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High Yield Boards > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Major protein sources in neonates

A

Whey and casein

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2
Q

Difference between whey and casein

A

Whey has greater cystein and less methionine than casein

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3
Q

Whey to casein ratio in: colostrum

A

80:20

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4
Q

Whey to casein ratio in: mature milk

A

55:45

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5
Q

Protein should provide what percent of total calories

A

7 to 15% to avoid negative nitrogen balance

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6
Q

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

A

Glutamine

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7
Q

How are maternal amino acids transferred across the placenta?

A

Active transport

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8
Q

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

A

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

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9
Q

Fetal AA and DHA accretion are critical for what

A

Brain and eye development

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10
Q

Provision of what is important to prevent essential fatty acid deficiency

A

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

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11
Q

Nomenclature of linoleic acid

A

18:2(n-6)

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12
Q

Nomenclature of alpha linolenic acid

A

18:3(n-3)

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13
Q

Most prevalent fatty acids in human milk

A

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

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14
Q

How many carbons in long chain fatty acids

A

12 to 20

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15
Q

How many carbons in very long chain fatty acids

A

Greater than are equal to 22

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16
Q

Linoleic acid gives rise to what?

A

Arachidonic acid in the n-6 pathway

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17
Q

Alpha linoleic acid gives rise to what

A

Eiscosapentaenoic acid and docosahexaenoic acid in the n-3 pathway

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18
Q

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

A

Essential fatty acid deficiency

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19
Q

How is essential fatty acid deficiency diagnosed?

A

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

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20
Q

Triene to tetraene ratio refers to:

A

Mead acid : Arachidonic acid ratio

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21
Q

What percent of the total daily calorie should fats provide

A

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

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22
Q

Omegaven is what type of fat

A

100% fish oil

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23
Q

How much fat do you need if given enterally

A

4.8-6.6 g/kg/day

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24
Q

Preterm carbohydrate requirement

A

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

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25
Q

Full-term carbohydrate requirement

A

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

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26
Q

Which type of vitamins have daily intake required to prevent deficiencies

A

Water soluble, vitamins

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27
Q

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

A

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

28
Q

Risk of folic acid deficiency in infants who are fed what

A

Evaporated milk or goat milk

29
Q

Anemia, methylmalonic acidemia and homocystinuria

A

Vitamin B12 deficiency

30
Q

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

A

Folate deficiency

31
Q

Vitamin B12 name

A

Cobalamin

32
Q

Vitamin E name

A

Alpha-tocopherol

33
Q

Symptoms of vitamin E deficiency

A

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

34
Q

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

A

Vitamin A (retinol)

35
Q

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

A

Vitamin B1 (thiamine)

36
Q

Other name for vitamin B1

A

Thiamine

37
Q

Other name for vitamin B2

A

Riboflavin

38
Q

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

A

Vitamin B2 deficiency

39
Q

Other name for vitamin B6

A

Pyridoxine

40
Q

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

A

Vitamin B6 deficiency

41
Q

Alopecia, dermatitis, scaling, seborrhea

A

Biotin deficiency

42
Q

Poor wound healing and bleeding gums

A

Vitamin C (ascorbic acid) deficiency

43
Q

Rickets, failure to thrive, possible tetany

A

Vitamin D deficiency

44
Q

Trace element deficiency that leads to cardiomyopathy

A

Selenium

45
Q

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

A

Zinc deficiency- acrodermatitis enteropathica

46
Q

As breast milk matures, its protein levels ________

A

Decrease

47
Q

Predominant carbohydrate in breast milk is

A

Lactose

48
Q

Lactose concentration is _______ in foremilk vs hind milk

A

Greater

49
Q

Fata greater in foremilk or hindmilk

A

Hindmilk

50
Q

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

A

No

51
Q

Why is cholesterol in breast milk

A

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

52
Q

Benefits of inositol

A

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

53
Q

Premature milk compared to regular

A

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

54
Q

What are the casein, extensively hydrolysis formulas?

A

Alimentum, nutramigen, and pregestimil

55
Q

What are the amino acid based formulas?

A

Elecare infant and Neocate

56
Q

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

A

Reduced

57
Q

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

A

Higher, greater

58
Q

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

A

Higher, greater

59
Q

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

A

Decrease manganese and copper and increase zinc

60
Q

What changes to trace elements are made in renal insufficiency

A

Decrease chromium and selenium

61
Q

Labs in TPN cholestasis

A

Increased direct bilirubin, increased serum bile acids, increased GGT

Increased LFTs (late finding)

62
Q

Kcal per gram of :
Carbohydrate
Protein
Fat

A

Carbohydrate- 3.4
Protein- 4
Fat- 10

63
Q

Calculation of nitrogen balance

A

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)

64
Q

Calculation of GIR

A

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

65
Q

What are the ketogenic amino acids?

A

Leucine and lysine

66
Q

Where does fetal energy come from

A

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

67
Q

Resting energy expenditure of a neonate

A

50 kcal/kg/day

High Yield Boards (15 decks)

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