General Surgery Board Practice Questions - Saudi Board General Surgery Final Written Exam

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A 45-year-old male is initiated on total parenteral nutrition (TPN) after a prolonged period of starvation due to severe small bowel obstruction. On day 3 of TPN, he develops muscle weakness, cardiac arrhythmias, and confusion. Laboratory studies reveal a serum phosphorus of 1.2 mg/dL. Which of the following is the most appropriate next step in management?

Increase the TPN infusion rate to deliver more calories Administer aggressive intravenous phosphate replacement and reduce caloric intake Administer intravenous insulin to correct hyperglycemia Discontinue TPN immediately and start clear liquid diet

Correct Answer:

Administer aggressive intravenous phosphate replacement and reduce caloric intake

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