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Bulimia nervosa — MCCQE Part 1 MCQ

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ModerateEating DisordersBulimia nervosaMCCQE Part 1

A 19-year-old woman has recurrent binge eating then self-induced vomiting 3-4x/week x 2 years. Dental erosion, parotid enlargement, Russell's sign. BMI 22. K 2.8, HCO3 32. Most important initial priority?

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Correct answer: B — Correct hypokalaemia and initiate CBT-E

Bulimia nervosa with dangerous hypokalaemia (arrhythmia risk). Correct K first. CBT-E first-line psychological treatment. Fluoxetine 60 mg effective adjunct but not sole treatment.

Reference: Canadian Eating Disorder Guidelines