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Psychiatry · Eating and sleep disorders: thiamine before refeeding
Sample itemA 24-year-old woman weighing 32 kg after months of near-total food refusal is to start nutritional rehabilitation. Which vitamin should be given before and during carbohydrate refeeding to prevent an acute neurological complication?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Thiamine
Carbohydrate loading raises thiamine demand in a depleted patient and can precipitate Wernicke encephalopathy. Thiamine is therefore given with refeeding, alongside monitoring of phosphate, potassium and magnesium.
Option by option
A. Phytomenadione
Phytomenadione corrects clotting factor deficiency and has no role in preventing this complication.
B. Thiamine (correct)
Correct. Thiamine is a cofactor for carbohydrate metabolism, and deficiency precipitates Wernicke encephalopathy.
C. Ascorbic acid
Ascorbic acid deficiency causes scurvy and does not cause an acute encephalopathy.
D. Pyridoxine
Pyridoxine deficiency causes neuropathy and seizures but is not the refeeding precaution.
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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