HPSSC - 2015
Mental Health Nursing
Easy
Which of the following clinical signs is a common physiological consequence of starvation in a patient with anorexia nervosa?
Appeared in: HPSSC - 2015
Explanation
- Amenorrhea, the cessation of menstruation, is a defining physiological consequence of anorexia nervosa.
- It results from the body's response to severe energy deficit and low body weight, which suppresses the hypothalamic-pituitary-gonadal (HPG) axis.
- Low levels of body fat lead to reduced leptin, which in turn decreases the pulsatile release of Gonadotropin-Releasing Hormone (GnRH).
- This suppression cascades to the pituitary, reducing Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) levels, which are necessary for the menstrual cycle.
- This is an adaptive mechanism to conserve energy by shutting down non-essential functions like reproduction.
Why Other Options Were Wrong
- Option B: Tachycardia (a fast heart rate) is incorrect. Starvation leads to bradycardia (a slow heart rate) as a compensatory mechanism to reduce myocardial oxygen consumption and conserve energy.
- Option C: Hypertension (high blood pressure) is incorrect. The cardiovascular effects of starvation include hypotension (low blood pressure) and orthostatic hypotension, resulting from decreased cardiac muscle mass and reduced blood volume.
- Option D: Fever (elevated body temperature) is incorrect. Starvation leads to hypothermia (low body temperature) due to the loss of insulating subcutaneous fat and a decreased metabolic rate as the body tries to conserve heat and energy.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Physiological consequences of starvation in anorexia nervosa to guide bedside assessment, documentation, and the next nursing action.
- Recognizing amenorrhea as an early and key sign of anorexia nervosa is crucial for diagnosis, especially in adolescents.
- Monitoring for bradycardia, hypotension, and hypothermia is a critical nursing responsibility, as these can indicate severe medical instability requiring hospitalization.
- What if? If a patient with anorexia nervosa who has been bradycardic suddenly becomes tachycardic during refeeding, the nurse must immediately suspect refeeding syndrome. This is a medical emergency caused by rapid fluid and electrolyte shifts and requires urgent intervention to prevent cardiac collapse.
How to Approach the Question
- First, identify the core condition in the question: anorexia nervosa, which is characterized by starvation.
- Next, recall the body's fundamental physiological response to starvation. The primary goal is to conserve energy.
- Analyze how energy conservation would affect the body's systems. Most functions will slow down or shut down.
- Evaluate each option based on this principle:
- Heart rate: To save energy, the heart would beat slower (bradycardia), not faster (tachycardia).
- Blood pressure: With a weaker heart muscle and less fluid, blood pressure would decrease (hypotension), not increase (hypertension).
Concept Tested & Keywords
- Concept Tested: Physiological consequences of starvation in anorexia nervosa
- Stem keywords: clinical signs, physiological consequence, starvation, anorexia nervosa
- Lead-in keywords: Which of the following
- Negative lead-in flag: false
Question ID
QKuLQlqNDNbbEjeTbt-jse
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6936-6938
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1501-1503, 1499-1501
Practise the full HPSSC - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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