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Neonatal Pharmacology > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Micronutrient deficiencies have ________ impacts during periods of ____ &______ as well as long-term effects on _________ _______.

A

Negative impacts
Growth & Development
Structural Integrity

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2
Q

T/F: Pediatric nutritional supplemental dietary recommendations are fairly well defined.

A

True

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3
Q

Early malnutrition may predispose us to an increased risk for ______ ________ later in life-specifically _______ _______

A

Chronic Diseases

Cardiovascular Disease

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4
Q

What is a supplement?

What forms can they come in?

Is a supplement a food or the sole item of a meal/diet?

A

A product that supplements the diet

Pill, Capsule, Tablet, Liquid

No

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5
Q

What are the most widely used types of dietary supplements?

A

Vitamins & Minerals

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6
Q

Supplement use is a/w what types of people/lifestyles?

A
  1. Higher income
  2. Smoke-free environment
  3. Lower BMI
  4. Less daily TV/Video time
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7
Q

Vitamin A is called?

A

Retinoid

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8
Q

Vit A is ___-soluble

A

Fat

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9
Q

Vit A is required for the transduction of light into neural signals necessary for vision. Therefore, intake in some forms have been associated w/decreased risk for:

A

Macular degeneration
Cataracts
Cancers
Cardiovascular events

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10
Q

Vit A plays an important role in?

Also in?

A

Vision

Vertebrae, spinal cord, limb development, formation of heart, eyes, ears.

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11
Q

T/F: Vit A increases macrophage phagocytic activity and increases cytokines that mediate T & B lymphocytic production.

A

True

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12
Q

What foods is Vit A found in?

A

Fish, Liver, Dairy, colorful Fruits and Vegies, some oily plants

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13
Q

What is the daily recommended intake of Vit A in infants based on?

A

Infants primarily fed breastmilk

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14
Q

Is Vit A common in the US?

A

No-rare. Cows milk, human milk (except preterm), and formulas are all good sources

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15
Q

Vit A deficiency might be an issue in children w/what disorder?

A

Fat-Malabsorption

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16
Q

Is preterm breastmilk low in Vit A?

A

Yes

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17
Q

A Cochrane review concluded that VLBW infants who were supplemented w/Vit A had a reduction in ______ or _______ requirement at 1 month of age and reduction of ______ requirement at 36 wks w/BW <1 kg

A

Death or Oxygen requirement

Oxygen

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18
Q

Vitamin A may prevent _____ ______ and promote ________.

A

Lung injury

Healing

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19
Q

Vit A reduced what lung Dz?

A

BPD

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20
Q

Low _____ levels has been shown to be a risk factor for Maternal-Child transmission of HIV

A

Vit A

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21
Q

Is there special recommendation concerning dietary supplementation w/Vit A?

A

No

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22
Q

Preterm infants fed breastmilk will need what?

A

Fortification of Vit A

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23
Q

There is some evidence that supplemental Vit A may be indicated for what type of preterm infants?

A

LBW

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24
Q

What is the other name for Vit D?

A

Calciferol

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25
Q

Vit D is essential for what?

A

Proper growth and development of skeletal system

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26
Q

Vit D works with ______ _____ to maintain serum ____ & ______ concentrations

A

Parathyroid Hormone

Ca++ & Phosphate

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27
Q

Where is Vit D synthesized?

A

Skin

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28
Q

The precursors of Vit D require what to convert to the Active form?

What is the common name for Vit D?

A

UVB light

the Sunshine Vitamin–deficiency is higher in areas where exposure to sunlight is limited

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29
Q

What sources is Vit D found?

A

Egg yolks, butter, whole milk, fatty fish, fish oils, mushrooms, liquid/dried milk, breakfast cereals

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30
Q

Is human milk low or high in Vit D?

A

Low–unless mom is receiving very high doses of the vitamin

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31
Q

Vit D deficiency leads to?

Characterized by?

A

Rickets

Impaired skeletal mineralization causing deformities and poorer linear growth of long bones

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32
Q

What are the clinical signs of Rickets in an infant?

Later in life?

A

Craniotables, Frontal skull bossing, Widened Ribs, Bowed legs, Muscle Weakness

Osteomalacia, various chronic Dz’s: CV, HTN, DM, inflammatory/autoimmune, CA

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33
Q

Hyper/Hypo-Calcemia and Hypervitaminosis D disrupts normal _____ function—>polydypsia & polyuria

A

Hypercalcemia

Kidney Function

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34
Q

The AAP recommends that all breastfed babies be supplemented with what vitamin?

