What clinical manifestation is Joan most likely to exhibit? (patient with eating disorder)

Reasoning: Choice A reason: Patients with anorexia nervosa often exhibit xerosis, or dry, flaky skin, due to severe dehydration and malnutrition. The lack of essential fatty acids and overall caloric restriction impairs the skin's ability to maintain a moisture barrier. Additionally, the body may develop lanugo, a fine, downy hair, as a compensatory thermoregulatory mechanism. Choice B reason: Fever is not typical in anorexia nervosa; rather, patients usually present with hypothermia. Because of the loss of subcutaneous fat and a lowered metabolic rate meant to conserve energy, these patients often have a core body temperature significantly lower than 37°C and frequently complain of feeling cold. Choice C reason: Instead of coarse hair, patients with severe eating disorders typically experience thinning of the scalp hair (alopecia) and the growth of lanugo. The hair that remains often becomes brittle and dull rather than coarse, reflecting a systemic deficiency in proteins and minerals necessary for healthy hair shaft development. Choice D reason: Hypotension, not hypertension, is the classic cardiovascular finding in restrictive eating disorders. Malnutrition leads to a weakened heart muscle (myocardial atrophy), resulting in bradycardia and low blood pressure. A blood pressure reading as low as 70/40 mmHg is not uncommon in severely emaciated patients requiring acute hospitalization.