CBC Título De Especialista Em Cirurgia Geral Practice Questions - Exame Para Obtenção Do Título De Especialista Em Cirurgia Geral - CBC AMB Exam

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A 62-year-old severely malnourished patient with gastric cancer (BMI 16 kg/m², 20% weight loss over 3 months) is started on aggressive high-calorie total parenteral nutrition. On postoperative day 2, the patient develops severe muscle weakness, confusion, cardiac arrhythmias, and acute respiratory failure. What electrolyte abnormality is the hallmark of this condition (Refeeding Syndrome / Síndrome de Realimentação)?

Severe hypophosphatemia, accompanied by hypokalemia and hypomagnesemia, triggered by insulin-mediated intracellular shift of electrolytes during carbohydrate reintroduction. Severe hyperphosphatemia and hypercalcemia resulting from massive osteoclastic bone resorption. Profound hypernatremia due to acute antidiuretic hormone suppression and renal water loss. Isolated severe hyperkalemia caused by acute tubular necrosis and rhabdomyolysis.

Correct Answer:

Severe hypophosphatemia, accompanied by hypokalemia and hypomagnesemia, triggered by insulin-mediated intracellular shift of electrolytes during carbohydrate reintroduction.

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