During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder?
a. Diarrhea
b. Amenorrhea
c. Appetite suppression
d. Erosion of tooth enamel
ANS: D
Some of the signs of bulimia include erosion of tooth enamel and increased dental caries. Check the back of the hands for abrasions caused by rubbing against the maxillary incisors during self-induced vomiting. Diarrhea is not a result of vomiting. Rather, it may occur in patients with inflammatory bowel disease and other gastrointestinal diseases. Amenorrhea can occur with anorexia nervosa, but it can also be a result of the weight loss from other causes. It can also indicate pregnancy in adolescent females. Appetite suppression can occur from central nervous system lesions or from oncologic and metabolic disorders.
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