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Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 51 Topic 6 Discussion

Medical Council of Canada Qualifying Examination Part 1 Exam MCCQE Question # 51 Topic 6 Discussion

MCCQE Exam Topic 6 Question 51 Discussion:
Question #: 51
Topic #: 6

A 24-year-old woman with chronic anorexia nervosa presents to the Emergency Department with diarrhea, chest pain and palpitations. She is noted to have a BMI of 13, a heart rate of 48/min, significant orthostatic hypotension and a temperature of 35.9 °C. Her electrocardiogram shows frequent premature ventricular contractions. Her blood work indicates elevated liver transaminases and evidence of acute kidney injury from dehydration. She agrees to admission for medical stabilization only if she does not receive fluids either orally or intravenously, as they will cause her to gain weight and to feel bloated. Which one of the following is the best next step?


A.

Refuse to admit her unless she agrees to full treatment


B.

Obtain a psychiatric consultation


C.

Assess her capacity to consent for medical treatment


D.

Start intravenous fluids and physically restrain if necessary


E.

Ask her if she has a substitute decision-maker


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