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Q1) Which among the following abnormality require treatment in refeeding syndrome 1.Hyponatremia 2. Hypoglycemia 3. Hypocalcemia 4. Hypophosphatemia
Ans 1 d
It occur with either enteral or parenteral nutrition, but is more common with the latter. It 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 required for hypokalemia and hypophosphatemia
Q2) A 50 year old male undergoes pancreatectomy for Carcinoma head of pancreas. Intra Op he received 5 units of PRBC. In the post op period on the 2nd day he develops ECG changes. Work up is done for Myocardial Ischemia which is negative. What is the most common cause of ECG changes here
a) Hyponatremia
b) Hyperkalemia c) Hypokalemia d) Hypercalcemia
Ans b
Transfusion of high volume of PRBC especially stored blood leads to hyperkalemia. In the setting of pancreatectomy in an already anemic patient, if massive blood transfusion is given, chances of hyperkalemia are there.
The ECG changes of Hyperkalemia are tall T waves, shortened QT interval and ST segment depression
Q3 ) Classical triad of adrenal insufficiency includes... A. Hyponatremia, hypokalemia, azotemia B. Hypernatremia, hypokalemia, hypotension C. Hypernatremia, hyperkalemia, hypotension D. Hyponatremia, hyperkalemia, azotemia
Ans d
general malaise, fatigue, weakness, anorexia, weight loss, nausea, vomiting, abdominal pain or diarrhea, which may alternate with constipation, hypotension,
