What is the most likely diagnosis for a woman with a BMI of 20 kg/m2 showing signs of parotid gland enlargement and knuckle abrasions?

What is the most likely diagnosis for a woman with a BMI of 20 kg/m2 showing signs of parotid gland enlargement and knuckle abrasions?

• A. Anorexia nervosa
• B. Bulimia nervosa
• C. Major depressive disorder
• D. Obsessive-compulsive disorder

Answer: (B)

The most likely diagnosis for a woman presenting with a BMI of 20 kg/m², signs of parotid gland enlargement, and knuckle abrasions points to bulimia nervosa. In bulimia nervosa, individuals often engage in recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting, excessive exercise, or the misuse of laxatives. These behaviors can lead to physical signs like parotid gland enlargement due to repeated vomiting, often referred to as "sialadenosis." Additionally, knuckle abrasions may occur as a result of using the fingers to induce vomiting, known as "Russell's sign." While a BMI of 20 kg/m² falls within the range considered normal, it is important to note that bulimia nervosa can exist in individuals at various weights, including those who are of normal weight. The presence of both parotid gland enlargement and knuckle abrasions strongly suggests bulimia rather than anorexia nervosa, which typically presents with significantly lower body weight and different physical findings. Major depressive disorder and obsessive-compulsive disorder do not specifically account for the combination of physical signs and behaviors associated with bulimia nervosa. Thus, the correct diagnosis in this context is bulimia

The most likely diagnosis for a woman presenting with a BMI of 20 kg/m², signs of parotid gland enlargement, and knuckle abrasions points to bulimia nervosa. In bulimia nervosa, individuals often engage in recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting, excessive exercise, or the misuse of laxatives. These behaviors can lead to physical signs like parotid gland enlargement due to repeated vomiting, often referred to as "sialadenosis." Additionally, knuckle abrasions may occur as a result of using the fingers to induce vomiting, known as "Russell's sign."

While a BMI of 20 kg/m² falls within the range considered normal, it is important to note that bulimia nervosa can exist in individuals at various weights, including those who are of normal weight. The presence of both parotid gland enlargement and knuckle abrasions strongly suggests bulimia rather than anorexia nervosa, which typically presents with significantly lower body weight and different physical findings.

Major depressive disorder and obsessive-compulsive disorder do not specifically account for the combination of physical signs and behaviors associated with bulimia nervosa. Thus, the correct diagnosis in this context is bulimia