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Eating disorder medical instability — DCH MCQ

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HardGrowth and nutritionEating disorder medical instabilityDCH

A 15-year-old girl has lost 9 kg, exercises secretly and has secondary amenorrhoea. Resting heart rate is 44/min, blood pressure is 86/54 mmHg and potassium is 3.1 mmol/L. What is the most important red flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Bradycardia with electrolyte disturbance

Bradycardia, hypotension and hypokalaemia indicate medical instability in a restrictive eating disorder and require urgent specialist assessment. Food avoidance and exercise are concerning, but the physiological compromise makes this an emergency. The pearl is that normal BMI does not exclude serious eating disorder risk.

Reference: NICE NG69; Junior MARSIPAN/RCPCH