Eating and sleep disorders: thiamine before refeeding: practice question

A Psychiatry 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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Psychiatry · Eating and sleep disorders: thiamine before refeeding

Sample item

A 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?

APhytomenadioneBThiamineCAscorbic acidDPyridoxine

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Thiamine. Carbohydrate loading raises thiamine demand in a depleted patient and can precipitate Wernicke encephalopathy.

Why is "Phytomenadione" not the answer?

Phytomenadione corrects clotting factor deficiency and has no role in preventing this complication.

Why is "Ascorbic acid" not the answer?

Ascorbic acid deficiency causes scurvy and does not cause an acute encephalopathy.

Why is "Pyridoxine" not the answer?

Pyridoxine deficiency causes neuropathy and seizures but is not the refeeding precaution.

What concept does this question test?

It tests Eating and sleep disorders: thiamine before refeeding in Psychiatry. Thiamine is therefore given with refeeding, alongside monitoring of phosphate, potassium and magnesium.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Eating and sleep disorders: thiamine before refeeding?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.