Anorexia Nervosa
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OVERVIEW
Anorexia Nervosa = chronic, severe, multi-system disorder which is rooted in a fear of becoming overweight with deliberate weight loss
- 1-2% of females
- ages 13-20
CLINICAL FEATURES
- thin
- major depression
- malnutrition
- cachexia
- hair loss
- amenorrhoea
- OP
- immunosuppression
- bradycardia
- hypotension
- cardiac failure
- delayed gastric emptying
- Concomitant substance use disorder (25-50% of patients: alcohol, nicotine, cocaine, and other stimulants)
INVESTIGATIONS
- hypochloraemic, metabolic alkalosis, hypokalaemia
- hypocalcaemia
- ECG: AV block, ST depression, TWI, prolonged QT, arrhythmias
MANAGEMENT
- rehydrate
- fix electrolytes
- cautious fluid therapy as can precipitate cardiac failure
- loss of lung elasticity -> high AWP
- RSI
- pressure cares
- hypothermia cares
- management of potential refeeding syndrome
References
LITFL
OTHER
NSW Health – Guidelines for the Inpatient Management of Adult Eating Disorders in General Medical and Psychiatric Settings in NSW
[cite]
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
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