Question 12

List the major biochemical abnormalities  that are usually associated with the following conditions:

a)   Adrenal insufficiency.

b)   Refeeding syndrome.

c)   Tumour lysis syndrome.

d)   Ethylene glycol toxicity.

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College Answer

Adrenal Insufficiency

Non anion gap acidosis Hypoglycaemia Hypercalcaemia

Refeeding Syndrome

Hypophosphataemia Hypokalaemia Hypomagnesaemia Hyperglycaemia

Tumour Lysis Syndrome

Hyperphosphataemia Hyperkalaemia Hypocalcaemia Hyperuricaemia Metabolic acidosis

Ethylene Glycol Toxicity

High anion gap acidosis High osmolar gap Hypocalcaemia


The tabulated answer from the college is comprehensive, and would be difficult to improve upon.

Instead, I will offer links to detailed discussions of the abovementioned syndromes.


Cooper, Mark Stuart, and Paul Michael Stewart. "Adrenal insufficiency in critical illness." Journal of intensive care medicine 22.6 (2007): 348-362.

Khan, Laeeq UR, et al. "Refeeding syndrome: a literature review."Gastroenterology research and practice 2011 (2010).

Howard, Scott C., Deborah P. Jones, and Ching-Hon Pui. "The tumor lysis syndrome." New England Journal of Medicine 364.19 (2011): 1844-1854.

Parry, Michael F., and Ronald Wallach. "Ethylene glycol poisoning." The American Journal of Medicine 57.1 (1974): 143-150.