All of the following conditions w ill have hvpernietabolic state except:

Ans: d (Anorexia nervosa) Ref: Harrison, 16th ed, 412,17th ed, p. 477Anorexia nervosa is a hypometabolic state, not a hyper-metabolic state.Hypemietabolic state is in which the demands of accelerated energy expenditure are met by skeletal and visceral proteolysis to provide amino acid substrates for gluconeogenesis.Eg: of hypemietabolic statesAcute stage of trauma--accidents, bums, major surgeryAcute sepsisAcute or chronic inflammation--pancreatitis, collagen diseaseDiagnostic criteria for anorexia nervosaDSM-IV divides anorexia nervosa into two subtypes:The restricting typeThe binge-eating/purging type.DSM-IV has four criteria for diagnosis of anorexia nervosa1. Refusal to maintain body at/or above a minimally normal weight for age and height.2. Intense fear of gaining weight3. The third criterion has three components.Disturbance in the way in which one's body weight or shape is experiencedUndue influence of body weight or shape on self-evaluationDenial of the seriousness of the current low body weight4. AmenorrheaOther features of anorexia nervosaIt occurs more often in females than in males, common age of onset is adolescence.Significant loss of weight occurs - usually more than 25% of original weight.No known medical illness which can account for weight loss is present.Anorexia is a misnomer as there is never a decrease in appetite initially. Infact many anorexia nervosa patients are preoccupied with food, often collecting recipes and preparing elaborate meals for their families.They drastically reduce their total food intake and disproportionately decrease the intake of high carbohydrate and fatty foods.