While assessing a teenage girl suspected of having bulimia nervosa, the health care provider may find which of the following clinical manifestations that would confirm the diagnosis? Select all that apply

Question

A) Large number of teeth with dental caries
B) Eroded tooth enamel leading to sensitive teeth
C) Kyphosis
D) Painless parotid gland enlargement
E) Skin with lanugo

Answer 1

Ans: A, B, D
Feedback:
The complications of bulimia nervosa include those resulting from overeating, self-induced vomiting, and cathartic and diuretic abuse. Dental abnormalities, such as sensitive teeth, increased dental caries, and periodontal disease, occur with frequent vomiting because the high acid content of the vomitus causes tooth enamel to dissolve. An unexplained physical response to vomiting is the development of benign, painless parotid gland enlargement. The most frequent complication of anorexia nervosa is amenorrhea and loss of secondary sex characteristics with decreased levels of estrogen, which can eventually lead to osteoporosis. Bone loss can occur in young women after as short a period of illness as 6 months. Symptomatic compression fractures and kyphosis have been reported. Skin with lanugo (i.e., increased amounts of fine hair) is also commonly seen in clients with anorexia nervosa.