Eating disorders: 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 disorders: bulimia nervosa

Sample item

A young woman of normal weight has recurrent episodes of binge eating followed by self-induced vomiting. Examination shows calluses on the knuckles and parotid enlargement. A typical metabolic abnormality is:

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

The answer and the reasoning

C. Hypokalaemic metabolic alkalosis

Vomiting causes loss of hydrogen and chloride, with volume depletion, producing hypokalaemic hypochloraemic metabolic alkalosis. Russell sign (knuckle calluses), dental erosion and parotid swelling are features, and fluoxetine with CBT is the treatment.

Option by option

  • A. Hyperkalaemic metabolic acidosis

    Hyperkalaemic acidosis is not expected with vomiting.

  • B. Hypercalcaemia

    Hypercalcaemia is not a feature.

  • C. Hypokalaemic metabolic alkalosis (correct)

    Correct. Vomiting leads to hypokalaemic metabolic alkalosis.

  • D. Hypernatraemia with acidosis

    Hypernatraemia is not characteristic.

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 C, Hypokalaemic metabolic alkalosis. Vomiting causes loss of hydrogen and chloride, with volume depletion, producing hypokalaemic hypochloraemic metabolic alkalosis.

Why is "Hyperkalaemic metabolic acidosis" not the answer?

Hyperkalaemic acidosis is not expected with vomiting.

Why is "Hypercalcaemia" not the answer?

Hypercalcaemia is not a feature.

Why is "Hypernatraemia with acidosis" not the answer?

Hypernatraemia is not characteristic.

What concept does this question test?

It tests Eating disorders: bulimia nervosa in Psychiatry. Russell sign (knuckle calluses), dental erosion and parotid swelling are features, and fluoxetine with CBT is the treatment.

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 disorders: 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.