Nutrition Flashcards
Vit B1
thiamine
Phylloquinone
Vitamin K
B2
Riboflavin
B3
Niacin
B5
Panto (pento) thenic acid
B9
folate
B12
cyanocobalamin
xerophthalmia (dry eyes)
nyctalopia (night blindness)
Retinol (Vit A) deficiency
Beri beri:
what is it?
what does it cause?
Thiamine B1 deficiency
causes: mental confusion, peripheral paralysis, muscle weakness, tachycardia, cardiomegaly
vit def causing anemia, angular stomatitis, serborrheic dermatitis?
(SAD)
B2: Riboflavin (think of preemies on too much phototherapy w/ B goggles)
Pellagra?
What is it,
what does it cause?
Vitamin B3 Niacin deficiency
3Ds: Dermatitis, Dementia, Diarrhea
(3Ds of B3)
also glossitis.
Sx of pyridoxine deficiency and toxicity?
Def: swelling of tongue, rash, neuropathy w/ INH
Tox: neuropathy
S/e or toxicity of folate (B9)
irritability, can mask B12 deficiency
too much vit C can cause what?
oxalate and cysteine kidney stones
what vit can trigger hemolytic crisis in G6PD def?
Vit C
Vit deficiency causing anemia, neuropathy, loss of DTRs, muscle weakness?
E Tocopherol
Potential Vit E toxicity?
liver
Vitamin D tox?
Sx and Tx
Similar sx to what?
hypercalcemia, hyperphosphatemia (think of these leaving bone), n/v, weakness
Polyuria, polydipsia, elevated BUN, kidney stones, renal failure (think of Vit D, DM)
Tx w/ hydration, Na+K, Lasix.
Vit D2
Ergocalciferol (2cs = Vit D2)
Vit D3
Cholecalciferol (3Cs = Vit D3)
25-hydroxy Vit D
Calcidiol, hydroxylated in liver (1 liver, 1 number)
1, 25 hydroxycalciferol
activated / hydroxylated in kidney. Calcitriol.
Two kidneys
Rickets?
Caused by what
Lab values
Vit D def low 25 OH Vit D High alk phos High PTH nl Ca, phos usually Can occur in setting of liver dz and decr availability of bile salts
what is acrodermatitis enteropathica? What does it cause?
zinc deficiency, autosomal recessive
dermatitis around mouth and in limbs, diarrhea, alopecia
remembering caloric requirements / kg?
1500 for first 20kg, then 29 cal/kg for each additional
How many kcal/kg/day to term and preterm infants require?
100-120 kcal/kg/day
Premature infants require how much protein
Full term infants require how much protein
preterm: 3.5 g/kg/day
term: 2-2.5 g/kg/day x mos
major reason post-op infant isn’t gaining weight?
incr UOP b/c of incr renal solute load
what are the important components of renal solute load?
sodium, potassium, chloride, phosphorus
An essential fatty acid?
lineoleic acid
recommended concentration of iron in iron fortified formula?
12mg/L
which infants require iron supp
preterm, LBW before 6 mos, no matter what
what classifies a low iron formula, and when should it be used?
1.5mg/L, never use it.
infant with scaly dermatitis, alopecia, TCP?
Essential fatty acid (lineoleic acid) deficiency
Edema, Erythrocyte explosion (hemolytic anemia), elevated Plts caused by what deficiency?
Vit E def
Zinc deficiency may be apparent in what time/event period?
when weaning from breast milk b/c it contains protein that facilitates zinc absorption
When to give protein hydrolysate formula?
soy protein allergy or milk protein allergy
What type of fat should preemies get?
medium chain TGs, b/c they have decr bile salts, but these aren’t sufficient for essential FAs.
Preemie formulas have 50% total fat from MC TGs vs 12% in regular breast milk
What acids are decreased in mature breast milk vs colostrum
arachidonic acid (AA) and docosahexaenoic acid (DHA) for neuro development
Colostrum vs mature milk?
which has more protein, fat, lactose, energy?
Colostrum has higher protein.
Mature milk has higher fat, lactose, energy
cow’s milk vs human milk on calcium, phosophorus?
breast milk has less phosphorous. Cow’s milk has a lot, so if its given to kid < 12 mos, they will get too much and develop low Calcium. (hypocowlcemia)
When no breast feeding?
Rx: flagyl (for trichomonas), diazepam, antithyroid meds, tetracycline, sulfonamides
HIV, HSV on breast
CMV / TB
radioactive meds/chemos,
Errors of metab: galactosemia, PKU, Urea cycle defects
How long should breast feeding be stopped for for technetium 99 scan?
1-2 days (contraindication to radioactive rule)
Protein concentration in Human milk, cow milk, modified cow formula.
Human milk has 0.9 g/dL
Cow milk 3.5 g/dL
Formula 1.4 g/dL
whey: casein is highest in what kind of milk?
What type of whey in cow vs human milk?
human milk is 70% whey (alpha lactalbumin), 30% casein VS
Cow milk: 20% whey (beta lactalbumin)
why is alphalactalbumin in human whey milk better?
its got more lactoferrin, lysozyme, IgA for easier digestion
calcium: phosphorous ratio in human milk vs cow formula
human milk: 2:1
cow formula: 1.5:1
(more phosphorous in formula…)
protein requirement for preemies
3-4 g/kg/day vs 2-3 in full term
Big thing to avoid in preemies w/ regard to protein intake
negative nitrogen balance which causes wt loss
role of lactose in milk?
for infants: inhibits bacterial adhesion to mucosal surface, reduces risk of bacterial infx.
typical wt gain for newborn per day and how many cal?
preemies?
20-30 g/day, requires 100 cal/kg/day
Preemies 15-20 g/day on 120cal/kg/day
obesity: distinguishing from overeating vs hormonal/genetic?
overeating: tall, advanced bone age
hormonal / genetic: short, delayed bone age
chance of obesity if present at age 6 vs age 12?
25% –> 75%
head / craniotabes w/ delayed suture and fontanel closure, frontal bossing and bad tooth enamel should lead to consideration of ?
Rickets
marasmus hallmark?
severe nutritional deficiency: muscle wasting w/o edema, normal hair
most common complication of NGT feeding?, 2nd?
most severe?
diarrhea, GERD
most severe: vomiting w/ aspiration
poor feeding, irritability, metaphyseal irregularity, normal vitD,neutropenia?
Who is at risk?
How to supplement?
copper def
preterm babies receiving inappropriate trace element supplementation with their parenteral nutrition
Copper 200mcg / L
si/sx of magnesium def?
hypotonia, apnea
