Free demo: Refeeding Syndrome DT/A01/2021/00053

Refeeding Clinical Case Study

Refeeding Syndrome DT/A01/2021/00053 CPD

Refeeding Syndrome DT/A01/2021/00053 CPD

Free demo: Refeeding Syndrome DT/A01/2021/00053 Refeeding Syndrome DT/A01/2021/00053 CPD

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Question 1 of 10

1. Question
1. Refeeding syndrome occurs when
- Previously starved patients develop life-threatening multiple organ failure
- Previously fasted patients develop a cluster of metabolic derangements upon aggressive reintroduction of nutrition
- Overweight or obese patients lose weight due to nutrient deprivation and then regain it
- Patients with an alcohol abuse history receive enteral or parenteral nutrition
Question 2 of 10

2. Question
Key risk groups for refeeding syndrome include
- Patients with low BMI or significant weight loss due to nutrition-impacting disease
- Patients with BMI >18.5kg/m2 with normal levels of serum phosphate, magnesium or potassium
- Frail elderly patients with poor nutritional intake for 5-10 hours or more
- Patients who abuse their prescription medications
Question 3 of 10

3. Question
Under fed/physiological conditions
- Potassium is the key nutrient required for many biological processes
- Phosphate is required to synthesis fats, glucose and amino acids from ATP molecules
- Phosphate, magnesium and potassium are all required for the production and activation of ATP
- Phosphate is required for ATP production, but is not essential for other biological processes
Question 4 of 10

4. Question
When people enter a fasted state
- The shortage of dietary fuels leads enhanced production of adipose known as “fat-adaptation”
- The shortage of dietary fuels leads to enhanced reliance on exogenous nutrient stores for energy
- The shortage of exogenous fuels leads to use of glycogen stores followed by reliance on fat and protein for energy
- The shortage of exogenous fuels leads to increased storage of phosphate, potassium and magnesium since they are not used for energy production
Question 5 of 10

5. Question
In a patient at risk for refeeding
- The full refeeding syndrome is often precipitated by nutrient deprivation
- Rising serum phosphate levels are the cardinal sign of impending refeeding syndrome and require intervention
- Serum electrolyte levels may appear falsely low because of upregulation of dormant enzymes
- Serum electrolyte levels may appear falsely normal due to a proportional reduction in total body water during starvation
Question 6 of 10

6. Question
One of the most important drivers of refeeding syndrome is
- The development of clinical signs and symptoms of organ dysfunction
- The correction of serum phosphate and potassium levels in a fasted patient
- The reintroduction of glucose to a patient who has become adapted to a starvation state
- Reduced glycolysis and movement of electrolytes from the intracellular to the extracellular compartment
Question 7 of 10

7. Question
Refeeding syndrome is diagnosed as being imminent when
- Patients develop signs of organ failure such as respiratory compromise and acute tubular necrosis
- Serum phosphate drops >30% from baseline or any two other electrolytes are low
- Serum phosphate falls below baseline together with signs of fluid overload
- Serum phosphate, potassium and magnesium all fall below 30% of the normal range
Question 8 of 10

8. Question
The mechanism behind the development of acute GIT dysfunction, respiratory failure and congestive heart failure in refeeding syndrome is
- The depletion of thiamine that occurs as a result of carbohydrate delivery
- The effect of anaemia (from poor ATP production in red blood cells) on those organ systems
- The cardiac arrythmias induced by hypokalaemia
- The fluid overload that occurs due to the anti-natriuretic effect of both hyperglycaemia and insulin secretion
Question 9 of 10

9. Question
The reason for respiratory difficulties in refeeding patients is
- A combination of pulmonary oedema, diaphragm weakness from starvation and high carbon dioxide levels
- A combination of pneumonia as a result of poor neutrophil function and delirium
- A combination of ventilatory fatigue and acidosis
- None of the above
Question 10 of 10

10. Question
The basics of monitoring and management of refeeding patients include
- Rapid progress to full feeding together with high dose thiamine to get patients through the risk period quickly
- Avoiding parenteral nutrition and starting enteral nutrition at 50% of the requirements.
- Slow progression of nutrition support together with careful monitoring and replacement of electrolytes and high dose vitamin B complex delivery
- Progressing nutrition at any rate as long as electrolytes are replaced 8-24 hourly

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