Formula-fed infants need to consume at least ___ Liter/day Vit D fortified formula

A

Vitamin D

1 L/day

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35
Q

Vit E functions as a _____ breaking ___________ to prevent free radical damage–especially important for cells exposed to ________ like the lungs and RBC’s.

A

Chain-breaking
Antioxidant
Oxygen

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36
Q

Name dietary sources of Vit E

A

Whole grains, nuts, vegetable oils, meats, what germ, safflower oil, sunflower oil

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37
Q

Does breatmilk supply adequate amounts of Vit E in Term and Preterm infants?

A

Yes, both

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38
Q

T/F: Vit E deficiency is common in the US

What are signs of Vit E deficiency?

A

False, it’s rare except situations r/t fat-malabsorption

Peripheral neuropathy, Hemolytic Anemia, Abnormalities in Platelet Fxn

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39
Q

Does the AAP recommend pharmacologic doses of Vit E for prevention or treatment of ROP, BPD, or IVH?

A

NO

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40
Q

When is the only time Vit E supplementation will be required?

A

Situations of Fat-malabsorption

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41
Q

What Vitamin functions as the coenzyme for synthesis of proteins involved in blood coagulation and bone metabolism?

A

Vitamin K

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42
Q

Which proteins are dependent on Vit K?

A 
Plasma Prothrombin (factor 2), 7, 9, 10
&amp; Protein C and Protein S
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43
Q

Where is Vit K sourced from?

A

Diet

Intestinal Flora

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44
Q

What are dietary sources of vit K?

A

Green leafy vegetables, vegetable oil, margarine

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45
Q

Are there high or low levels of Vitamin K in human breastmilk?

A

Low

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46
Q

Are oral Vit K supplements licensed in the US?

A

No

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47
Q

Vit K deficiency is a/w bleeding during the first few ______s of life

A

Weeks

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48
Q

Vit K deficiency bleeding is categorized as?

A

Early
Classic
Late

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49
Q

Is Vit K toxicity rare or common?

A

Rare-and no adverse effects have been reported

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50
Q

Is there a relationship between Vit K at birth and childhood CA/Leukemia?

A

No

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51
Q

NB’s have __________ stores of Vit K at birth d/t ______ _________ transfer.

A

Inadequate

Poor Placental transfer

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52
Q

Serum Vit K level is ____ or ____________ in cord blood.

A

Low

Undetectable

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53
Q

Early Vit K deficiency happens when?

What are some sequellae?

Early Vit K deficiency is sometimes noted in which infant’s?

A

First 24 hrs life

ICH, Cephalic hematomas, intra-abdominal hemorrhages

Infants w/mom’s tx’d w/anti-hypertensives or anti-convulsants during pregnancy

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54
Q

When does Classic Vit K deficiency happen?

What signs might you see?

A

Day 2-7

Bleeding from umbilical stump, GI tract, or circ site

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55
Q

When does Late Vit K deficiency happen?

What often results?

A

Day7-3 months of age.

ICH and sometimes death

56
Q

T/F: In babies w/ fat-malabsorption, Vit K supplement may be needed.

A

True

57
Q

What might be an option of supplementation for families who do not want their infant to receive a dose of Vit K at birth?

A

Maternal Vit K supplement (although not seen in practice)

58
Q

What is the most abundant mineral in the body?

A

Ca++

59
Q

What mineral is the main structural component of the skeletal system?

A

Ca++

60
Q

What mineral is regulated by several hormones including PTH,and Calcitonin?

A

Ca++

61
Q

Low/High Ca++ concentrations generally imply abnormal _______ function or _____ failure

A

Low
Parathyroid
Kidney

62
Q

In what foods is Ca+ found?

A

Dairy products
Dark green veggies
Legumes
Fortified food

63
Q

___% Ca++ is found in bones and teeth. The other % is also crucial for health.

A

99%

64
Q

Where is the remaining 1% Ca++ found?

How does it function?

