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Neo Board Review MAP > Growth and Nutrition > Flashcards

Growth and Nutrition Flashcards

1
Q

Highest growth velocity in-utero

A

28-32 weeks

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2
Q

Stage 3 intrauterine growth pattern

A

Hypertrophy: 28-40 weeks, cell growth

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3
Q

Ponderal index

A

PI <10% for GA: growth restricted

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4
Q

Symmetric IUGR

A

Growth inhibition during stage one/hyperplasia
Produces undersized fetus with fewer cells that are normal cell size
Normal PI, weight/length/HC all <10%

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5
Q

Asymmetric IUGR

A

Growth inhibition during stage 2/3 (hypertrophy)
Decreased cell size
Normal cell number
Low PI, weight <10%, length/HC preserved

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6
Q

IGF I

A

Occurs late in gestation

Increased expression associated with increased brain growth

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7
Q

IGF II

A

Predominant IGF for majority of gestation

Important for early growth

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8
Q

IGF binding proteins

A

Balance between IGFs and IGF BPs essential for normal growth

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9
Q

Placenta and growth

A

Direct relationship between growth of the placenta and growth of the fetus
After 20 weeks the placenta produces growth factors and growth regulating hormones

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10
Q

Placental growth hormone

A

Produced by syncyciotrophoblasts
Regulator of maternal insulin resistance

May influence fetal growth by modifying substrate availability

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11
Q

Causes of an LGA infant

A

Maternal diabetes
Beckwith Wiedemann (high IGF2)
SGB
Sotos syndrome

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12
Q

What causes IUGR due to wasting?

A

Post dates

Donahue syndrome

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13
Q

Stage one intrauterine growth pattern

A

Hyperplasia: 4-20 weeks GA, cell division

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14
Q

Stage two intrauterine growth pattern

A

Hyperplasia and hypertrophy: 20-28 weeks GA, division and cell growth

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15
Q

Causes of symmetric IUGR

A 
Genetic abnormalities
Early in-utero infections
Substance abuse
Chronic maternal anemia
Cigarettes
Radiation
Maternal lupus
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16
Q

Causes of asymmetric IUGR

A 
Utero placental insufficiency
Chronic HTN/renal disease
Hemoglobinopathies
Placental infarcts/problems
Altitude
Substance abuse
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17
Q

Combined type IUGR

A

Low PI
Skeletal shortening
Decrease in soft tissue mass

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18
Q

Vitamin B1 (Thiamine) deficiency

A 
Beriberi: 
Fatigue
Irritability
Constipation
Cardiac failure
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19
Q

Syndromes associated with thiamine deficiency

A

Pyruvate dehydrogenase complex deficiency

Maple syrup urine disease

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20
Q

Vitamin B2 (riboflavin) deficiency

A

Failure to thrive
Photophobia/blurred vision
Dermatitis
Mucositis

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21
Q

Syndromes associated with vitamin B2 (riboflavin) deficiency

A

Glutaric aciduria type 1

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22
Q

Vitamin B6 (pyridoxine) deficiency

A

Dermatitis
Mucositis
Hypochromic anemia
Possible seizures

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23
Q

Syndromes associated with vitamin B6 deficiency

A

Homocystinuria

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24
Q

Biotin (vitamin B7) deficiency

A

Alopecia
Dermatitis
Scaling
Seborrhea

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25
Q

Syndromes associated with biotin (vitamin B7) deficiency

A

3-methylcrotonyl glycinuria
Propionic acidemia
Biotinidase deficiency
Pyruvate dehydrogenase complex deficiency/pyruvate carboxylase deficiency

“Baby Michelangelo painted bad pantyhose”

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26
Q

Vitamin C deficiency

A

Poor wound healing

Bleeding gums

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27
Q

Syndromes associated with vitamin C deficiency

A

Transient tyrosinemia

28
Q

Function of chromium

A

Regulates insulin levels 2/2 role in insulin metabolism

29
Q

Chromium deficiency

A

Humans -> diabetes

30
Q

Copper

A

Critical for production of RBCs
Absorption of iron
A/w multiple enzyme activities

31
Q

Copper deficiency

A 
Anemia
Osteoporosis
Depigmentation of hair/skin
Neutropenia
Poor weight gain
Hypotonia, ataxia later in life
32
Q

