Alice, a 16-year-old girl, presents to the emergency department with her mother who is concerned that her daughter hasn’t eaten for the past three days.
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Alice denies any vomiting or feeling out of control of what she eats. Her mother reports that she has becoming more controlling about food, insisting on preparing meals, eating alone and has seen her weighing food. Her exact weight loss isn’t known, but it is felt she has lost over a stone in the two months. Despite this Alice feels she is still fat. She admits food dominates her life.
What important screening questions would you ask to identify if she may have an eating disorder?
Alice scores 3 on the SCOFF screening questions, and you suspect she has anorexia nervosa.
What are the key features you will be looking for on examination?
As part of your assessment you do an ECG and blood tests.
What results would suggest Alice is high risk and requires medical admission?