nutrition Flashcards
Vitamin A deficiency
Retinol deficiency. Most common cause of blindness in young children worldwide. xerophtalmia, night blindness (nyctalopia) keratinization and clouding of cornea
Vitamin A toxicity
pseudotumor cerebri, scaly skin and hepatomegaly
Vitamin B1 deficiency
Thiamine deficiency. Beri, beri - confusion, peripheral paralysis, muscle weakness, tachycardia, cardiomegaly. wernicke encephalopathy: confusion, ataxia, opthalmoplegia and Korsakoff: worse forma of wernicke with memoy loss and confabulation
Vitamin B2 deficiency
Riboflavin deficiency. Anemia, cheilosis, stomatitis and seborrheic dermatitis. Premies on prolonged phototherapy are at risk for riboflavin deficiency
Vitamin B3 deficiency
Niacin deficiency. Dermatitis, diarrhea, dementia, glossitis
Vitamin B6 deficiency
Pyridoxine. Swelling of the tongue and rash - neuropathy
Vitamin B6 toxicity
Neuropathy
Vitamin B9 deficiency
Folate deficiency. large tongue and macrocytic anemia
Vitamin C deficiency
initial signs are nondescript - irritability, digestive disturbance, anorexia. Follicular hyperkeratosis, bleeding gums, poor wound healing, corkscrew hairs, normocytic, normochromic anemia. Xray findings = dense bands at metaphyseal end.
Vitamin E deficiency
hemolytic anemia in preemies and neurological effects in older children (neuropathy and muscle weakness), peripheral edema, thrombocytosis
Why do kids turn yellow when they eat too many carrots/sweet potatoes?
Taking in a lot of beta carotene which is converted to vita A. Make sure sclera and oral mucosa are not yellow. No need to get bili if no icterus
Vitamin D excess
causes hypercalcemia and hyperphosphatemia, nausea, vomiting, weakness. Manage with hydration, corerction of electrolyte disturbances and lasix. Can have polyuria, polydipsia and renal failure
Ergocalciferol
Vitamin D2. plant derived, not as potent in raising 25-OH vita d levels as D3
cholecalciferol
Vitamin D3. animal based
calcidiol
25- hydroxy vita D - hydroxylated in the liver
calcitriol
1,25 hydroxycalciferol - activated form, hydroxylated in the kidney
lab abnormalities in rickets
vitamin D low, PTH high, ca and phos may be normal. elevated alk phos
What are the caloric requirements for a child?
first 10kg = 100kcal/kg (early newborn and preemie may be as high as 120-150), second 10kg = 50kcal/kg, next 10kg = 20 kcal/kg
What are the caloric requirements for term and preterm infant?
100-120kcal/kg/d
How much protein per day do premature infants require?
3.5g/kg/d
How much protein do term infants need?
2-2.5g/kg/d for first 6 months
How much iron supplementation should be in iron fortified formula?
12mg/L. * Iron fortified formula doesnt cause constipation
What are the symptoms of milk protein allergy/intolerance?
Vomiting, rash, irritability, may have heme positive stools, or blood in stool
What is treatment of milk protein allergy/severe intolerance?
Change to protein hydrolysate formula or completely eliminate protein (dairy) from mothers diet
What is the frequency of cows milk allergy/intolerance and when does it resolve?
Cow milk–protein intolerance is reported in 2% to 5% of infants within the first 1 to 3 months of life, typically resolves by 1 year of age
Zinc deficiency
dry skin, thin hair, poor wound healing, perioral rashes, hypogeusia (decreased taste) ,*Breast milk has a protein that helps zinc absorption so if a kid recently weaned, probably this, Menkes kinky hair syndrome
Why can’t babies get cows milk until 1 year of age
because has higher phosphorus load which can cause hypocalcemia
Drugs for which breast feeding is contraindicated
metronidazole, diazepam, antithyroid meds, chemotherapy, tetracycline, sulfonamides
Which has more whey, human or cows milk?
human milk (70;30%), cows (20:80%)
How much should a newborn gain per day in first few days of life?
20-30g/d (Needs 100kcal/kg/d)
How much does a preemie gain in first few days?
May only gain 15-20g/d on 120kcal/kg/d
Overweight BMI
85th -95th percentile
Obesity BMI
> 95th percentile
Severe Obesity BMI
> 99th percentile
Kids on goat milk are at risk for…
folate deficiency
Vegan kids are at risk for…
b12 deficiency, iron, Ca, Zn def (Can only get B12 from animal products therefore have to take a supplement)
Excess vitamin C
oxalate and cysteine nephrosclerosis. Can trigger hemolytic crisis is G6PD patients
Treatment of hemorrhagic disease of the newborn
vitamin K (for factor 2,7,9,10), FFP for clotting factors immediately
Kwashiorkor
strictly a protein deficiency. Typically develops in young kids during weaning or post-weaning period. Pitting edema, rash, thin/frail hair, pallor, overall thin appearance, hepatomegaly, increased risk of infection. May have “flag sign” alternating areas of goo and bad hair b/c nutritional intake is seasonal.
If on goats milk, what are kids at risk for?
folate deficiency
Marasmus
general nutritional disorder. Muscle wasting without edema. lose temporal and buccalf at pads at end stage.
Most common complication of NG tube
1 - diarrhea 2 - GE reflux
Most severe complication of NG tube
vomiting with aspiration
Which vitamins are very important for wound healing
Vita A, C, zinc and iron
When should you supplement infants with iron and how much?
Breastfed babies, 4-6 months should get 1mg/kg of iron until iron rich foods are introduced. No supplementation needed if formula fed. All preterm, breastfed infants need 2mg/kg starting at 1 month of age until 12mos. If formula fed and preterm, may still benefit from 1mg/kg
Who needs fluoride supplementation?
If fluoride in the water is negligible (0.6PPM
