Nutrition Flashcards
Trace element deficiency
ANEMIA
Neutropenia
Osteoporosis
Depigmentation of hair, skin
Hypotonia -> later, ataxia
Poor wt gain
Copper deficiency
- Cu role in RBC devp and iron absorption
- Hard to measure Cu levels in serum, uncertain what normal level is
- Cu stores by 28 weeks - so if deficient post-natally, may not have sx until 2 months
Trace element deficiency
Microcytic, hypochromic anemia
Vitamin C enhances absorption
Iron
Trace element deficiency
- produce glutathione peroxidase - antioxidant properties
- Cardiomyopathy in humans
- Muscle disease in animals
Selenium
involved in insulin metabolism (lipid and carb metabolism) - in animals, diabetes. uncertain humans
Chromium
Manganese
Acrodermatitis enteropathica
- FTT, alopecia, diarrhea, dermatitis esp perianal, rash (crusted, erythematous)
Zinc
Acrodermatitis enteropathic -> AR, abnormality of Zn absorption or transport
NOTE: Acquired Zn deficiency - mat Zn defn can lead to FGR, can lead to poor wound healing
water soluble vs fat soluble vitamins
water soluble - need to get from diet; do not linger in system so not get toxic from it
fat soluble - not necessarily diet dependent (?); can take longer to excrete so potential for toxicities
Vitamin deficiency
- FTT
- generalized scaling
- anormal epiphyseal bone formation and tooth enamel
- photophobia / conjunctivities
- pulmonary epithelial devp
Vit A / Retinol
- eyes, enamel
- CLD
Vitamin deficiency
- fatigue, irritable, constipation, cardiac failure
Associated with which metabolic disorder
B1 = thiamine
- Sx of BeriBeri (constipation, myocarditis)
- Ass with pyruvate dehydrogenase complex deficiency and maple syrup urine disease
Vitamin deficiency
- blurry vision
B2 = riboflavin
Vitamin E deficiency
E
- an ANTI-OXIDANT (sometimes given with Fe to prevent from oxidant effects)
- hemolysis, neutropenia, high retic
Vitamin deficiency
- seizures
B6 = pyridoxine
- homo”SIX”tinuria
Vitamin deficiency
- scurvy, bleeding gums
Vit C = abscorbic acid
Transient tyrosinemia “tangerine”
macrocytic anemia
B12 cobalamine
methylmalonic acidemia, homocystinuria
seborrhea, alopecia, scaling dermatitis
Biotin deficiency
Associated with propionic acidemia, biotinidase deficiency, pyruviate dehydrogenase complex deficiency
hemorrhaghic disease of newborn
bleeding umbilical stump, intracranial hemorrhage
NB - less Vit K because produced by gut bacteria (not as much in newborns yet), liver (still a bit immature). LESS Vit K in maternal breast milk so also increased RF.
Other Vit deficiencies - revisited
Vit E, K, B12, A, C deficiencies
Copper deficiency
Anemia - important in RBC production, helps with absorption of iron; also neutropenia, osteoporosis
Depigmented hair
Menkes (cannot absorp Cu - neonatal death - XLR)- brittle hair, Cu deficiency, metabolic disorder
Essential amino acids
Scaly dermatitis, alopecia
Increased risk of infection
May have thrombocytopenia
May present even after 3 to 5 days of NPO
Essential fatty acid deficiency
Holman index
Ration of triene (mead acid) to tetraene (arachidonic acid)
> 0.2 = diagnostic for ESFAD
ECF and ICF compartments by GA born
When various digestive enzymes are at adult levels
Foremilk vs hindmilk
Foremilk - more calories
Hindmilk - more fat
Same protein
Colostrum vs mature milk
Colostrom - more protein, more calories
Mature milk - less of the above
Donor breast milk
Less of everything because of Holder pasteurization – in general, no IgM. less immunoglobulins, less lactoferrin.
Preterm vs term milk
More protein, more Na,Cl
Breast milk vs. formula
- more cholesterol (important for devp, bile acid synthesis)
- more choline
- more carnitine
- more LCFA
- more DHA
- immunoglobulins
- more lipase
- LESS AMINO ACIDS
50% of calories in MBM = fat
Preterm vs term formula
- more of everything EXCEPT lactose (because premature infants have less lactose)
- about the same iron and **
- preterm formula is iso-osmolar unless fortify to higher calories
- More MCT
whey: casein
what is variable in breastmilk - triglycerides and FFA –> depends on maternal ethnicity, diet
B. biotin
A
B
E
Newborn energy expenditure
D
B
Changes in body composition with increasing GA
4 days of NPO - alopecia, scaly dermatitis, thrombocytopenia
Essential fatty acid deficiency
Holman index > 0.2 (triene MEAD / tetraene arachidonic acid)
Fat digestion
- lipases are hydro**
- bile salts are hydro **
- triglycerides are hydro**
TG hydrophobic so need to be emulsified first
BS are ampiphilic
LIpases are water soluble
D
Long term PN cholestasis
metabolic acidosis (because increase non-protein metabolizable acids)
hyperglycemia
metabolic bone disease
cholestasis
decreased growth
