Nutrition

Question 1

Major protein sources in neonates

Answer 1

Whey and casein

Question 2

Difference between whey and casein

Answer 2

Whey has greater cystein and less methionine than casein

Question 3

Whey to casein ratio in: colostrum

Answer 3

80:20

Question 4

Whey to casein ratio in: mature milk

Answer 4

55:45

Question 5

Protein should provide what percent of total calories

Answer 5

7 to 15% to avoid negative nitrogen balance

Question 6

Which amino acid represents the largest amino acid concentration in human milk, and is thought to be a primary fuel enterocytes in the newborn

Answer 6

Glutamine

Question 7

How are maternal amino acids transferred across the placenta?

Answer 7

Active transport

Question 8

What critical fatty acids are transferred across the placenta to the developing fetus?

Answer 8

Arachidonic acid (AA) and docosahexaenoic acid (DHA), increasing proportion in the third trimester

Question 9

Fetal AA and DHA accretion are critical for what

Answer 9

Brain and eye development

Question 10

Provision of what is important to prevent essential fatty acid deficiency

Answer 10

Linoleic acid (LA) and alpha-linolenic acid (ALS)

Question 11

Nomenclature of linoleic acid

Answer 11

18:2(n-6)

Question 12

Nomenclature of alpha linolenic acid

Answer 12

18:3(n-3)

Question 13

Most prevalent fatty acids in human milk

Answer 13

Oleic acid (18:1(n-9)) and palmitic acid (16:0)

Question 14

How many carbons in long chain fatty acids

Answer 14

12 to 20

Question 15

How many carbons in very long chain fatty acids

Answer 15

Greater than are equal to 22

Question 16

Linoleic acid gives rise to what?

Answer 16

Arachidonic acid in the n-6 pathway

Question 17

Alpha linoleic acid gives rise to what

Answer 17

Eiscosapentaenoic acid and docosahexaenoic acid in the n-3 pathway

Question 18

Scaly dermatitis, alopecia, thrombocytopenia, susceptibility to bacterial infection, and failure to thrive

Answer 18

Essential fatty acid deficiency

Question 19

How is essential fatty acid deficiency diagnosed?

Answer 19

Increased triene to tetraene ratio (>0.2), also referred to as the Holman index

Question 20

Triene to tetraene ratio refers to:

Answer 20

Mead acid : Arachidonic acid ratio

Question 21

What percent of the total daily calorie should fats provide

Answer 21

30-50% (should not exceed 60% of total calories)

Question 22

Omegaven is what type of fat

Answer 22

100% fish oil

Question 23

How much fat do you need if given enterally

Answer 23

4.8-6.6 g/kg/day

Question 24

Preterm carbohydrate requirement

Answer 24

Glucose utilization rate is 5 to 8 mg/kg/min

Question 25

Full-term carbohydrate requirement

Answer 25

Glucose utilization rate is 3-5 mg/kg/min

Question 26

Which type of vitamins have daily intake required to prevent deficiencies

Answer 26

Water soluble, vitamins

Question 27

How do water-soluble vitamins and fat-soluble vitamins cross the placenta

Answer 27

Water-soluble:active transport Fat-soluble: simple or facilitated diffusion

Question 28

Risk of folic acid deficiency in infants who are fed what

Answer 28

Evaporated milk or goat milk

Question 29

Anemia, methylmalonic acidemia and homocystinuria

Answer 29

Vitamin B12 deficiency

Question 30

Poor weight gain, anemia, often co-exists with iron deficiency

Answer 30

Folate deficiency

Question 31

Vitamin B12 name

Answer 31

Cobalamin

Question 32

Vitamin E name

Answer 32

Alpha-tocopherol

Question 33

Symptoms of vitamin E deficiency

Answer 33

Increased sensitivity of red blood cells to H2O2 and hemolysis, anemia and reticulocytosis, thrombocytosis, acanthocytosis, neurological deficits

Question 34

Photophobia, conjunctivitis, abnormal epiphyseal bone formation and tooth enamel, generalized scaling, failure to thrive, deficiency may play a role in the development of chronic lung disease

