Eating and sleep disorders: laboratory findings in bulimia nervosa: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Eating and sleep disorders: laboratory findings in bulimia nervosa

Sample item

A normal-weight woman who vomits after binges has painless bilateral swelling of the cheeks in front of the ears. Which laboratory change is most likely to accompany this swelling?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Raised serum amylase of salivary origin

Repeated vomiting causes parotid enlargement (sialadenosis) and a rise in salivary-type amylase. Vomiting also loses gastric acid, so the usual acid-base picture is metabolic alkalosis with raised bicarbonate. Lipase is not raised unless true pancreatitis develops.

Option by option

  • A. Raised serum amylase of salivary origin (correct)

    Correct. Parotid enlargement from vomiting raises amylase of salivary type.

  • B. Raised serum lipase indicating pancreatitis

    A raised lipase would point to pancreatitis, which painless parotid swelling does not indicate.

  • C. Raised serum calcium from hyperparathyroidism

    Hypercalcaemia is not a feature of purging and does not explain parotid swelling.

  • D. Low serum bicarbonate with metabolic acidosis

    Vomiting causes alkalosis with high bicarbonate, not acidosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Raised serum amylase of salivary origin. Repeated vomiting causes parotid enlargement (sialadenosis) and a rise in salivary-type amylase.

Why is "Raised serum lipase indicating pancreatitis" not the answer?

A raised lipase would point to pancreatitis, which painless parotid swelling does not indicate.

Why is "Raised serum calcium from hyperparathyroidism" not the answer?

Hypercalcaemia is not a feature of purging and does not explain parotid swelling.

Why is "Low serum bicarbonate with metabolic acidosis" not the answer?

Vomiting causes alkalosis with high bicarbonate, not acidosis.

What concept does this question test?

It tests Eating and sleep disorders: laboratory findings in bulimia nervosa in Psychiatry. Vomiting also loses gastric acid, so the usual acid-base picture is metabolic alkalosis with raised bicarbonate. Lipase is not raised unless true pancreatitis develops.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Eating and sleep disorders: laboratory findings in bulimia nervosa?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.