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#day4_pediatrics > NUTRITION > Flashcards

NUTRITION Flashcards

1
Q

The most practical and pertinent guide in evaluating nutritional status in children is:

A

Regular or periodic follow up of weight and height

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2
Q

Colostrum is produced over the first 2 days of lactation. The secretion has higher protein and lower fat and lactose than mature human milk. Likewise, it is especially rich in:

A

IgA

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3
Q

The whey-to-casein ratio in mature human milk is about

A

3:2

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4
Q

Foremilk

A

released at the start of feeding; watery; HIGH LACTOSE AND PROTEIN

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5
Q

Hindmilk

A

released as feeding progresses until towards the end of feeding; creamy; HIGH FAT (5X MORE THAN FOREMILK)

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6
Q

FIRST 0-7 DAYS

  • 37-84 mL/day; D1-2 of life
  • Watery (>80% water)
  • protein-rich
  • High in Ig/protective factors: lactoferrin, lysozyme
  • Na, vit A/K & growth factors
  • Low levels: fat & carbohydrates
A

COLOSTRUM

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7
Q
  • Between colostrum & mature milk
  • Rising levels of macronutrients
A

TRANSITIONAL MILK

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8
Q
  • D 10-14 of life
  • Colostrum content + high fat & lactose
A

MATURE MILK

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9
Q

o produced when breastfeeding frequency decreases

o reverts to being more like colostrum

A

INVOLUTIONARY MILK

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10
Q

BREAST MILK COMPOSITION

A
  • casein to whey ratio - low
    • 10:90 in early milk
    • 40:60 in mature milk
    • 50:50 in late lactation
  • fat globules bound by membranes rich in:
    • phospholipids – cell growth & brain development
    • cholesterol – facilitates myelination of the CNS
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11
Q

Breast milk has MORE compared to Formula milk except

A

§ Iron

§ Vit D

§ Vit K

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12
Q

Definitive test for GERD

A

esophageal pH probe

•

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13
Q

management for intractable GERD, refractory esophagitis & strictures, with morbidities from chronic pulmonary disease (recurrence rate of 14%)

A

Fundoplication

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14
Q

Which of the following is an absolute contraindication to breastfeeding?

A

nfant with galactosemia

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15
Q

CONTRAINDICATIONS TO BREASTFEEDING

A
  • Galactosemia
  • Septicemia
  • Active TB
  • Breast Cancer
  • Malaria
  • Substance Abuse
  • Severe neurosis or Psychosis
  • HIV
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16
Q

Micronutrient deficiency that presents with Vesiculobullous, eczematous, dry scaly or psoriasiform lesions symmetric perioral, sacral, and perianal areas; Chronic diarrhea, Stomatitis, Glossitis, Irritability, superinfection

A

Zinc

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17
Q

Generalized scaly dermatitis; Alopecia, Thrombocytopenia, Failure to thrive

A

Essential Fatty Acids deficiency

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18
Q

Edema, erythema and burning of sun exposed skin on the face neck hands on butterfly distribution dermatitis around the neck; Diarrhea, dementia

A

Niacin (Pellagra) / Vit B3

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19
Q

Alopecia with neurological symptoms

A

Biotin / Vit B7

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20
Q

This is seen in what condition?

A

Vitamin A deficiency

“BItot SPot”

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21
Q

Disease of growing bone which occurs in children only before fusion of the epiphyses

A

Rickets

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22
Q

“rachitic rosary” and “Harrison groove” are seen in what disorder?

A

Rickets

* Widening of the costochondral junctions leads to “rachitic rosary”

* “Harrison groove” is a horizontal depression along the lower anterior chest due to pulling of the softened ribs by the diaphragm during inspiration

23
Q

This is seen in what disease?

A

Rickets

* Windswept deformity (valgus deformity of 1 leg with varus deformity of the other leg)

24
Q

Treatment of Rickets

A

Vitamin D 300,000-600,000 IU orally or IM as 2-4 doses over 1 day (Stoss therapy)

  • Either strategy should be followed by daily Vit D intake of 400 IU/day as a multivitamin
  • Adequate dietary calcium & phosphorus
25
Q
A
26
Q

Angular cheilosis (perleche) and Glossitis (magenta tongue) are associated with?

