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Bulimia nervosa with medical risk — CCFP MCQ

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HardMental healthBulimia nervosa with medical riskCCFP

A 17-year-old has binge eating with self-induced vomiting several times weekly. BMI is in the reference range, potassium is 3.2 mmol/L and QTc is 485 ms. What is the most appropriate immediate plan?

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Correct answer: EArrange urgent assessment of electrolyte and cardiac complications

The best answer is “Arrange urgent assessment of electrolyte and cardiac complications”. Hypokalaemia with QTc prolongation after recurrent vomiting can cause life-threatening arrhythmia regardless of BMI and requires urgent medical assessment and monitored correction. Fluoxetine and eating-disorder treatment may be appropriate after acute stability is established, but they do not treat the immediate electrolyte and cardiac risk.

Reference: Canadian Paediatric Society: A guide to the community management of paediatric eating disorders: https://cps.ca/en/documents/position/eating-disorders