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ASD and Eating Disorders — MRCPsych Paper B MCQ

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ModerateEating DisordersASD and Eating DisordersMRCPsych Paper B

A 24-year-old woman presents after restricting her food intake and losing 8 kg over 6 weeks. Her pulse is 38 beats per minute, blood pressure is 86/54 mmHg and serum potassium is 2.8 mmol/L. Her developmental history also suggests longstanding social-communication difficulties, sensory sensitivities and rigid routines consistent with possible autism spectrum disorder. What is the immediate clinical priority?

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Correct answer: D — Arrange urgent medical assessment and stabilisation of the eating disorder

The correct answer is D. Bradycardia, hypotension and marked hypokalaemia indicate potentially life-threatening medical compromise from the eating disorder. NICE recommends acute medical care for severe electrolyte disturbance or malnutrition and medical stabilisation when physical health is severely compromised. Possible autism remains clinically important and should subsequently be assessed using developmental history and appropriately adapted communication, but it must not delay emergency management. Option E reverses the risk-based priority. Option C is inappropriate because completing both diagnostic assessments would delay urgent treatment. Option B is too absolute: medical instability takes priority, but autism-related information can still inform immediate care and later assessment. Option A is incorrect because clinical urgency and risk, rather than order of onset, determine priority.

Reference: National Institute for Health and Care Excellence. Eating disorders: recognition and treatment (NG69), sections 1.10.3 and 1.11.1. 2017, updated 2020 and reviewed 2024. https://www.nice.org.uk/guidance/ng69/chapter/recommendations