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Nutrition Flashcards

1
Q

Only bacteria not killed by Holder pasteurization

A

B. cereus

“you cant be serious!”

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2
Q

Decreases with advancing GA and birthweight

A
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3
Q

Increase with advancing GA and birthweight

A
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4
Q

Fetal growth by GA

A
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5
Q

SGA vs IUGR

A
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6
Q

Estimated fetal energy expenditure

A

35-55 kcal/kg/day

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7
Q

Fetal energy sources

A
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8
Q

multiple gestation and fetal growth

A
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9
Q

neonatal caloric requirement

A

120-150 kcal/kg/day to balance energy expenditure and allow for proper growth

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10
Q

amino acids that are glucose precursors

A

Alanine
Glutamic acid
Aspartic acid

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11
Q

Essential amino acids

A
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12
Q

protein digestion

A
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13
Q
A

essential fatty acid deficiency:
- dermatitis (dry, scaly, snowflake)
- alopecia
- thrombocytopenia
- susceptibility to bacterial infection
- failure to thrive

triene:tetraene ratio of >0.2 is diagnostic
Mead (incr) : arachidonic acid ratio (dec)

can be prevented with as little as 0.5-1.0g/kg/day lipid

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14
Q

water soluble vitamins

A

vitamin B complex, vitamin C

not formed by precursors (except niacin from tryptophan)
dialy intake required to prevent deficiences
does not accumulate in the body (except vitamin B12)
most cross placenta by active transport

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15
Q

fat soluble vitamins

A

ADEK

synthesized from precursors
daily intake not typically required except in specific circumstances (ex. CF)
not easily excreted so can accumulate in the body and has potential for toxicity
placental transfer by simple or facilitated diffusion

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16
Q

Vitamin A
Retinol

A
  • important for pulmonary epithelial growth and cellular differentiation
  • deficiency may play a role in development of CLD

Deficiency:
- photophobia
- conjunctivitis
- abnormal epiphyseal bone formation and tooth enamel
- generalized scaling
- failure to thrive

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17
Q

Vitamin B1
Thiamine

A

Beriberi
- fatigue
- irritability
- constipation
- cardiac failure

Associated with pyruvate dehydrogenase complex deficiency and MSUD

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18
Q

Vitamin B2
Riboflavin

A
  • Failure to thrive
  • photophobia
  • blurred vision
  • dermatitis
  • mucositis

Associated with glutaric aciduria type 1

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19
Q

Vitamin B6
Pyridoxine

A
  • Dermatitis
  • mucositis
  • hypochromic anemia
  • possible seizures

Associated with homocystinuria

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20
Q

Vitamin B12
Cobalamin

A

High risk: breast-fed infants of vegetarian mothers who do not ingest eggs or dairy products

  • megaloblastic MACROCYTIC anemia with hypersegmented neutrophils (same as folic acid deficiency)

Associated with methylmalonic acidemia and homocystinuria

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21
Q

Biotin

A
  • Alopecia
  • dermatitis
  • scaling
  • seborrhea

Associated with:
- biotinidase deficiency
- beta-methylcrotonyl glycinuria
- propionic acidemia
- pyruvate dehydrogenase complex deficiency

