Refeeding Syndrome⚡Mnemonic⚡ : 100% Chance You Won’t Forget !

Causes of Refeeding Syndrome

• Mnemonic: “PENGUIN”
  • P – Prolonged fasting
  • E – Eating disorders
  • N – Nutritional recovery
  • G – Gastric bypass surgery recovery
  • U – Undernutrition
  • I – Intensive care unit recovery
  • N – No previous adequate nutrition

Triggers for Refeeding Syndrome

• Mnemonic: “SHARK”
  • S – Sudden calorie intake
  • H – Hyperglycemia
  • A – Alcoholic recovery
  • R – Rapid electrolyte shifts
  • K – Ketosis cessation

Risk Factors for Refeeding Syndrome

• Mnemonic: “RACCOON”
  • R – Recent weight loss
  • A – Anorexia nervosa
  • C – Chronic alcoholism
  • C – Chronic malnutrition
  • O – Oncology patients
  • O – Older adults with poor intake
  • N – No intake for more than 10 days

Warning Signs of Refeeding Syndrome

• Mnemonic: “WHALE”
  • W – Weakness
  • H – Hypophosphatemia
  • A – Arrhythmias
  • L – Low potassium
  • E – Edema

Predisposing Factors of Refeeding Syndrome

• Mnemonic: “DOLPHIN”
  • D – Dieting, extreme
  • O – Organ failure
  • L – Low BMI
  • P – Poor dietary history
  • H – Hypokalemia
  • I – Inadequate B-vitamin intake
  • N – Nutrient depletion

Signs & Symptoms of Refeeding Syndrome

• Mnemonic: “SEAL”
  • S – Seizures
  • E – Electrolyte imbalances
  • A – Anemia
  • L – Low magnesium

Characteristic Findings In Refeeding Syndrome

• Mnemonic: “OTTER”
  • O – Osmotic diuresis
  • T – Thiamine deficiency
  • T – Tachycardia
  • E – Electrolyte depletion
  • R – Respiratory distress

Clinical Features of Refeeding Syndrome

• Mnemonic: “PARAKEET”
  • P – Psychiatric comorbidities (in anorexia nervosa)
  • A – Arrhythmia risk
  • R – Reduced blood phosphorus
  • A – Anorexia
  • K – K+ (potassium) depletion
  • E – Elevated insulin release
  • E – Edema formation
  • T – Tachypnea

What Should Be Avoided In Refeeding Syndrome

• Mnemonic: “CROW”
  • C – Carbohydrate overload
  • R – Rapid electrolyte replacement
  • O – Overhydration
  • W – Wrong dietary composition

Drugs Used To Treat Refeeding Syndrome

• Mnemonic: “SWAN”
  • S – Supplements (vitamins and minerals)
  • W – Water-soluble vitamin supplementation
  • A – Antioxidants (if indicated)
  • N – Nutritional support (carefully managed)

Drugs To Avoid In Refeeding Syndrome

• Mnemonic: “FALCON”
  • F – Fast-acting insulin (high doses)
  • A – Alcohol (may worsen thiamine deficiency)
  • L – Laxatives (may exacerbate electrolyte imbalance)
  • C – Corticosteroids (can worsen glucose control)
  • O – Opiates (if avoidable)
  • N – NSAIDs (potential kidney stress)

Radiological Features of Refeeding Syndrome

• Mnemonic: “BAT”
  • B – Biventricular heart enlargement (from fluid overload)
  • A – Ascites (in severe cases)
  • T – Transient osteopenia

Diagnostic Tests for Refeeding Syndrome

• Mnemonic: “EAGLE”
  • E – Electrolyte panels
  • A – Arterial blood gases
  • G – Glucose monitoring
  • L – Liver function tests
  • E – ECG for heart monitoring

Laboratory Findings In Refeeding Syndrome

• Mnemonic: “MOUSE”
  • M – Magnesium levels, low
  • O – Osmolality alterations
  • U – Urea reduction
  • S – Serum phosphate drop
  • E – Elevated liver enzymes (in some cases)

Complications of Refeeding Syndrome

• Mnemonic: “BEAR”
  • B – Bradycardia
  • E – Edema, pulmonary
  • A – Arrhythmias
  • R – Respiratory failure

Differential Diagnosis of Refeeding Syndrome

• Mnemonic: “JAGUAR”
  • J – Jaundice (other causes)
  • A – Anorexia nervosa (separate management)
  • G – Gastritis, acute
  • U – Ulcerative colitis
  • A – Addison’s disease
  • R – Renal failure