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Internal Medicine

Answer 1
  1. A 75-year-old woman with dementia and limited oral intake for the last 10 days. RFS is a common clinical syndrome that typically occurs in subnourished patients upon commencement of nutrition by the oral, intravenous, or enteral route. Intravenous saline-dextrose solutions also can precipitate RFS.1 Patients with normal oral intake are not at risk for RFS, but an elderly patient with poor intake for10 days would be at high risk upon reinstituting nutrition. Acute electrolyte and fluid shifts are responsible for the bulk of morbidity and mortality of RFS.

     Marinella MA. Refeeding syndrome. In: Frequently overlooked diagnoses in acute care. Philadelphia: Hanley & Belfus; 2003:79-83.

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