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Anorexia Nervosa — RACP Paediatrics MCQ

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ModerateAdolescent MedicineAnorexia NervosaRACP Paediatrics

A 14-year-old girl presents with amenorrhoea, significant weight loss (BMI 15 kg/m²), bradycardia, and lanugo hair. She reports feeling fat despite being underweight. What is the most important initial investigation to assess medical stability?

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Correct answer: D — ECG and serum electrolytes (especially potassium, phosphate, magnesium)

In anorexia nervosa, ECG and electrolytes are the most important initial investigations to assess medical stability. Hypokalaemia, hypophosphataemia, and hypomagnesaemia can cause life-threatening cardiac arrhythmias. ECG may show bradycardia, prolonged QTc, or ST changes. Refeeding syndrome risk must be assessed before nutritional rehabilitation.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Eating Disorders