is associated with bulimia nervosa

TRUE Comp to Psych Studies pg 523

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7.Amenorrhoea is seen in bulimia nervosa

TRUE Comp to Psych Studies pg 524

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9. Anorexia nervosa of later onset has higher

mortality..... than that of earlier onset.

TRUE Seminars in Gen Adult Psych pg883

( if ..... than that of very early onset I would answer

false )

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18. Self-neglect in the elderly (Diogenes' syndrome) is

likely to be caused by delusions.

FALSE Seminars Old Age Psych pg166

...refers to a syndrome of self-neglect in older

people, unaccompanied by a medical or psychiatric

condition sufficient to account for the situation.

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Self neglect in the elderly (Diogenes syndrome) is generally thought to be burnt-out personality disorder

TRUE

Manchester course notes on old age p11

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1. Self-induced vomiting and deliberate self harm are associated in adolescent girls. true

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12. Peripheral CCK release reduces satiety .false

puri pg 461

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Pseudocyesis is associated with social isolation true

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13. Approximately 30% of women experience the blues after pregnancy true ans 30 to 80 percent page 557 companion

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9. Anorexia nervosa of latter onset have a higher mortality than earlier onset

answer- true.

older age of onset

is associated with poor outcome

ref- p377, revision notes in psychiatry by Puri

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Hypothrodism cause hirsutism is false ---it causes dry hair, dry skin and alopecia

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2. PEPTIC ULCER IS A RECOGNISED COMPLICATION OF BULIMIA NERVOSA.... TRUE

Medical Complications:

Like all eating disorders bulimics are also at a high risk for dying, especially if they are purging, using laxatives and doing

excessive exercise. Many bulimics have died from cardiac arrest, which is usually caused by low potassium or an electrolyte imbalance. There have also been cases when bulimics have died because of a ruptured oesophagus due to excessive vomiting. Other complications that arise are:

Erosion of tooth enamel because of repeated exposure to acidic gastric contents

Dental cavities, sensitivity to hot or cold food

Swelling and soreness in the salivary glands (from repeated vomiting)

Stomach Ulcers

Ruptures of the stomach and oesophagus

Abnormal build-up of fluid in the intestines

Disruption in the normal bowel release function

Electrolyte imbalance

Dehydration

A greater risk for suicidal behaviour

Decrease in libido

Cathartic colon (caused from laxative abuse)

Edema (swelling of hands and feet)

Low blood pressure

Development of peptic ulcers and pancreatitis (inflammation of the pancreas)

Gastric dilation and rupture

Abrasions on back of hands and knuckles

Anaemia

Cardiac arrest and death

Treatment:

The treatment of bulimia consists of individual psychotherapy and nutritional direction. However, what you have to realise is that you cannot cure a bulimic by trying to control their behaviour or worse shrugging it off. What the patient needs is support. As most of the patients are very hard on themselves and they need support to help understand things better.

Don't wait for evolution. Get

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15. TRUE

Ref: Archives of Suicide research, 1995

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The Eating Disorders Inventory is a self-reported questionnaire

true

Source- Manchester course

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1.Self-induced vomiting and deliberate self harm are associated in adolescent girls

TRUE

a subgroup of bulimia nervosa patients have multiple impulsive behaviours - described by Lacey (1993)

- drinking alcohol +++

- substance misuse

- stealing

- DSH

(ref Companion p523-525)

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re q 14 'baby blues' and 'muddled'?

This terminology belongs in the world of popular psychology not psychiatry so I looked it up in a reputable parenting book:

'Baby blues-

commonest sympt tearfulness, many emotional/ upset/

anxious/ tense, other sympts memory lapses/ feeling of helplessness/ confusion'

Sounds like 'muddled' to me....

TRUE?

ref Association of Postnatal Illness

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1) Self induced vomiting and DSH assoc in adol girls

T - can't find it explicitly written anywhere though

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2) PUD - bulimia

T - most texts agree that med complications about the same but more severe in AN. Core psychiatry pg 231 actually states it but most others will not really commit.

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