Of Pretense and Persuasions

Sunday, July 16, 2006

Medical Complications of Anorexia

I'm doing the workup on a person who came in with a diagnosis of "end-stage anorexia" [wtf?] but, on the ward, demonstrates no classic anorexic behaviors. She has had severe wt loss and looks like a skeleton, so I've been keeping tabs on any possible medical complications I need to look out for:

Cardiovascular: Bradycardia, CHF, Dysrhythmias, EKG abnormalities, MVP, Pericardial effusion, Orthostsatic hypotension

Derm: Acrocyanosis, Brittle hair, brittle nails, carotene pigmentation, Edema, Hair Loss, Lanugo hair, Russell's Sign

Endocrine: Amenorrhea, Diabetes insipidus, hypercortisolemai, hypothermia, low T3 syndrome, pubertal delay

GI: acute pancreatitits, Barrett's esophagus, constipation, delayed gastric emptying, Eso/gastric rupture, fatty infiltration and focal necrosis of liver, gallstones, intestinal atrophy, mallory weiss tears, SMA syndrome

Neuro: Cortical atrophy, Myopathy, Peripheral neuropathy, Seizures

Skeletal: Osteopenia, Osteoporosis, Osteoporotic fractures

Brownie points for anyone who know's what the terms highlighted in red mean. Sounds like a good assignment for Mrs. P.M. [ehem].

PHARM Note: My patient is hypertensive and came in with a prescription for Clonidine. Why is this impt? Because the side effects of clonidie include nausea, vomiting, contipation and anorexia. We took her off of it.

1 Comments:

At 8:48 PM, Blogger Lori said...

EKG abnormalities include prolonged QTc, which can put the pt at risk for ventricular arrhythmias and toursades des pointes. To calculate QTc, QT interval divided by square root of preceding RR interval. Always calculate yourself; this is one you don't trust the EKG machine for. Always take the average of 3 calculations. If the pt has it, talk to cards, and monitor.

Worry about cardiomyopathy if any h/o ipecac abuse.

And always be sure someone bothered to look for the regular old medical causes that can coexist with eating d/o: HIV, TB.

 

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