Growth & Development/Nutrition Flashcards
1
Q
birthweight doubles by
A
4 months
2
Q
birthweight triples by
A
12 months
3
Q
regain birthweight by
A
10 to 14 days
4
Q
height increases 50% by
A
1 year
5
Q
height doubles by
A
4 years
6
Q
height triples by
A
13 years
7
Q
growth rate during first year of life
A
20 cm/yr
8
Q
normal head circumference at birth
A
35 cm
9
Q
head growth in first 6 months
A
1 cm/month
10
Q
head growth from 6 months to 1 year
A
1/2 cm/month
11
Q
cause of weight drop followed by length but normal HC
A
inadequate caloric intake
12
Q
cause of length decrease but normal weight
A
endocrine disorders
13
Q
cause of weight and length dropping together
A
chronic medical conditions
14
Q
conditions with separate growth charts
A
Downs, Turners, Williams
15
Q
track and coo
A
2 months
16
Q
brings toys to their mouth
A
4 months
17
Q
transfer in hands
A
6 month
18
Q
sit up
A
6 months
19
Q
pointing
A
1 year
20
Q
stack 2 to 3 cubes
A
18 months
21
Q
stack 4 to 6 cubes
A
24 month
22
Q
stack 8 cubes
A
36 month
23
Q
walk upstairs alternating feet
A
3 years
24
Q
identify opposites
A
4 years
25
draws a square
5 years
26
walks backwards
5 years
27
draws a circle
3 years
28
draws a cross
4 years
29
draws a triangle
6 years
30
draws a diamond
7 years
31
stuttering is normal up to age
3 or 4 (workup after preK)
32
early intervention for age
<3
33
structured development screening at age
9, 18 and 24 or 30 months
34
autism screening at age
18 and 24 months
35
normal weight gain per year from 2 years to adolescence
5 pounds/year
36
growth rate from 4 yrs to adolescence
2 inches/year
37
most common type of craniosynostosis
scaphocephaly aka dolichocephaly (premature closure of sagittal suture causing long and narrow head)
38
what age do you lose moro reflex
3 to 6 months
39
roll from front to back
4 month
40
roll from back to front
6 months
41
holds head to 90 degrees and lifts chest
4 months
42
sits with support
6 months
43
sits without support
7 months
44
metabolic syndrome and HDL
<40
45
metabolic syndrome and TG's
>110
46
metabolic syndrome and fasting glucose
>110
47
metabolic syndrome and waist circumference
>90th%ile
48
metabolic syndrome criteria
must have at least 3 of 6 (BMI, BP, waist circumference, TG, HDL, glucose)
49
BMI to consider bariatric surgery
>/= 120th%ile
50
can follow a one step command
15 months
51
can scribble
15 to 18 months
52
2 word sentences
18 months to 2 years
53
hops on one foot
4 years
54
follows rules of the game
6 years
55
fat soluble vitamins
ADEK
56
retinol aka
vitamin A
57
tocopherol aka
vitamin E
58
phylloquinone aka
vitamin K
59
thiamine aka
vitamin B1
60
riboflavin aka
vitamin B2
61
niacin aka
vitamin B3
62
pantothenic acid aka
vitamin B5
63
pyridoxine aka
vitamin B6
64
folate aka
vitamin B9
65
cyanocobalamin aka
vitamin B12
66
ascorbic acid aka
vitamin c
67
most common cause of blindness
vitamin A (retinol) deficiency
68
vitamin A toxicity can cause
pseudotumor cerebri
69
xerophthalmia and nyctalopia 2/2 to what deficiency
eye dryness and night blindness 2/2 vitamin A (retinol) deficiency
70
vegetarian with a large tongue and macrocytic anemia 2/2 what deficiency
vitamin B9 (folate)
71
vegetarian w/ macrocytic anemia and pernicious anemia due to decreased intrinsic factor is 2/2 what deficiency
vitamin B12 (cyanocobalamin)
72
leg tenderness, poor wound healing and bleeding gums 2/2 what deficiency
vitamin c (ascorbic acid)
73
vitamin c toxicity can cause
oxalate and cysteine nephrocalcinosis OR hemolytic crisis in G6PD deficiency
74
hemolytic anemia in preemies 2/2 what deficiency
vitamin E (tocopherol)
75
neuropathy, peripheral edema, thrombocytosis and muscle weakness 2/2 what deficiency
```
vitamin E (tocopherol)
triple E - edema, erythrocyte explosion, elevated platelets
```
76
vitamin E toxicity can cause
liver damage
77
hemorrhagic disease of the newborn 2/2
vitamin K deficiency (phylloquinone)
78
vitamin K dependent factors
factors 2, 7, 9 and 10
79
ergocalciferol aka
vitamin D2 (2 c's)
80
cholecalciferol aka
vitamin D3 (3 c's)
81
calcidiol aka
25-hydroxy vitamin D
82
25-hydroxy vitamin D is synthesized where
liver (1 hydroxy)
83
1,25- dihydroxycholecalciferol is synthesized where
kidneys (2 hydroxys)
84
calcitriol aka
1,25-dihydroxycholecalciferol
85
calcitriol MOA
increases calcium absorption in the gut and released it into the blood to form bone (aka 1,25-dihydroxycholecalciferol)
86
primary storage form of vitamin D to measure
25-hydroxy vitamin D
87
vitamin D excess causes
hypercalcemia and hyperphosphatemia resulting in nausea, vomiting, weakness, polyuria, polydipsia, elevated BUN, nephrolithiasis (vitamin D and Diabetes can look similar)
88
calorie requirement calculation
same as fluids - 100kcal/kg first 10 kg, 50 kcal/kg next 10 kg, 20 kcal/kg anymore kgs
