Refeeding syndrome is a potentially fatal electrolyte disorder occurring when nutrition is reintroduced to severely malnourished patients. The pathophysiology centers on a rapid fall in which electrolyte after refeeding begins?

• A Serum potassium
• B Serum phosphate ✓
• C Serum magnesium
• D Serum sodium

Explanation

Refeeding syndrome is primarily characterized by severe hypophosphatemia occurring when carbohydrate reintroduction stimulates insulin release, driving phosphate intracellularly (into cells for ATP and 2,3-DPG synthesis), precipitously dropping serum phosphate. Phosphate depletion impairs ATP synthesis, causes myocardial dysfunction, respiratory failure, hemolytic anemia, and neuromuscular complications. Prevention involves gradual reintroduction of nutrition, phosphate supplementation, and monitoring of electrolytes (also K+, Mg2+, thiamine) before and during refeeding.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.