Which of the following symptoms is not a characteristic manifestation of anorexia nervosa?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Menorrhagia, which is abnormally heavy or prolonged menstrual bleeding, is incorrect. It is not a symptom of anorexia nervosa.
The characteristic reproductive symptom in females with anorexia nervosa is amenorrhea (the absence of menstruation) or oligomenorrhea (infrequent periods).
Amenorrhea results from the body's response to severe weight loss and malnutrition, which suppresses the hormones (LH, FSH, estrogen) necessary for the menstrual cycle.

Why Other Options Were Wrong

Option A: Hypotension (low blood pressure) is a very common and characteristic cardiovascular finding in anorexia nervosa, resulting from starvation's effects on the heart muscle and fluid balance.
Option C: Pallor (paleness) is a frequent sign in individuals with anorexia nervosa. It is typically caused by anemia resulting from deficiencies in iron, folate, or vitamin B12.
Option D: Constipation is one of the most common gastrointestinal complaints in anorexia nervosa. It is caused by slowed gut motility due to decreased food intake and dehydration.

Related Visual

body diagram illustrating the systemic effects of anorexia nervosa on various organs and systems, including the brain, heart, skin, GI tract, and reproductive system. Highlight...

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Anorexia Nervosa as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in the early identification of eating disorders by assessing for physical signs like hypotension, bradycardia, lanugo, and inquiring about menstrual history during routine check-ups.
A comprehensive physical assessment is vital. Monitoring vital signs, especially for orthostatic hypotension, and assessing skin, hair, and GI function can reveal the severity of malnutrition.
Management of anorexia nervosa requires a multidisciplinary team approach, including medical, psychological, and nutritional support. The nurse is often the central coordinator of this care.

How to Approach the Question

First, identify the keyword 'NOT' in the question stem. This indicates you are looking for the option that is an exception or does not fit with the others.
The core subject is 'anorexia nervosa'. Recall the key physiological effects of starvation and severe malnutrition on the body's systems.
Evaluate each option: A) Hypotension, C) Pallor, and D) Constipation are all plausible consequences of a low-energy, malnourished state.
Consider option B) Menorrhagia (heavy bleeding). Contrast this with what you know about the reproductive effects of low body weight. Severe malnutrition shuts down non-essential functions, including the reproductive cycle, leading to the absence of periods (amenorrhea).
Conclude that menorrhagia is the opposite of the expected symptom, making it the correct answer to this 'NOT' question.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of Anorexia Nervosa
Stem keywords: anorexia nervosa, symptoms, characteristic manifestation
Lead-in keywords: not
Negative lead-in flag: This question uses negative framing ('NOT'), asking the test-taker to identify the option that does not belong.

Question ID

QHB41CZG_LwTMZNYLBzZCz

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) p. 1501-1503

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