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PAEDIATRICS > 1. Nutrition Rehab Unit > Flashcards

1. Nutrition Rehab Unit Flashcards

1
Q

Define severe acute malnutrition in children x3

A

Bilateral pitting edema
MUAC <11.5cm
Weight for height/length z score of <-3 SD for children 6-59M ie 5 years

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2
Q

What is the criteria to return to phase 1 in SAM management x3

A

Development of re-feeding diarrhea with weight loss
Any signs of fluid overload and/or heart failure eg crackles or swelling
Re-appearance of edema

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3
Q

Problems in a child that may result in failure to improve from SAM x5

A

Infections
Serious underlying disease
Malabsorption of nutrients
Vitamin or mineral deficiency
Insuffucient food given

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4
Q

State 10 complications of SAM

A

Hypoglycemia, hypothermia, dehydration, electrolyte imbalance, infections, anemia, malabsorption/diarrhea, retarded wound healing, growth retardation, multiorgan failure

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5
Q

State 3 clinical features of shock

A

Weak pulse
Cold peripheries
Increased capillary refill time

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6
Q

Define severe anemia and its transfusion guidelines

A

Hb<4g/dl or Hct<12%
Give 10ml/kg of whole blood over 4 hours and frusemide(loop diuretic) halfway through the transfusion

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7
Q

State 5 benefits of breastfeeding to children

A

1.Decreased rate of UTI, bacterial sepsis
2.Lower risk of neonatal and infant death
3.Lower risk of chronic illness- Diabetes, leukemia, Crohn’s disease
4. Decreased frequency and severity of diarrheal illness, respiratory infections, otitis media

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8
Q

State 3 benefits of breast feeding to women

A

Reduced risk of cancer- breast and ovarian
Reduced risk of cardiovascular disease
Reduced risk of diabetes type 2

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9
Q

Define nevirapine and how long its used

A

A drug used to treat HIV infection in children with 72 hours of birth to 6 weeks

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10
Q

Factors contributing to trace elements deficiencies in children x2

A

Increased demand of growth
Gastroenteritis and malabsorption

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11
Q

State 5 clinical manifestations of vitamin D deficiency

A

Features of rickets
Hypocalcemia and hypophosphatemia
Laryngospasm
Muscle weakness
Delay in motor development

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12
Q

State 3 characteristic of nephrotic syndrome

A

Proteinuria >3.5g/24hours
Hypoalbuminemia
Oedema

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13
Q

State 6 causes of vitamin K deficiency

A

Baby:
Low intake
Delayed feeding
Breastfed infants

Maternal:
Poor transfer across the placenta
Maternal medications eg warfarin
Use of broad spectrum antibiotics

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14
Q

State 5 effects of iodine deficiency in children

A

Intellectual impairment
Fetal loss
Brain damage
Enlarged goiter
Growth retardation

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15
Q

Define SAM in adolescents x3

A

Bilateral pitting edema, MUAC<18.5cm or BMI<16

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16
Q

Classification of edema x3

A

1+ is located in the feet or lower legs
2+ is extending to the arms or upper body
3+ is extending to the face

17
Q

State 5 consequences of reductive adaptation on the liver

A

1.Reduced gluconeogenesis resulting in hypoglycemia
2.Reduced protein production
3.Decreased ability to excrete toxins
4.Reduced heat production
5.Decreased ability to cope with excess dietary proteins

18
Q

State the consequences of reductive adaption on the kidneys

A

Decreased ability to excrete excess sodium resulting in fluid accumulation increasing risk of fluid overload

19
Q

State the consequences of reductive adaptation on the heart

A

Fluid overload results in death due to cardiac overload

20
Q

State the effects of reductive adaptation on the GIT x4

A
  1. Less gastric acid and enzymes
  2. Impaired digestion and absorption
  3. Reduced motility which may result in bacterial colonizing the stomach and intestines
  4. Reduced cell replication and repair resulting in bacterial translocation through the mucosa
21
Q

Describe the classification for complicated SAM x5

A

MUAC <11.5cm
Edema in both feet/++
Breastfeeding problem
No appetite for RUTF
Medical complications

22
Q

Define three types of SAM

A

Kwashiorkor
Marasmus
Marasmic kwashiorkor

23
Q

State three eye signs of Vit A deficiency

A

Dry conjunctiva or cornea
Corneal ulceration
Keratomalacia - drying and clouding of the cornea

24
Q

Define hypoglycemia in children and its management x4

A

Blood glucose< 3mmol/L OR <54mg/dL
Oral- 50ml of 10% glucose
IV- 5ml/kg of 10% glucose
F75 2-3hourly feeds
Antibiotics - benzylpenicillin 5D then oral amoxicillin for 7D and gentamycin for 7D

25
Q

Guidelines for administering resomal x2

A

5ml/kg every 30 minutes for the first 2 hours
Then 5-10ml every hour for the next 4-10 hours alternating with F75

26
Q

State the refeeding syndrome triad

A

Hypokalemia
Hypomagnesemia
Hypophosphatemia

27
Q

State 5 long term complications of SAM

A

Recurrent illness
Increased risk of mortality
Poor school performance
Impaired cognitive function
Lower adult economic activity

28
Q

State 4 signs of heart failure

A

Neck veins sticking out
Irregular heartbeat or heart sounds
Swelling in feet, ankles and abdomen
Crackles in lungs due to fluid build up

29
Q

Causes of edema x6

A

Liver cirrhosis
Kidney disease
Congestive heart failure
Long term protein deficiency
Inadequate lymphatic drainage
Weak or damaged vein in the legs

30
Q

State characteristics of kwashiokor x5

A

Low protein intake
Enlarged fatty liver
Distended abdomen
Pitting edema
Muscle atrophy

31
Q

State 4 characteristics of marasmus

A

Total calorie deficiency
Diffuse loss of muscle and fat
No abdominal distension
No edema

32
Q

State causes of anemia in SAM x3

A

Reductive adaptation due to decreased BMR hence decreased o2 requirement
Lack of iron, B12 and folate
Parasitic infections - hookworm

33
Q

Effects of zinc deficiency x3

A

Hypogonadism
Dwarfism
Dermatitis

34
Q

Factors that decreased cutaneous production of vitamin d x4

A

Increased skin pigmentation
Covering skin + sunscreens
Spending less time outside
Staying away from the equator

PAEDIATRICS (20 decks)

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