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Anorexia nervosa medical instability — RACP Paediatrics MCQ

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HardAdolescent health, Aboriginal and Torres Strait Islander child health, ethicsAnorexia nervosa medical instabilityRACP Paediatrics

A 14-year-old has lost 12 kg in four months through dietary restriction and compulsive exercise. Heart rate is 42/min, temperature 35.5°C and postural systolic drop is 28 mmHg. ECG shows QTc prolongation and phosphate is low-normal. What is the most appropriate management?

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Correct answer: A — Admit for medical stabilisation and supervised nutritional rehabilitation

Bradycardia, hypothermia, orthostatic instability and QTc prolongation indicate medical instability in an eating disorder. Admission allows cardiac monitoring, electrolyte surveillance and cautious refeeding. BMI alone should not determine risk because rapid weight loss and vital-sign abnormalities are highly important.

Reference: RCH Eating disorders guideline; RACP Adolescent Medicine Knowledge Guide