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Peds Shelf > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Why do term infants lose 5% of birth weight in the first few days of life?

A

Loss of extracellular water

Suboptimal caloric intake

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2
Q

How much food do newborns require, how often do they feed?

A

110 - 115 kcal/kg/day - gain 30g/day

Start at 6 hours, q 3-4 hours

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3
Q

Colostrum

A

2-4 days after delivery

High: Protein (IgA), minerals, immune factors

Low: Carbs

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4
Q

Benefits of breast feeding

A

Decreases infection, incidence of chronic disease

Decreased PP bleeding, risk of ovarian and breast cancer, delayed ovulation,

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5
Q

Why is whole cow’s milk not recommended until 1 year of age?

A

Infants GI tract not developed enough to digest, predisposing to allergy

*Can lead to GI blood loss and iron deficiency

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6
Q

Contraindications to breastfeeding

A

Breast cancer

Chemotherapy, some drugs, street drugs

Herpetic breast lesions

Active, untreated TB

CMV, HIV

Galactosemia

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7
Q

Signs of insufficient feeding of infant

A

< 6 wet diapers/day after 1 week

< 7 feeds/day

Continual hunger/crying

Continual sleepy

Loss > 10% of weight

Increasing jaundice

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8
Q

When should solid foods be introduced?

A

4-6 months

*Introduce individually, 1 week apart*

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9
Q

Who gets cows milk formula?

A

Premature

Transitional

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10
Q

Who gets soy protein based formula?

A

Galactosemia

Lactose Intolerance

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11
Q

Who gets protein hydroxylate formula?

A

Malabsorption

Food allergies

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12
Q

Who gets amino acid based formula?

A

Food allergies

Short gut

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13
Q

Who gets high medium-chain triglyceride oil?

A

Chylous ascites

Chylothroax

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14
Q

Do not use 2% milk before ________ or skim milk before ________.

A

2 years

5 years

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15
Q

Neonates have a _________ percentage of total body water per weight than adults.

A

larger, 70-75%

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16
Q

What are signs of dehydration in an infant?

A

PARCHED

Pee, pressure

Anterior fontanelle

Refill, capillary

Crying

Heart rate

Elasticity of skin

Dryness of mucous membranes

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17
Q

Diabetes Insipidus

A

No ADH - Low urine specific gravity

*appear euvolemic - loss is from intracellular/interstitial spaces

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18
Q

How do you treat hyper K? (6)

A

Calcium chloride or gluconate 10% solution - stabilize cardiac membrane

Sodium bicarb, albuterol neb, or glucose + insulin

Kayexalate resin (slow)

Furosemide

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19
Q

At what age do you supplement Fluoride?

A

> 6 months if pt. has well water

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20
Q

What infants get vitamin D deficiency?

A

Mom has insufficient intake

Inadequate infant sun exposure

Fed on whole cows milk

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21
Q

What infants get Iron deficient?

A

Breastfed infants @ 4-6 months

*Preterm should start @ 2 months

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22
Q

5-week old infant feeding poorly on standard formula switched to whole cow’s milk has an afebrile grand mal seizure and tremulousness.

A

Hypocalcemia 2/2 Vitamin D deficiency

23
Q

Breast milk has ____ iron than cows milk.

The iron in breast milk is _____ bioavailable than in cows milk.

A

Less

More

24
Q

How does one develop Hypervitaminosis A? What are the symptoms?

A

Congenital absence of enzymes needed to convert provitamin A carotenoids to vitamin A

Inc. ingestions of carotenoid-containing food

Acute: pseudotumor cerebri = bulging fontanelle, drowsy, CN palsies

Chronic: Poor weight gain, irritable, tender swelling of bones, pruritis, fissures, desquamation

25
Q

If mom is a strict vegetarian what should you supplement?

A

Thiamine - beriberi weak/irritable, N/V, pruritus, tremor

B12

26
Q

What complications are seen with childhood obesity?

A

SHADE

SCFE

HTN

Apnea

Diabetes

Embarrassment

27
Q

Any child with a rectal temp > _____ in the first 6 months of life should be seen immediately.

