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Case Study 96: Anorexia Nervosa.

1- Identify one major risk factor for anorexia nervosa from this patient’s history of present illness.

2- Identify a minimum of seven clinical manifestations from the review of system above that are consistent with a diagnosis of anorexia nervosa.

3- Identify three vital signs that are consistent with a diagnosis of anorexia nervosa.

4- Calculate this patient’s body mass index to confirm that the patient is technically underweight.

5- Identify three clinical manifestations from the skin and HEENT examinations above that suggest Jenny is dehydrated.

6- Why did the eating disorders specialist examine the patient’s teeth, a procedure that is not common in a physical examination?

7- Which negative abdominal clinical signs parallels a single clinical symptom reported by the patient during the review of symptoms?

8- What is the significance of the rectal examination?

9- Which four laboratory blood test results are consistent with dehydration?

10- Do any of the laboratory data support a diagnosis of anemia?

11- Is the patient at risk of developing infections?

12- This patient has many clinical manifestations that are associated with hypothyroidism disease. Is this patient hypothyroid?

13- Based on the patient’s laboratory blood test results, provide one reasonable explanation for the observed level +1 peripheral edema.

12- Can the patient’s recent amenorrhea be explained by any of the laboratory blood test results shown in Table 96.2?

14- Which of the following findings from the laboratory blood test has to be of greatest concern and why: hypernatremia, hypokalemia, hypoglycemia, hypomagnesemia, hypocalcemia, or hypophosphatemia?

15- Some patients with anorexia nervosa are hypercholesterolemic. Does this patient in this case study have a markedly elevated serum cholesterol concentration?