A 17-year-old girl presents to the clinic for a sports physical. Physical examination findings reveal bradycardia, multiple erosions of tooth enamel, and scars on her knuckles. She appears healthy otherwise. You should ask her if she:
a. binges and vomits.
b. has regular menstrual periods.
c. has constipation frequently.
d. is cold intolerant.
A
In young adults, usually female, bradycardia, knuckle scars, and tooth decay are signs of chronic, self-induced vomiting characteristic of bulimia. Amenorrhea can occur from increased physical activity or anorexia. Constipation and cold intolerance are usually symptoms of anorexia nervosa.
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