Johanna is a 15 year old girl who was referred to North York General Hospital from Southlake Hospital for an eating disorder – anorexia nervosa.HISTORY OF ILLNESS PRESENTED: Johanna has restricted her food intake since November 2013. She says that during the month of November to December, she would chew her food and then spit it out. She said that during this time, she also counted calories and consumed excessive amounts of water and gum to curb her appetite. During the month of December, she continued her attempts to lose weight by fasting. Johanna states that she would go entire days without consuming food and would only consume Diet Pepsi. During this time, she said she would have occasional binges in which she would consume between 2,000 and 6,000 calories. She did not participate in any purging activities, but used an herbal cleansing pill that she said was a laxative after these binges. She did not use any diuretics. She states that she would try to exercise to maintain her weight loss, but could only do so in 5-10 minute intervals due to her fatigue. Johanna visited her family doctor in November and again in December when she was found to have health problems. a weight loss from 159 pounds to 157 pounds. At that time, Johanna's doctor applied to the New Market Eating Disorder Treatment Program, but Johanna's family has yet to receive a response from the clinic and in fact stated that It seemed full until April. Johanna complained of presyncope when moving from a sitting to a standing position. She also had 2 episodes of syncope when getting up from sitting. She complains of intolerance to cold, thinning hair and fatigue. Her parents encouraged her to eat more over the past month, but she had abdominal problems... middle of paper ... with the test showing it was actually the dye that had rubbed off on his clothes. Bowel sounds were normal and no masses were palpated. The remainder of her dermatology exam revealed areas of redness and dry skin on her lower extremities and upper arms. No lanugo was detected.PRINT AND PLAN:Johanna is a 15-year-old girl, previously healthy, who has been suffering for several months from an eating disorder, anorexia nervosa. When she was seen before her arrival at North York General Hospital, she stated that if she went home she would refuse to eat, which was the reason for her admission here. Over the next few days, the day team will develop a plan with the dietitian regarding the nutrition Johanna needs. We will also monitor his electrolytes, weight and urine output. Thank you for including us in this patient’s care...