ROSH Gastrointestinal Practice Exam

In a 16-year-old girl with weight loss, irregular periods, and concerns about food choices, what constellation of signs should raise concern?

1. Anemia, bradycardia, osteopenia

2. Anemia, easy bruising, multiple fractures

3. Disordered eating, amenorrhea, abnormal body image

4. Disordered eating, amenorrhea, osteopenia

The correct answer is: Disordered eating, amenorrhea, osteopenia

In the context of a 16-year-old girl experiencing weight loss, irregular periods, and issues surrounding food choices, the presence of disordered eating, amenorrhea, and osteopenia is particularly concerning. This combination of signs reflects potential severe consequences of eating disorders, such as anorexia nervosa, which can occur in adolescents. Disordered eating indicates unhealthy eating behaviors or patterns, which may include restricting food intake, binge eating, or purging. This behavior can lead to significant physical and psychological health issues. Amenorrhea, which is the absence of menstruation, signals disturbances in hormonal regulation often associated with low body weight and nutritional deficiencies, commonly seen in individuals with eating disorders. Osteopenia, a condition characterized by lower than normal bone density, can result from prolonged malnutrition and lack of essential nutrients, putting patients at increased risk for osteoporosis and fractures. Together, these signs underscore the potential for a serious underlying condition that requires urgent attention and intervention. Monitoring and addressing these factors become critical in the management of a patient at risk for severe health complications stemming from disordered eating behaviors.