Gastroenterology · UKMLA & AKT
Bulimia nervosa
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise bulimia nervosa — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Normal or fluctuating body weight - key distinguishing feature from anorexia nervosa
- Russell's sign - calluses/scarring on dorsal knuckles from teeth scraping during self-induced vomiting; pathognomonic
- Parotid/submandibular gland enlargement - bilateral, painless; 'chipmunk' jaw appearance
- Dental enamel erosion - palatal surfaces of upper incisors; dentist may be first to raise concern
- GORD, bloating, mouth ulcers, sore throat - from repeated acid exposure
- Psychological features - over-evaluation of self-worth based on weight/shape; guilt and shame; comorbid depression, anxiety, self-harm
Classic vignette: young woman of normal weight with acid reflux/dental erosion, bilateral jaw swelling, and knuckle calluses. Venous blood gas shows metabolic alkalosis with hypokalaemia - this is bulimia nervosa until proven otherwise.
Unlock the full Bulimia nervosa revision
Get the complete high-yield notes (6 more sections covering investigations, management and complications), 10 practice questions, mock exams and AI tutoring. Start free.