Nutrition – refeeding Syndrome

Q) What should be done to prevent refeeding syndrome in a 70yr old on TPN?

#Aiims 2022, # General Surgery, Nutrition

a) Infuse amino acids  and lipids separately
b) Slowly increase calorie
c) Avoid lipid TPN
d) Slow infusion of TPN

Ans b 

Refeeding syndrome - results  in hypophosphataemia, hypocalcaemia and hypomagnesaemia.

Patients at risk include those with alcohol dependency, those suffering severe malnutrition,
anorexics and those who have undergone prolonged periods of fasting.

Treatment involves matching intakes with requirements and assiduously avoiding overfeeding.

Calorie delivery should be increased slowly and vitamins administered
regularly.

Hypophosphataemia and hypomagnesaemia require treatment.

Ref Bailey page 288

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Claudication pain

Q) 70 year old male has pain in right buttock on standing and gets relieved on sitting. What will be the next relevant  test to be ordered in him?

a) Doppler B/l lower limbs

b) MRI spine

c) Echo cardiography

d) Ankle Brachial Index

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