Nutrition

Question 1

Fetal growth factors

Answer 1

Genetic-
Maternal-
Uterine size/circulation and placental implantation
Nutrition (delayed effects)
Endocrine increased in GH, GH-peptides (placental lactogen)
Placental-

Question 2

What effect does placental lactogen have on fetal growth?

Answer 2

Relative insulin-resistance–>
Increased glucose and lipid concentrations–>
Increased fetal insulin–>
Increased fetal growth, adiposity, decreased protein breakdown

Mediated by IGF

Question 3

What components of fetal composition decrease with gestational age and BW?

Answer 3

Total body water
Extracellular water
Sodium
Chloride

Question 4

What components of fetal composition increase with gestational age and BW?

Answer 4

Intracellular water
Protein
Fat
Calcium
Phosphorus
Magnesium
Iron

Question 5

What is the daily calorie expenditure of a fetus?

Answer 5

35-55kcal/kg/d

Question 6

Where does the fetus get the majority of its energy source?

Answer 6

Maternal glucose 
    2/3 of fetal energy
    Transferred by facilitated diffusion
    ---> Glycolysis
    ---> Carbon source
    ---> Glycogen storage

Question 7

What are the sources of caloric energy for the fetus?

Answer 7

Maternal glucose (2/3)
Placental lactate (1/4)
Maternal amino acids (remaining- transferred by active transport)

Question 8

Essential amino acids

Answer 8

Lysine
Phenylalanine
Threonine
Tryptophan
Methionine
Histidine
Valine
Leucine
Isoleucine

Question 9

Essential fatty acids are

Answer 9

Linoleic

Linolenic

Question 10

LCPUFA’s are absorbed by

Answer 10

Reesterification
Chylomicron formation
Lymphatic transport by lipoproteins

Question 11

S/MCFA are absorbed by

Answer 11

Hydrolyzed to FFA

Absorption across mucosa

Question 12

A _____:______ ratio of _____ suggests fatty acid deficiency

Answer 12

Triene: tetrene ratio

> 0.4

Question 13

The predominant carbohydrate in breast milk and most formulas is

Answer 13

Lactose

Question 14

Transport of water soluble vitamins across the placenta is by

Answer 14

Active transport

Question 15

Transport the fat soluble vitamins across the placenta is by

Answer 15

Simple or facilitated diffusion

Question 16

Megaloblastic macrocytic anemia with hypersigmented neutrophils is caused by ____ deficiency

Answer 16

Vitamin B12 and folic acid

Question 17

Vitamin B12 deficiency with anemia is associated with

Answer 17

Methylmalonic acidia

Homocystinuria

Question 18

Vitamin E deficiency presents with

Answer 18

Hemolysis
Anemia and reticulocytosis
Thrombocytosis
Acanthocytosis
Neurologic deficits

Question 19

Photophobia, conjunctivitis, abnormal epithelial bone formation, abnormal tooth enamel, scaling, failure to thrive are associated with ______ deficiency

Answer 19

Vitamin A

Question 20

Fatigue irritability constipation cardiac failure (beriberi syndrome) are associated with ______ deficiency

Answer 20

Vitamin B1

Question 21

Food to thrive, photophobia, blurred vision, dermatitis, mucositis are associated with ______ deficiency

Answer 21

Vitamin B2

Question 22

Metabolic disorders associated with vitamin B1 deficiency are

Answer 22

Pyruvate dehydrogenase complex deficiency

Maple syrup urine disease

Question 23

Glutaric aciduria type 1 is associated with ______ deficiency

Answer 23

Vitamin B2

Question 24

Hypochromic anemia, seizures, dermatitis, mucositis are associated with ______ deficiency

Answer 24

Vitamin b6

Question 25

Homocysteinuria is associated with ___ deficiency

Answer 25

Vitamin b6

Question 26

Alopecia, dermatitis, scaling, seborrhea are associated with ______ deficiency

Answer 26

Biotin

Question 27

Biotin deficiency is associated with these four metabolic disorders

Answer 27

Biotinidase deficiency Beta methylcrotonyl glycinuria Propionic academia Pyruvate dehydrogenase complex deficiency

Question 28

Poor wound healing and bleeding gums is associated with ______ deficiency

Answer 28

Vitamin C

Question 29

Transient tyrosinemia can be associated with _____ deficiency

Answer 29

Vitamin C

Question 30

Chromium is related to

Answer 30

Insulin production

Question 31

Copper is related to

Answer 31

RBC production

Question 32

Iron is related to

Answer 32

Hemoglobin and myoglobin Duodenum/jejunum absorption

Question 33

Manganese is related to

Answer 33

Enzyme activation | Bone structure

Question 34

A cofactor for glutamine peroxidase is

Answer 34

Selenium

Question 35

A component of enzymes carbonic anhydrase and carboxypeptidase is

Answer 35

Zinc

Question 36

Zinc deficiency or impaired transport can cause

Answer 36

``` FTT Alopecia Diarrhea Dermatitis Acrodermatitis enteropathica Acquired zinc deficiency ```

Question 37

In pregnancy, milk production is inhibited by

Answer 37

Estrogen | Progesterone

Question 38

Lactose augments GI production is

Answer 38

Lactobacilli

Question 39

Immunoglobulin in breast milk is

Answer 39

IgA

Question 40

The main enzyme in breast milk is

Answer 40

Lipase

Question 41

Primary breast milk components are

Answer 41

Whey (protein) Lactose (CHO) Long chain unsaturated fatty acids

Question 42

Fatty acids increased in breast milk

Answer 42

Palmitic acid Arachnidonic acid DHA Cholesterol

Question 43

Inositol is involved in

Answer 43

Membrane synthesis Retinal injury prevention Surfactant production

Question 44

Choline is a component of _____ and ______, involved in ________

Answer 44

Acetylcholine Phophatidylcholine CNS development

Question 45

Carbohydrate gives ____ kcal/g and should be ___% of total kcal

Answer 45

3.4kcal/g 50%

Question 46

Fats are ____kcal/g and should be ____% of total kcal

Answer 46

9kcal/g 40%

Question 47

Protein is ____ kcal/g and should be ___% of total kcal

Answer 47

4 kcal/g 10%

Question 48

Calcium phosphorus ratio should be

Answer 48

1.3-1.7:1

Question 49

Lipid calories calculation

Answer 49

TF x 2.2kcal/ml

Question 50

Protein calories calculation

Answer 50

Protein g/kg/d x 4 kcal/g

Question 51

Fat calories calculation

Answer 51

Fat g/kcal/d x 9 kcal/g

Question 52

GIR calculation

Answer 52

(% dextrose. X. TF)/ 144