
You are caring for a 41 year old woman with short gut syndrome on home intravenous artificial feeding. After

doing well for the past two years, she rapidly develops nausea, vomiting, bilateral sixth nerve palsies, nystagmus, ataxia, and slow mentation. Your immediate next action is to:
- Eliminate copper from the trace element formulation because of acute copper toxicity causing an iatrogenic Wilson’s disease.
- Query the Home IV company about whether they have been adding vitamins to the solutions. Immediately request high doses of thiamin to correct thiamin deficiency, which has caused multiple neurologic complications.
- Eliminate vitamin A from the solution because this represents acute vitamin A toxicity.
- Query the Home IV company about whether they have been adding vitamins to the solutions. Immediately request high doses of niacin to correct niacin deficiency causing pellagra.
Answer
Category:
Gastroenterology MCQs
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