Refeeding Syndrome Diagnosis — FRCA Final MCQ

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ModerateIntensive Care MedicineRefeeding Syndrome DiagnosisFRCA Final

ICU day 2: severe pancreatitis, starts NG feeding. 48h later: confusion, tachycardia, phosphate 0.3 mmol/L. Diagnosis?

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Correct answer: A — Refeeding syndrome

Refeeding syndrome: malnourished patient begins nutrition → insulin → drives glucose/phosphate/Mg/K intracellularly → extracellular depletion. Hypophosphataemia (<0.5) is hallmark. Prevention: NICE CG32, start ≤10 kcal/kg/day, supplement thiamine/electrolytes BEFORE refeeding.

Reference: NICE – 2023 – CG32 Nutrition support; ESPEN – 2023