Which is associated with bulimia nervosa?
A.
Very low BMI
B.
Decreased size of parotid glands
C.
Calluses on the hands and fingers (Russell’s sign)
D.
Fluid and electrolyte overload
The correct answer and explanation is:
The correct answer is C. Calluses on the hands and fingers (Russell’s sign).
Explanation:
Bulimia nervosa is an eating disorder characterized by episodes of binge eating followed by compensatory behaviors such as purging, fasting, or excessive exercise to prevent weight gain. Several physical signs and symptoms can be associated with bulimia nervosa, and one notable sign is Russell’s sign, which refers to calluses or abrasions on the knuckles or the back of the hands and fingers.
Russell’s sign occurs as a result of repeated self-induced vomiting. Individuals with bulimia nervosa may use their fingers to induce vomiting, causing friction between their fingers and teeth. This repeated trauma leads to callus formation on the hands and fingers. The presence of Russell’s sign is indicative of frequent vomiting and is often a key physical examination finding in patients with bulimia nervosa.
Let’s briefly review why the other options are less associated with bulimia nervosa:
- A. Very low BMI: Bulimia nervosa does not always correlate with a very low BMI. While some individuals with bulimia may have a low BMI due to frequent purging and restricted eating, others may have a normal or even slightly above-normal weight. The disorder is more about the pattern of disordered eating and compensatory behaviors rather than a specific weight category.
- B. Decreased size of parotid glands: Bulimia nervosa often leads to an increase in the size of the parotid glands, not a decrease. Frequent vomiting can cause parotitis, or inflammation of the parotid glands, leading to their enlargement. This enlargement is a common finding in individuals with bulimia and is a result of the body’s response to frequent vomiting.
- D. Fluid and electrolyte overload: This is not a common feature of bulimia nervosa. Instead, individuals with bulimia nervosa may experience fluid and electrolyte imbalances due to frequent purging. Vomiting can lead to dehydration and electrolyte imbalances, but fluid overload is not typically associated with the disorder.
In summary, Russell’s sign (C) is the most characteristic physical finding associated with bulimia nervosa, highlighting the physical consequences of repeated self-induced vomiting.