A 28-year-old woman presents to the emergency department after a near-syncope episode. She describes severe dietary restriction, self-induced

Question

A 28-year-old woman presents to the emergency department after a near-syncope episode. She describes severe dietary restriction, self-induced vomiting and an intense fear of weight gain. Her weight has fallen from 89 kg to 70 kg in 10 weeks; at 1.75 m tall, her current BMI is 22.9 kg/m². She has had negligible nutritional intake for 11 days. Her pulse is 46/min, blood pressure is 92/56 mmHg, potassium is 2.6 mmol/L and phosphate is 0.59 mmol/L. An ECG shows sinus bradycardia, U waves and a QTc of 510 ms. She agrees to treatment. The available specialist eating-disorder unit cannot provide continuous cardiac monitoring. Which initial management and disposition plan is most appropriate?

Accepted Answer

Arrange cardiac-monitored medical admission, electrolyte replacement and thiamine-supported supervised refeeding.

Answer

Arrange specialist eating-disorder admission, electrolyte replacement and thiamine-supported supervised refeeding.

Answer

Arrange cardiac-monitored medical admission, electrolyte replacement and refeeding after biochemical normalisation.

Answer

Arrange cardiac-monitored medical admission, electrolyte replacement and unrestricted oral refeeding.

Answer

Arrange medical day-unit care, electrolyte replacement and thiamine-supported supervised refeeding.

Medically unstable restrictive eating disorder with high refeeding risk — MRCEM SBA MCQ