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Bulimia nervosa — MCCQE Part 1 MCQ

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ModerateEating DisorderBulimia nervosaMCCQE Part 1

22-year-old woman presents with binge eating and self-induced vomiting. BMI is normal but potassium is 3.0 mmol/L and dental enamel is eroded. Which of the following is the most appropriate next step?

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Correct answer: E — Assess medical stability, correct electrolytes and arrange eating-disorder treatment

Assess medical stability, correct electrolytes and arrange eating-disorder treatment is best because purging can be medically dangerous even at normal BMI. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Electrolyte disturbance can cause arrhythmia.

Reference: Canadian eating disorder guidance