CDN Eating Disorder Treatment 4 — Questions and Answers
Question 1: Which lab finding is most indicative of severe malnutrition requiring immediate medical stabilization before outpatient eating disorder treatment?
- Serum albumin of 3.8 g/dL
- Heart rate of 46 bpm (Correct answer)
- Blood glucose of 90 mg/dL
- Hemoglobin of 12 g/dL
Correct answer: Heart rate of 46 bpm
Bradycardia (heart rate below 50 bpm) is a medical emergency in anorexia nervosa and requires inpatient stabilization.
Question 2: The 'fear foods' hierarchy used in eating disorder treatment is a tool derived from which theoretical framework?
- Cognitive behavioral therapy (Correct answer)
- Psychodynamic therapy
- Solution-focused brief therapy
- Narrative therapy
Correct answer: Cognitive behavioral therapy
The fear foods hierarchy is a CBT exposure tool where patients gradually face avoided foods from least to most feared.
Question 3: Which eating disorder has the highest mortality rate among all psychiatric disorders?
- Binge eating disorder
- Bulimia nervosa
- Anorexia nervosa (Correct answer)
- Avoidant/restrictive food intake disorder
Correct answer: Anorexia nervosa
Anorexia nervosa has the highest mortality of any psychiatric disorder, with deaths from cardiac complications and suicide.
Question 4: A night eating syndrome (NES) patient reports consuming >25% of daily calories after the evening meal. Which intervention is first-line?
- Nocturnal tube feeding to redistribute calories
- Structured meal timing with earlier caloric distribution (Correct answer)
- Immediate pharmacotherapy with SSRIs
- Sleep restriction therapy only
Correct answer: Structured meal timing with earlier caloric distribution
Restructuring meal timing to distribute calories more evenly throughout the day addresses the core behavioral pattern of NES.
Question 5: Which serum marker, though not specific, is often monitored as a proxy for nutritional rehabilitation progress in anorexia nervosa?
- C-reactive protein
- Prealbumin (transthyretin) (Correct answer)
- Homocysteine
- Ferritin
Correct answer: Prealbumin (transthyretin)
Prealbumin has a short half-life (~2 days), making it a more sensitive marker of recent nutritional status changes than albumin.
Question 6: Orthorexia nervosa is characterized by:
- Bingeing on 'healthy' foods only
- Obsessive focus on consuming 'pure' or 'correct' foods with significant life impairment (Correct answer)
- Alternating between restriction and compensatory exercise
- Fear of weight gain with maintained normal intake
Correct answer: Obsessive focus on consuming 'pure' or 'correct' foods with significant life impairment
Orthorexia involves a pathological preoccupation with food purity and quality that causes significant functional impairment, though it is not yet a formal DSM diagnosis.
Question 7: In treating an athlete with relative energy deficiency in sport (RED-S), the primary nutrition intervention is:
- Increasing protein intake to 2.5 g/kg/day
- Restoring energy availability to ≥45 kcal/kg of fat-free mass per day (Correct answer)
- Eliminating all high-fat foods from the diet
- Supplementing with iron and B12 only
Correct answer: Restoring energy availability to ≥45 kcal/kg of fat-free mass per day
RED-S is caused by insufficient energy availability; restoring it to ≥45 kcal/kg FFM/day reverses hormonal, bone, and metabolic disruptions.
CDN Eating Disorder Treatment 4
Which lab finding is most indicative of severe malnutrition requiring immediate medical stabilization before outpatient eating disorder treatment?