A

> 101.4˚F

28
Q

At what age may kids start using a cup?

A

6-9 months

29
Q

At what age should they begin brushing teeth? First dentist appt?

A

1 year

2 years

30
Q

What are risk factors for anemia? (4)

A

Low SES

BW < 1.5 kg

Whole milk before 6 months

Low iron formula/iron rich foods

31
Q

When is the first hearing screen?

A

Shortly after birth

32
Q

How long does a child need to use a car seat?

A

Until 40 lbs

33
Q

What vaccines do kids get?

A

Hep B

DTaP (kids < 7yo)

H flu B

Poliomyelitis

MMR live (CI w/ allergy to neomycin or gelatin)

Varicella live (CI w/ allergy to neomycin or gelatin)

Influenza CI w/ chicken or egg protein anaphylaxis

Pneumococcus PCV-7 indicated for < 2yo

RSV GA < 32 wk, <2yo + chronic lung disease

34
Q

Belladona, mushrooms, antihistamines, TCAs can show what toxidrome?

A

Anticholinergic

Dry mouth/thirst, urinary retention, flushed, dilated pupils, tachy

35
Q

What toxidrome is caused by organophosphates, mushrooms, black widow spider bites, tobacco?

A

Cholinergic

Hypersecretion, fasciculation, weakness, bronchospasm, arrhythmia, convulsions, coma

36
Q

What toxidrome is caused by Haloperidol and Metoclopramide?

A

Extra-pyramidal

Tremor, rigidity

37
Q

What toxidrome is caused by Salicylates (ASA)?

A

Hypermetabolic

Fever, tachy, hyperpnea, restless, convulsions, metabolic acidosis

38
Q

What toxidrome is caused by Lomotil, heroin, methadone, codeine, Demerol, morphine, etc.

A

Opiates

CNS depression, dilated pupils, hypothermia, hypotension

39
Q

What toxidrome is caused by cessation of EtOH, benzos, barbiturates, and opiates?

A

Opiate Withdrawal

Abdominal cramps, diarrhea, lacrimation, sweating, tachy, restless, hallucinations

40
Q

What toxidrome is caused by amphetamines, cocaine, theophylline, and caffeine?

A

Sympathomimetics

Hyperthermia, HTN, tachypnea, dilated pupils, psychosis, convulsions

41
Q

How are toxic ingestions treated? (3)

A

Activated charcoal

Antidotes

Supportive care

42
Q

How do you treat APAP overdose?

A

N-acetylcysteine (Mucomyst)

*Metabolic acidosis*

43
Q

How do you treat TCA overdose?

A

Intubate

Activated charcoal

Sodium Bicarb

44
Q

An anticholinergic toxidrome + widened QRS and flattened T waves is suggestive of what ingestion?

A

TCA

45
Q

How do you treat organophosphate OD?

A

Atropine

Pralidoxime

46
Q

How do you treat heavy metal OD?

A

Dimercaprol

Succimer, DMSA

EDTA

47
Q

How do you treat iron OD?

A

Deferoxime

48
Q

What skeletal injuries suggest abuse? (5)

A

Spiral fractures in lower extremities

Posterior rib fx

Metaphyseal “chip” fx

Multiple fx

Different ages

49
Q

What can mimic meningitis or sepsis?

A

Shaken baby syndrome

50
Q

What do you do if you suspect abuse?

A

Report to CPS

51
Q

What 4 ways can neglect present?

A

FTT

Poor hygiene - severe diaper rash

Developmental/speech delay

Delayed immunizations

52
Q

If nonorganic FTT (insufficient feeding) is suspected, what do you do?

A

Admit with unlimited feeding for 1 week

*2oz/24 hr of weight gain is expected

53
Q

If you suspect neglect, what should you do?

A

Report to CPS

54
Q

What are ways in which Munchausen by proxy might present? (6)

A

Children < 6, Mom (usually) has some medical knowledge

Vomiting - ipecac

Chronic diarrhea - laxatives

Recurrent abscesses or sepsis

Apnea - choking

Fever - heat thermometer

Bloody vomiting/diarrhea - adding to specimen

Peds Shelf (11 decks)

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