Sun28November0333PM 31

A 19-year-old lady is admitted to hospital following collapse. She is also severely dehydrated.

The patient is known to suffer from anorexia and her body mass index is 14 kg/m2 (18-25). She has not been eating solid food for over a month now. She is admitted to hospital for rehydration and feeding.

Which of the following should be very closely monitored during this time?

(Please select 1 option)

Glucose

Calcium Incorrect answer selected

Sodium

Zinc

Phosphate This is the correct answer

Explanation

Refeeding syndrome is well recognised in severely malnourished patients. Cellular uptake of potassium, phosphate and magnesium can result in precipitous drops in these electrolyte levels, resulting in complications including cardiac arrhythmias.

The main electrolytes which ought to be monitored during refeeding syndrome are phosphate, potassium and magnesium. Thiamine supplementation is recommended during the first 10 days of refeeding. The calorific intake is gradually titrated up over time.

Zinc deficiency is recognised in long term total parenteral nutrition, and this may present with an inflammatory rash around the mouth or anus, known as acrodermatitis enterohepathica.

Answer Statistics

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2%

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3%

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4

94%

Times answered: 295