This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Fluid, Electrolyte and Nutrition, Subject name: Surgery
All of the following are true about refeeding syndrome except: 
Select and explain. 
A. Occur with TPN only, not seen in enteral nutrition, B. Associated with increased risk of arrhythmia, C. Occur with rapid & excessive feeding of patients with severe underlying malnutrition, D. Hypophosphatemia & hypomagnesemia requires treatment
A: Occur with TPN only, not seen in enteral nutrition
Answer: A: Occur with TPN only, not seen in enteral nutrition 
Explanation: REFEEDING SYNDROME: - Potentially lethal condition - Occurs with rapid & excessive feeding of patients with severe underlying malnutrition due to starvation, alcoholism, delayed nutritional suppo, anorexia nervosa & massive weight loss in obese patients Pathophysiology - With refeeding, shift in metabolism from fat to carbohydrate substrate - Increased insulin release - Cellular uptake of electrolyte paicularly: - Phosphate - Hypophosphatemia - Magnesium - Hypomagnesemia - Potassium- Hypokalemia - Calcium- Hypocalcemia - Increased risk of arrhythmia, confusion, respiratory failure & death due to dyselectrolytemia.