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Refeeding Syndrome Risk — RACP Paediatrics MCQ

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HardAdolescent MedicineRefeeding Syndrome RiskRACP Paediatrics

A 16-year-old girl presents with restricting food intake, intense fear of weight gain, and a BMI of 15 kg/m2. She has bradycardia (HR 45), hypothermia, lanugo hair, and amenorrhoea. What immediate medical complication should be assessed for?

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Correct answer: B — Refeeding syndrome risk on nutritional rehabilitation

Severe anorexia nervosa with BMI <16 and bradycardia requires medical stabilisation. Refeeding syndrome (hypophosphataemia, hypokalaemia, hypomagnesaemia, fluid overload) is a life-threatening complication of nutritional rehabilitation. Feeds should be started slowly (start low, advance slow) with close electrolyte monitoring, particularly phosphate.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Eating Disorders