Psych · Child and adolescent psychiatry — eating disorders
Eating disorders in adolescence
Also known as Adolescent anorexia nervosa · Adolescent bulimia nervosa · Binge-eating disorder adolescents · ARFID · Family-based treatment · FBT · Maudsley family therapy · Refeeding syndrome · Atypical anorexia nervosa
Exam-exhaustive fellowship reference on eating disorders in adolescence — DSM-5-TR/ICD-11 AN, BN, BED and ARFID; medical risk and admission thresholds; refeeding syndrome and higher-calorie refeeding evidence; family-based treatment; SSRIs in BN not AN; capacity and compulsory care principles. FRANZCP-primary, globally tagged.
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10 MCQs with explanations
Target exams
FRANZCPMRCPsychABPNMD-DNBNEET-SS
Red flags
Medical instability — severe bradycardia, orthostatic hypotension, hypothermia, hypoglycaemia, electrolyte crisis, prolonged QTc, or rapid weight loss — requires urgent paediatric medical assessment and often admissionRefeeding syndrome risk — hypophosphataemia, oedema, arrhythmia during nutritional rehabilitation; protocolised refeeding with electrolyte and ECG monitoringActive suicidal ideation, intent or plan — elevated mortality includes suicide; same-day risk assessment and safety planningAtypical anorexia nervosa with significant restriction or rapid weight loss at a 'normal' BMI — do not discharge on weight alonePurge-related medical risk — hypokalaemia, metabolic alkalosis, arrhythmia, Mallory-Weiss, aspiration — even when BMI is normalInability to eat or drink with life-threatening restriction and impaired capacity — escalate legal and medical pathways under local statutes
Meet the patient
A 15-year-old dancer has lost a quarter of her body weight over six months. She eats only "safe" foods, runs before dawn, and has not menstruated in four months. Her heart rate is 42, she is cold, and she fainted at the barre yesterday. Her parents are frightened; she insists she is fine.[5][20]
The registrar wants to talk about the meal plan. The examiner's question is the one that decides whether she goes home or to a paediatric bed: "Is she medically stable, and what are your admission thresholds?" Weight is a vital sign here, but it is not the whole story.[5][25]
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