A 17-year-old girl is brought to the physician for the evaluation of fatigue for the past 6 months. During this period, she has had a 5-kg (11-lbs) weight loss. She states that she has no friends. When she is not in school, she spends most of her time in bed. She has no history of serious illness. Her mother has major depressive disorder. She appears pale. Her BMI is 19 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 65/min, and blood pressure is 110/70 mm Hg. Examination shows dry skin, brittle nails, and calluses on the knuckles. The remainder of the examination shows no abnormalities. Laboratory studies show: Which of the following is the most likely cause of this patient's condition?

Question

A 17-year-old girl is brought to the physician for the evaluation of fatigue for the past 6 months. During this period, she has had a 5-kg (11-lbs) weight loss. She states that she has no friends. When she is not in school, she spends most of her time in bed. She has no history of serious illness. Her mother has major depressive disorder. She appears pale. Her BMI is 19 kg/m2. Her temperature is 37.0°C (98.6°F), pulse is 65/min, and blood pressure is 110/70 mm Hg. Examination shows dry skin, brittle nails, and calluses on the knuckles. The remainder of the examination shows no abnormalities. Laboratory studies show:  Which of the following is the most likely cause of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Bulimia nervosa is characterized by episodes of binge eating and compensatory weight-reduction behaviors.  Signs of self-induced vomiting include hypokalemia, metabolic alkalosis, parotid gland enlargement, dorsal hand calluses, and dental erosion.

A 17-Year-Old Girl Is Brought to the Physician for the Evaluation