think of why you take biotin as to what happens if you are deficient

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22
Q

Vitamin C
Ascorbic acid

A

Poor wound healing and bleeding gums

Associated with transient tyrosinemia

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23
Q

Vitamin D

A

Rickets
failure to thrive
possible tetany

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24
Q

Folic acid
Folate

A

HIGH risk: infants fed only evaporated milk or goat’s milk

  • poor weight gain
  • anemia- macrocytic with hypersegmented neutrophils

often coexists with iron deficiency

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25
Vitamin E Alpha-Tocopherol
Recommended concurrently with iron administration to protect from iron-induced hemolysis
26
Vitamin K
- coagulation Associated with hemorrhagic disease of newborns
27
Chromium
regulates glucose levels because of role in insulin metabolism Deficiency: unknown in humans
28
Copper
- critical for production of RBCs, hemoglobin formation - important in absorption of iron - associated with multiple enzyme activities Deficiency: - anemia - osteopenia - depigmentation of hair and skin - neutropenia - poor weight gain - hypotonia - ataxia later in life
29
Iron
- Component of hemoglobin and myoglobin required for transport of oxygen and carbon dioxide - absorbed predominantly in duodenum and prox jejunum - Vitamin C enhances absorption Deficiency: - anemia (microcytic, hypochromic) - Failure to thrive
30
Manganese
- role in enzyme activation (ex. superoxide dismutase) - important for normal bone structure - role in CHO metabolism Deficiency: unknown
31
Selenium
- cofactor for glutamine peroxidase Deficiency: cardiomyopathy
32
Zinc
- important component of several enzymes (ex. carbonic anhydrase) - important for growth Deficiency: **Acrodermatitis enteropathica**: - AR - abnormality of zinc absorption or transport - FTT, alopecia, diarrhea, dermatitis (perianal), ocular changes, rash, nail hypoplasia/dysplasia Acquired deficiency: - preterm infants receiving inadequate amounts of zinc - maternal zinc deficiency--> FGR, congential anomalies - infants with malabsorption, poor weight gain, poor wound healing, anemia (iron deficiency)
33
SGLT1
apical surface galactose and glucose active transport less efficient in newborn- especially preterm
34
GLUT5
apical surface fructose facilitated/passive transport
35
GLUT2
basal surface galactose, glucose, fructose
36
TPN cholestasis
reduce copper and manganese
37
Bacteriocidal in breastmilk
secretory IgA lactoferrin
38
colostrum ratio W:C
80:20
39
Mature milk W:C
55:45
40
preterm BM has more ?? than mature milk
PROTEIN!
41
Formula is higher in ??? compared to human milk
Na Ca K Cl Mg Ph amino acids
42
Normal magnesium
1.7-3.6 Symptoms of <1.2
43
components preserved with pasteurization
vit A, D, E lactose LCPUFA epidermal growth factor IgA, IgG
44
which Ig is destroyed with pasteurization?
IgM
45
zinc deficiency acrodermatitis enteropathia
defective zinc uptake in the duodenum and jejunum because of abnormality in zinc transporter protein **ZIP4** FTT, alopecia, diarrhea, perianal dermatitis, rash (crusted, erythematous involving face/extremeties/anogenital areas)
46
at what age does fetal lactase reach adult concentrations?
36 weeks
47
what % of protein should be in the diet to prevent a negative nitrogen balance?
7-15%
48
what requires the greatest amount of energy expenditure in a neonate?
resting metabolic rate 40-60 kcals/kg/day
49
selenium
essential component of glutathione peroxidase, protecting the body from oxidant damage
50
chromium
plays a role in carbohydrate and lipid metabolism clinical deficiency remains to be described
51
copper
red blood cell production hemoglobin formation iron absorption
52
iron
not routinely included in TPN due to : - concerns about iron overload - suppression of immune function - propagation of free oxygen radicals
53
zinc
important for bone formation function of transcriptional factors and steroid receptors
54
cause of renal agenesis
ureteric bud fails to develop
55
hormon that plays the biggest role in placental regulation of fetal nutrient supply
placental lactogen
56
brain and eye development
LCPUFA omega 3 and omega 6
57
decreases with advancing GA/BW
total body water extracellular water sodium content chloride conten
58
increases with advancing GA/BW
intracellular water protein fat calcium, phosphorus, magnesium iron
59
Differences in body composition in SGA vs AGA
SGA infants have: 1. reduced total body mass 2. reduced lean mass 3. reduced bone mineral contant 4. reduced muscle mass --> lower nitrogen content 5. lower fetal plasma glucose/insulin --> lower glycogen contant in liver and muscle
60
glucose and galactose transport
ACTIVE transport across apical surface via SGLT1 (help from N/K pump) less efficient in the newborn, especially preemie crosses into circulation via GLUT2
61
fructose transport
FACILITATED/PASSIVE transport via GLUT 5 crosses into circulation via GLUT2
62
neonate has adequate carb DIGESTION because of?
normal glucoamylase normal glucosidases/disaccharidases *except for lactase*
63
neonate has adequate carb ABSORPTION becaues of?
largely adequate digestion colonic salvage pathway
64
fat malabsorption minimized in preemie due to:
1. lingual lipase, gastric lipase, lipases in BM --> TG breakdown 2. increased amounts of more easily digested MCFA in BM
65
intestinal absorption

Neonatology Boards (19 decks)

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