Nutrition and malnutrition: refeeding syndrome: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Nutrition and malnutrition: refeeding syndrome

Sample item

On day 4 of aggressive nutritional rehabilitation, a severely malnourished child develops weakness, respiratory failure and arrhythmia. Which biochemical abnormality is most likely responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Hypophosphataemia

Refeeding syndrome follows an abrupt carbohydrate load that drives insulin release and shifts phosphate, potassium and magnesium into cells. Hypophosphataemia causes muscle weakness, respiratory failure and cardiac dysfunction.

Option by option

  • A. Hyperkalaemia

    Potassium falls rather than rises during refeeding.

  • B. Hypercalcaemia

    Hypercalcaemia is not part of refeeding syndrome.

  • C. Hypernatraemia

    Sodium disturbance is not the principal abnormality.

  • D. Hypophosphataemia (correct)

    Correct. Low phosphate is the hallmark.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Hypophosphataemia. Refeeding syndrome follows an abrupt carbohydrate load that drives insulin release and shifts phosphate, potassium and magnesium into cells.

Why is "Hyperkalaemia" not the answer?

Potassium falls rather than rises during refeeding.

Why is "Hypercalcaemia" not the answer?

Hypercalcaemia is not part of refeeding syndrome.

Why is "Hypernatraemia" not the answer?

Sodium disturbance is not the principal abnormality.

What concept does this question test?

It tests Nutrition and malnutrition: refeeding syndrome in Pediatrics. Hypophosphataemia causes muscle weakness, respiratory failure and cardiac dysfunction.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nutrition and malnutrition: refeeding syndrome?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.