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IS THIS AN EMERGENCY?
Psychological Assessment & Diagnosis
Urgent Care
Initial Medical Assessment
Further Medical Assessments
When to Worry
Discussing Weight
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Further Medical Assessments

Further medical investigations can happen at later appointments

Work your way through these investigations at a pace that works for you and your patient. 

Brain

Short term

  • Confusion, drowsiness, seizures, poor memory, and concentration
  • Depression, anxiety, and OCD
  • Insomnia (anxiety vs hunger keeping awake)

Long term

  • Brain atrophy

Growth trajectory/charts in young people

Refer to the below resources:

  • Healthy Weight for Kids
  • Growth Charts & Goal Weight

ENT

  • Parotid swelling
  • Dental (tooth and gum disease from malnutrition, caries from purging)

Endocrine

  • Amenorrhoea
  • Sick euthyroid
  • Poor temperature regulation
  • Hypoglycaemia
  • Osteoporosis

Cardiovascular

  • Arrhythmia, long QTc
  • Long term: oedema, heart failure

GIT

  • Decreased gastric mobility
  • Bloating
  • Constipation
  • Dysphagia
  • Pancreatitis (scope if purging >5 years)

LFTS

  • Can be abnormal in starvation and refeeding

Bone Marrow

  • Low WCC
  • Anaemia (chronic disease or iron def)
  • Thrombocytopaenia
  • Immune response to infection

Healthy Weight for Kids

Determine a healthy weight range for kids

Clinical Growth Charts

Center for Disease Control & Prevention

The following medical investigations may be conducted as indicated:

  • ECG

Useful in all individuals as it provides a more accurate resting pulse and assesses for arrhythmia's (especially prolonged QTc which is common with severe weight loss).

  • Blood Tests

This may include: full blood count, electrolytes, liver function tests, glucose, calcium, magnesium, phosphate, thyroid stimulating hormone, tri-iodothyronine, serum thyroxine, follicle stimulating hormone, luteinising hormone and oestradiol. 

  • Bone Densitometry

Indicated in individuals that are restricting their energy intake for >6 months, if underweight, with or without amenorrhoea. 

  • Other Investigations

Erythrocyte sedimentation rate, ferritin, B12, folate, anti-transglutaminase antibodies and stool microscopy. 

Growth charts & goal weight made simple: eating disorder recovery

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