Iron

A

Component of hemoglobin
Absorbed in duodenum and proximal jejunum
Vitamin C enhances absorption

33
Q

Iron deficiency

A

Microcytic, hypochromic anemia

Failure to thrive

34
Q

Manganese

A

Enzyme activation
Important for normal bone structure
Role in carbohydrate metabolism

35
Q

Selenium

A

Cofactor for glutamine peroxidase

36
Q

Selenium deficiency

A

Humans - muscle disease

Animals - cardiomyopathy

37
Q

Zinc

A

Important component of several enzymes (carbonic anhydrase and carboxypeptidase)
Important for growth

38
Q

Acrodermatitis enteropathica

A

Autosomal recessive

Abnormality of zinc absorption or transport

39
Q

Zinc deficiency

A 
Failure to thrive
Alopecia
Diarrhea
Dermatitis
Ocular changes
Rash (crusted, erythematous)
Nail hypoplasia/dysplasia
40
Q

Trace elements and TPN cholestasis

A

Decrease manganese and copper

Increase zinc

41
Q

Trace elements and renal disease

A

Decrease chromium and selenium

42
Q

Essential fatty acids

A

Linoleic acid

Linolenic acid

43
Q

Essential amino acids

A

PVT TIM HaLL

Phenylalanine
Valine 
Threonine 
Tryptophan
Isoleucine 
Methionine 
Histidine
Leucine
Lysine
44
Q

Conditionally essential amino acids

A

GG PATT

Glutamine 
Glycine 
Proline 
Arginine
Taurine
Tyrosine
45
Q

Calcium:phosphorus ratio in TPN

A

1.3:1

46
Q

What is the concern with giving high amounts of calcium and phosphorus in TPN?

A

Precipitation

47
Q

Preterm breastmilk versus term breastmilk

A 
Pretterm breastmilk has more:
Protein
Sodium
Chloride
Long chain polyunsaturated FAs (LC PUFAs)

It has less lactose

48
Q

Hindmilk versus foremilk

A

Foremilk has higher lactose but lower fat

Both have the same amount of protein

49
Q

Symptoms of essential fatty acid deficiency

A 
Hemorrhagic dermatitis
Skin atrophy
Weakness
Impaired vision
Edema
Hypertension
Poor growth
Thrombocytopenia
50
Q

Triene:Tetraene Ratio (Hollman ratio)

A

T:T ratio >0.4 considered essential fatty acid deficiency

Characterized by a decrease of arachidonic acid and increase in mead’s acid (produced in excess during EFAD)

51
Q

Goals for TPN

A

30-50% calories as fat
35-65% calories as carbohydrate
7-15% calories as protein

52
Q

Whey:casein 80:20

A

Colostrum

53
Q

Whey:casein 50:50

A

Mature human milk

54
Q

Whey:casein 60:40

A

Preterm breastmilk, formulas

55
Q

What is the most important amino acid that assists in the metabolism of fat?

A

Carnitine

56
Q

What is the most prevalent fat in human milk?

A

Triglycerides

57
Q

What are some whey proteins?

A

Alpha lactalbumin
Lactoferrin
Secretory IgA

58
Q

Iron absorption

A

Human milk 50%
Preterm infants 33%
Human milk has less iron than formula but more is absorbed

59
Q

Neonatal nitrogen absorption is

A

Normal

60
Q

How does hyponatremia lead to poor growth

A

Inhibition of Na/H antiporter 

61
Q

Human breast milk has more ____ than cows milk formula

A

Long chain polyunsaturated FAs
Carnitine
Cholesterol
DHA

62
Q

Human breast milk has less ____ than cows milk formula

A

Protein

63
Q

In human milk palmitic acid is present in the ___ Position which makes it more easily absorbed

A

Beta

64
Q

Syndromes associated with vitamin B12 (cobalamin) deficiency

A

Methylmalonic acidemia

65
Q

Folate

A

Vitamin B9

66
Q

Effects of pasteurization on breastmilk

A

Fats, fat soluble vitamins, lactose all retained
Lymphocytes, Alk Phos, cytokines, growth factors, lipoprotein, lipases are destroyed
All of IgM is destroyed

67
Q

Cholesterol in breastmilk

A

Doesn’t depend on maternal diet

Neo Board Review MAP (18 decks)

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