A

Vit B2, Scurvy and Zinc deficiency

27
Q

This is seen in what deficiency state?

A

Vit B3 deficiency

” Casal Necklace “

28
Q

Mothers who have been long term users of high estrogencontaining contraceptives may have lower levels of _____ and need supplements of 20mg/day

A

Vit B6

29
Q

Microcytic anemia, cheilosis, glossitis, dermatitis

A

Vit B6 deficiency

30
Q

This is seen in what deficiency state?

A

Vitamin C deficiency (Scurvy)

  • “scorbutic rosary” at the costochondral junction & depression of the sternum
  • Angulation of the scorbutic beads is sharper than the rachitic rosary
31
Q
  • Bluish, purple spongy swellings of the mucous membranes esp. over the upper incisors
  • Other symptoms: swollen joints, purpura and ecchymoses, poor wound & fracture healing
  • perifollicular hemorrhages, hyperkeratosis of hair follicles, “corkscrew hair”
  • X ray changes: distal ends of long bones with a ground-glass appearance
A

Scurvy

32
Q

Most micronutrients in breastmilk are not affected by maternal diet/status. _____ and _____ are affected by maternal status.

A

Vitamin D and Iodine

33
Q

full-term neonates are born with sufficient stores of ____ and ____ that are enough for the first 6 months of life.

A

Iron and Zinc

34
Q

Bowlegs or knock knees Caput quadratum, Periosteal osteoid Craniotabes Ping pong ball sensation Rachitic rosary, Pigeon chest Harrison groove

A

Vit D Deficiency

35
Q

“White line” on end of shafts, Scorbutic rosary/beads

A

Vit C deficiency

36
Q

Pellagra, Casal necklace, Pellagrous glove and boots, Glove and boots lesion

A

Niacin (Vit B3) deficiency

37
Q

Perleche

A

Vir B2 deficiency

38
Q

Bitot spots, Xerosis conjunctivae, Xerosis cornea

A

Vit A Deficiency

39
Q

Hyperostosis, Absence of metaphyseal changes

A

Vit A Intoxication

40
Q

A deficiency of this trace element is associated with skin ulcers, reduced immune response and hypogonadal dwarfism:

A

Zinc

41
Q

Irritability, pruritus, painful extremities, with brawny swelling, coarse hair, dry skin, seborrhea and increased intracranial pressure is seen in

A

Hypervitaminosis A

42
Q

In a Southwestern town in Mindanao, children are fed mostly with corn as staple. The most common vitamin deficiency encountered in these children is:

A

Niacin

43
Q

In children with malnutrition, the most seriously compromised immunologic function is:

A

Antibody production

* One of the macronutrients severely affected in malnutrition are proteins (think Kwashiorkor). Therefore, problem in proteins → problem in antibodies.

44
Q

anthropometrics useful to assess Wasting and Acute malnutrition

A

Weight for height

45
Q

§ Measures linear growth

§ Represents cumulative impact of adverse events

A

Height for age (length for age if <2)

46
Q

For malnutrition, the term we are looking for is WASTING. Only three parameters can be used depending on age of patient:

A

Weight for length/height, MUAC, BMI

47
Q

Differentiate kwashiorkor and marasmus

A
48
Q

Severe wasting is extreme thinness diagnosed by

A

weight-forlength (or height) below −3 SD of the WHO Child Growth Standards

49
Q

children ages 6-59 mos, a mid-upper arm circumference ____ also denotes extreme thinness

A

<115mm

50
Q

Hallmark of REFEEDING SYNDROME

A

severe hypophosphatemia

51
Q

BMI PERCENTILE FOR AGE

A
52
Q
  • Rare complication of extreme exogenous obesity in which patients have severe cardiorespiratory distress with alveolar hypoventilation & a decrease in pulmonary, tidal & expiratory reserve volumes
  • Polycythemia, hypoxemia, cyanosis, cardiac enlargement, CHF, somnolence
  • Weight reduction as rapidly as possible
A

PICKWICKIAN SYNDROME

53
Q

Treatment goal for obesity

A

Weight maintenance

#day4_pediatrics (15 decks)

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