module 8

Question 1

Refeeding syndrome (RFS) occurs when

Answer 1

nutrition is reintroduced (whether orally, enterally or parenterally) after a period of starvation or poor intake, especially in the already malnourished patient.

Question 2

Pathophysiology of RFS

Answer 2

The body changes back to carbohydrate metabolism (anabolism) from protein and fat metabolism (catabolic state) and glucose becomes the primary source of energy once again. The increased glucose load, with a corresponding increase in the release of insulin, leads to cellular uptake of glucose, potassium, magnesium, and phosphate. This shift of electrolytes back into the cell causes hypokalaemia, hypomagnesaemia, and hypophosphataemia. Insulin also exhibits a natriuretic effect on the kidneys with the retention of sodium, causing fluid retention and expansion of the extracellular fluid volume

Question 3

Necrotising Enterocolitis (NEC)

Answer 3

is an inflammatory bowel condition.

Question 4

Signs of abdominal bleeding

Answer 4

 tachycardia
 abdominal distension / pain
 hypotension
 change in level of consciousness
 poor perfusion
 fall in serum Hb.

Question 5

*Type 1 Diabetes Mellitus is an

Answer 5

autoimmune disorder where antibodies destroy the insulin producing cells in the pancreas (islet cells).

Question 6

Type 2 Diabetes Mellitus is where

Answer 6

the body develops resistance to insulin. With increasing childhood obesity many children now present with type 2 diabetes.