Answer 34

Vitamin A (retinol)

Question 35

Beriberi (symptoms include fatigue, irritability, constipation, cardiac failure), associated with private dehydrogenase complex deficiency and maple syrup urine disease

Answer 35

Vitamin B1 (thiamine)

Question 36

Other name for vitamin B1

Answer 36

Thiamine

Question 37

Other name for vitamin B2

Answer 37

Riboflavin

Question 38

Failure to thrive, photophobia, blurred vision, dermatitis, mucositis; associated with glutamic aciduria type I

Answer 38

Vitamin B2 deficiency

Question 39

Other name for vitamin B6

Answer 39

Pyridoxine

Question 40

Dermatitis, mucositis, hypochromic anemia, possible seizures, associated with homocystineuria

Answer 40

Vitamin B6 deficiency

Question 41

Alopecia, dermatitis, scaling, seborrhea

Answer 41

Biotin deficiency

Question 42

Poor wound healing and bleeding gums

Answer 42

Vitamin C (ascorbic acid) deficiency

Question 43

Rickets, failure to thrive, possible tetany

Answer 43

Vitamin D deficiency

Question 44

Trace element deficiency that leads to cardiomyopathy

Answer 44

Selenium

Question 45

Failure to thrive, alopecia, diarrhea, dermatitis, ocular changes, rash, nail hypoplasia

Answer 45

Zinc deficiency- acrodermatitis enteropathica

Question 46

As breast milk matures, its protein levels ________

Answer 46

Decrease

Question 47

Predominant carbohydrate in breast milk is

Answer 47

Lactose

Question 48

Lactose concentration is _______ in foremilk vs hind milk

Answer 48

Greater

Question 49

Fata greater in foremilk or hindmilk

Answer 49

Hindmilk

Question 50

Does cholesterol in breast milk depend on a woman’s diet

Answer 50

No

Question 51

Why is cholesterol in breast milk

Answer 51

Necessary for tissue growth and is a precursor of bile salts and steroid hormones

Question 52

Benefits of inositol

Answer 52

Involved in membrane synthesis and activities, reduces retinal injury, may enhance surfactant production

Question 53

Premature milk compared to regular

Answer 53

Increased protein and electrolytes, but still inadequate protein, calcium, phosphorus, and vitamin D

Question 54

What are the casein, extensively hydrolysis formulas?

Answer 54

Alimentum, nutramigen, and pregestimil

Question 55

What are the amino acid based formulas?

Answer 55

Elecare infant and Neocate

Question 56

Preterm formulas have _____ amount of lactose compared to full term formulas

Answer 56

Reduced

Question 57

Preterm formulas have ______ total fat content and ________proportion of medium chain triglycerides

Answer 57

Higher, greater

Question 58

Preterm formulas have _____ total protein content and _______proportion of whey protein

Answer 58

Higher, greater

Question 59

What changes to trace elements need to be made with TPN cholestasis

Answer 59

Decrease manganese and copper and increase zinc

Question 60

What changes to trace elements are made in renal insufficiency

Answer 60

Decrease chromium and selenium

Question 61

Labs in TPN cholestasis

Answer 61

Increased direct bilirubin, increased serum bile acids, increased GGT Increased LFTs (late finding)

Question 62

Kcal per gram of : Carbohydrate Protein Fat

Answer 62

Carbohydrate- 3.4 Protein- 4 Fat- 10

Question 63

Calculation of nitrogen balance

Answer 63

Nitrogen intake- nitrogen lost Nitrogen intake= protein in g/day x 0.16 Nitrogen lost=urine losses as measured by urinary urea concentrations + estimated stool losses (4g)

Question 64

Calculation of GIR

Answer 64

[(%dextrose x mL/kg/day)]/144

Question 65

What are the ketogenic amino acids?

Answer 65

Leucine and lysine

Question 66

Where does fetal energy come from

Answer 66

2/3 from maternal glucose transferred across the placenta by facilitated diffusion; 1/4 from placental lactate; remaining is maternal amino acids

Question 67

Resting energy expenditure of a neonate

Answer 67

50 kcal/kg/day