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Psych CASC / OSCESpecialty psychiatry — eating disorders

Psych CASC / OSCE · Specialty psychiatry — eating disorders

Explain anorexia nervosa care and refeeding safety to a parent — CASC communication station

MRCPsych/FRANZCP-style communication station: explain AN, medical risk, refeeding, FBT, and limits of medication to a carer.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
Parent of a 15-year-old recently admitted with restricting anorexia nervosa wants a clear explanation of the diagnosis, why heart rate is dangerous, what refeeding syndrome is, why the family will lead meals in FBT after discharge, and whether olanzapine is needed now.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the paediatric/adolescent medical ward with eating disorder liaison. [5]

Candidate instructions. Explain the diagnosis of anorexia nervosa in plain language, why medical monitoring matters (heart rate, electrolytes), what refeeding syndrome is and how the team prevents it, why family-based treatment is recommended after stabilisation, and give a balanced answer on medication (not first-line in this adolescent scenario). Check understanding and invite questions. The examiner plays the parent. [1][2][5]

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References5ShowHide
  1. [1]Lock J, Le Grange D, Agras WS, et al. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa Arch Gen Psychiatry, 2010.PMID 20921118
  2. [2]Society for Adolescent Health and Medicine Refeeding hypophosphatemia in hospitalized adolescents with anorexia nervosa: a position statement of the Society for Adolescent Health and Medicine J Adolesc Health, 2014.PMID 25151056
  3. [3]Sachs KV, Harnke B, Mehler PS, et al. Cardiovascular complications of anorexia nervosa: A systematic review Int J Eat Disord, 2016.PMID 26710932
  4. [4]Attia E, Steinglass JE, Walsh BT, et al. Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial Am J Psychiatry, 2019.PMID 30654643
  5. [5]Society for Adolescent Health and Medicine Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults J Adolesc Health, 2022.PMID 36058805
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