(1500 kcal first 20 then 20kcal/kg)
89
catch up growth for preemies should occur by when
2 years
90
premature infant protein requirement
3.5 g/kg/day
91
full term infant protein requirement
2-2.5 g/kg/day for the first 6 months
92
essential fatty acid
linoleic acid
93
recommended iron concentration in iron fortified formula
12 mg/L
94
5 month old on iron fortified formula presents with constipation
add fruit juice to increase the osmotic load
95
milk protein allergy formula
elemental formula (cross reactivity with soy)
96
bloating and diarrhea after viral gastro 2/2
secondary lactase deficiency
97
FPIES
food protein induced enterocolitis syndrome (severe milk protein intolerance, non IgE mediated)
98
FPIES presentation
heme positive stools or hematochezia with a normal abdominal exam
99
scaly dermatitis with alopecia and thrombocytopenia 2/2 what deficiency
essential fatty acid
100
treatment for scaly dermatitis with alopecia and thrombocytopenia
IV lipids (especially linoleum acid)
101
acrodermatitis enteropathica 2/2
zinc deficiency (dermatitis with alopecia)
102
extensive eczematous eruption around mouth and anus and alopecia in baby recently weaned off of breast milk
zinc deficiency (breast milk helps zinc absorption)
103
high tissue copper level with low serum copper and ceruloplasmin
Menke's kinky hair syndrome
104
jaundice and hepatomegaly with acute neurologic deterioration
Wilson's disease 2/2 copper deposition in liver and brain
105
Wilson's disease diagnosis
livery biopsy (ceruloplasmin levels low but not diagnostic)
106
preemies have increased requirement of vitamin
D (also need vitamin E supplementation to avoid hemolysis)
107
preemie vs full term fat digestion
preemies have decreased bile acids so difficult to absorb long chain TGs and fat soluble vitamins sp meed more medium chain TGs in formula
108
colostrum is high in
protein (high levels of immunoglobulins, IgA) low in ergo-cholecalciferol
109
hind milk is high in
fat
110
cow's milk vs human milk if <1
cow's is higher in phosphorus which results in hypocalcemia if given before 1 year
111
contraindications to breast feed
antithyroid meds, HSV, HIV, TB, CMV, radioactive meds, chemo, errors of metabolism (PKU, urea cycle defect), flatly, diazepam, sulfonamides, tetracycline
112
human vs cow's milk whey:casein ratio
human has more whey (whey better)
113
type of whey in human vs cow's milk
```
human = alpha lactalbumin
cow's = beta-lactalbumin
```
114
protein concentration breast vs formula
more in formula
115
minerals in breast vs formula
more in formula
116
iron absorption in breast vs formula
better in breast (breast has less iron ant but better absorption)
117
renal solute load in breast vs formula
higher in formula
118
average weight gain per day in full term
20 to 30 g/day
119
average weight gain per day in preemie
15 to 20 g/day
120
preemie formula
24 kcal/oz, 60/40 whey:casein, MCT's, more calcium and phosphorus
121
overweight BMI
85-95
122
obese BMI
>95
123
risk for what with lots of diet soda
osteopenia 2/2 high phosphorus in it
124
goats milk = risk for
folate and B6 deficiency
125
vegan = risk for
B12 deficiency
126
pot belly, rash, pitting edema. thin hair, pallor
protein deficiency - kwashiorkor
127
muscle wasting without edema and normal hair
marasmus - general nutritional deficiency
128
general nutritional deficiency
marasmus
129
protein malnutrition
kwashiorkor
130
most common complication of NG feeds
diarrhea (2nd most common = reflux)
131
most severe complication of NG feeds
vomiting with aspiration
132
nutrition in renal disease
70% of calories should be carbs, lipids 20% and need low phosphorus
133
vitamins essential to wound healing
C, A and zinc
134
CF patients require
fat soluble vitamin supplements (A, D, E, K) - protein and fat malabsorption 2/2 pancreatic insufficiency
135
burn patient nutrition
high carb diet because cannot use fat and increased amounts of calcium and magnesium
136
vitamin that functions as a membrane bound antioxidant that inhibits free radical catalyzed lipid per oxidation and terminates radical chain reactions
vitamin E
137
paraesthesias, foot and wrist drop, ophthalmoplegia, ataxia and confusion 2/2 what deficiency
vitamin B1 (thiamine) - beriberi
138
wernicke encephalopathy
ophthalmoplegia, ataxia and confusion 2/2 vitamin B1 (thiamine) deficiency
139
cheilosis and sore tongue 2/2 what deficiency
vitamin B2 (riboflavin)
140
dermatitis, diarrhea and dementia 2/2 what deficiency
vitamin B3 (niacin)
141
when to introduce a cup
6 to 9 months
142
when should breastfed preterm infants start iron supplementation
1 month
143
vitamin and mineral deficiency common in strict vegan diet
vitamin B12, iron, calcium and zinc
