nutrition

Question 1

Vitamin A deficiency

Answer 1

Retinol deficiency. Most common cause of blindness in young children worldwide. xerophtalmia, night blindness (nyctalopia) keratinization and clouding of cornea

Question 2

Vitamin A toxicity

Answer 2

pseudotumor cerebri, scaly skin and hepatomegaly

Question 3

Vitamin B1 deficiency

Answer 3

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

Question 4

Vitamin B2 deficiency

Answer 4

Riboflavin deficiency. Anemia, cheilosis, stomatitis and seborrheic dermatitis. Premies on prolonged phototherapy are at risk for riboflavin deficiency

Question 5

Vitamin B3 deficiency

Answer 5

Niacin deficiency. Dermatitis, diarrhea, dementia, glossitis

Question 6

Vitamin B6 deficiency

Answer 6

Pyridoxine. Swelling of the tongue and rash - neuropathy

Question 7

Vitamin B6 toxicity

Answer 7

Neuropathy

Question 8

Vitamin B9 deficiency

Answer 8

Folate deficiency. large tongue and macrocytic anemia

Question 9

Vitamin C deficiency

Answer 9

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.

Question 10

Vitamin E deficiency

Answer 10

hemolytic anemia in preemies and neurological effects in older children (neuropathy and muscle weakness), peripheral edema, thrombocytosis

Question 11

Why do kids turn yellow when they eat too many carrots/sweet potatoes?

Answer 11

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

Question 12

Vitamin D excess

Answer 12

causes hypercalcemia and hyperphosphatemia, nausea, vomiting, weakness. Manage with hydration, corerction of electrolyte disturbances and lasix. Can have polyuria, polydipsia and renal failure

Question 13

Ergocalciferol

Answer 13

Vitamin D2. plant derived, not as potent in raising 25-OH vita d levels as D3

Question 14

cholecalciferol

Answer 14

Vitamin D3. animal based

Question 15

calcidiol

Answer 15

25- hydroxy vita D - hydroxylated in the liver

Question 16

calcitriol

Answer 16

1,25 hydroxycalciferol - activated form, hydroxylated in the kidney

Question 17

lab abnormalities in rickets

Answer 17

vitamin D low, PTH high, ca and phos may be normal. elevated alk phos

Question 18

What are the caloric requirements for a child?

Answer 18

first 10kg = 100kcal/kg (early newborn and preemie may be as high as 120-150), second 10kg = 50kcal/kg, next 10kg = 20 kcal/kg

Question 19

What are the caloric requirements for term and preterm infant?

Answer 19

100-120kcal/kg/d

Question 20

How much protein per day do premature infants require?

Answer 20

3.5g/kg/d

Question 21

How much protein do term infants need?

Answer 21

2-2.5g/kg/d for first 6 months

Question 22

How much iron supplementation should be in iron fortified formula?

Answer 22

12mg/L. * Iron fortified formula doesnt cause constipation

Question 23

What are the symptoms of milk protein allergy/intolerance?

Answer 23

Vomiting, rash, irritability, may have heme positive stools, or blood in stool

Question 24

What is treatment of milk protein allergy/severe intolerance?

Answer 24

Change to protein hydrolysate formula or completely eliminate protein (dairy) from mothers diet

Question 25

What is the frequency of cows milk allergy/intolerance and when does it resolve?

Answer 25

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

Question 26

Zinc deficiency

Answer 26

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

Question 27

Why can’t babies get cows milk until 1 year of age

Answer 27

because has higher phosphorus load which can cause hypocalcemia

Question 28

Drugs for which breast feeding is contraindicated

Answer 28

metronidazole, diazepam, antithyroid meds, chemotherapy, tetracycline, sulfonamides

Question 29

Which has more whey, human or cows milk?

Answer 29

human milk (70;30%), cows (20:80%)

Question 30

How much should a newborn gain per day in first few days of life?

Answer 30

20-30g/d (Needs 100kcal/kg/d)

Question 31

How much does a preemie gain in first few days?

Answer 31

May only gain 15-20g/d on 120kcal/kg/d

Question 32

Overweight BMI

Answer 32

85th -95th percentile

Question 33

Obesity BMI

Answer 33

> 95th percentile

Question 34

Severe Obesity BMI

Answer 34

> 99th percentile

Question 35

Kids on goat milk are at risk for…

Answer 35

folate deficiency

Question 36

Vegan kids are at risk for…

Answer 36

b12 deficiency, iron, Ca, Zn def (Can only get B12 from animal products therefore have to take a supplement)

Question 37

Excess vitamin C

Answer 37

oxalate and cysteine nephrosclerosis. Can trigger hemolytic crisis is G6PD patients

Question 38

Treatment of hemorrhagic disease of the newborn

Answer 38

vitamin K (for factor 2,7,9,10), FFP for clotting factors immediately

Question 39

Kwashiorkor

Answer 39

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.

Question 40

If on goats milk, what are kids at risk for?

Answer 40

folate deficiency

Question 41

Marasmus

Answer 41

general nutritional disorder. Muscle wasting without edema. lose temporal and buccalf at pads at end stage.

Question 42

Most common complication of NG tube

Answer 42

1 - diarrhea 2 - GE reflux

Question 43

Most severe complication of NG tube

Answer 43

vomiting with aspiration

Question 44

Which vitamins are very important for wound healing

Answer 44

Vita A, C, zinc and iron

Question 45

When should you supplement infants with iron and how much?

Answer 45

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

Question 46

Who needs fluoride supplementation?

Answer 46

If fluoride in the water is negligible (0.6PPM