A

Plasma & Soft tissues

Vasoconstriction, Vasodilation, Muscle contraction, Nerve impulse transmission, Hormone secretion

65
Q

Intake of Ca++ from fromula may need to be ______ in order to achieve the same retention as infants who are fed human milk (term infants)

A

Greater

66
Q

LBW infants are at risk for these biochemical abnormalities when deficiencies of Ca++ exist:

A 
Rickets
Low rates of bone mineralization
Reduced linear growth
Low net mineral retention
Hypophosphatemia
Reduced bone mass and subsequent Osteoporosis
67
Q

T/F: Effects of excessive intake are not known in infants/children

A

True

68
Q

In term infants, Human milk is thought to be a __________ source of Ca++ for the first ___ months of life.

A

Sufficient

6 months

69
Q

Preterm infants have _______ Ca++ needs than Term infants

A

Higher

70
Q

T/F: AAP recommends supplementation of Ca++ in preemies?

A

True

via: HMF, premature formulas, multivitamin preparations

71
Q

In adults w/excessive Ca++ intake what might they have?

A

Poor muscle tone, Kidney stones, Hypercalcemia, Renal insufficiency, Constipation, Excessive urine loss, Nausea, Coma, Death

72
Q

Iron is an essential _______

A

Mineral

73
Q

Iron constitutes several classes of ______

Including:

A

Protein

  • Heme proteins (hemoglobin)
  • Iron-sulfur
  • Nonheme enzymes (flavoproteins)
  • Enzymes involved in iron storage and transport
74
Q

Iron plays a role in _____ synthesis

A

DNA

75
Q

___ proteins are required for the transport of oxygen from lungs to tissues

A

Heme proteins

76
Q

____ deficiency is the best known nutritional deficiency in the world.
The best known consequence from it is_____.

A

Iron

Anemia

77
Q

___% of the word’s Anemia is from Iron deficiency accounting for >840,000 deaths/year.

A

50%

78
Q

__-__% of Full Term infants will develop iron deficiency Anemia.

Preemies are at higher/lower incidence.

A

3-30%

Higher

79
Q

Iron deficiency anemia causes ______ & ______ developmental delays

A

Mental

Motor

80
Q

Iron supplemented in kids >2y/o, resulted in what?

A

Increased cognition and enhanced physical performance

81
Q

Homeostasis of Iron is primarily maintained through the coordinated _________ of absorption and __________.

A

regulation

transport

82
Q

What are dietary sources of iron?

A

Heme-based: animal-based foods
None-heme based: grain, fruits, vegetables
Human milk: highly bioavailable source
Cow milk-based formula is less well absorbed, recommended >1 yr. age

83
Q

AAP: healthy, full-term babies should receive Iron supplemented sources starting at ___-___ months from complimentary foods.

A

4-6 months

84
Q

Preterm or LBW infants should begin iron supplementation at ___ month of age

A

1 month

in NICU- at 2 wks of age if on full feeds

85
Q

What are adverse effects of Excess iron administration?

A 
Promotion of cellular oxidation
Impaired resistance to infection
Interference w/absorption or metabolism of other nutrients
GI abnormalities
Behavioral disturbances
86
Q

Zinc is an essential _____ ________.

A

trace mineral

87
Q

Zinc has numerous ______ and ________ functions.

A

Physiologic

Biochemical

88
Q

Zinc is a structural and/or regulatory component of nearly 300 _______ in which it maintains structural integrity and plays a role in regulation of gene ____________.

A

enzymes

expression

89
Q

Like iron, Zinc is absorbed greater from a _____-based diet vs. _____-based.

A

Animal

Plant

90
Q

Name some animal food sources of Zinc

A

Red meat
Oysters
Poultry
Liver

91
Q

Name some plant food sources of Zinc

A 
Beans
Nuts
Whole grains
Fortified cereals
Legumes
92
Q

T/F: Zinc is highly bioavailable in human milk

A

True

93
Q

Zinc concentrations ________ as lactation progresses

A

Decline

94
Q

Zinc concentration is ______ in human milk vs. cow milk (just like iron)

A

Higher

95
Q

Absorption of Zinc is _____ in Soy formulas compared to cow milk-based formulas and human milk

A

Less

96
Q

Name some signs of Zinc deficiency

A 
Growth retardation
Alopecia
Diarrhea
Delayed sexual maturation and impotence
Eye and skin lesions
Loss of appetite
Behavior (ADHD)
97
Q

Excess Zinc intake causes:

A

Suppression of immune response
Decreased HDL cholesterol
Reduced Copper
Acute toxicity: epigastric pain, diarrhea, N&V

98
Q

What does chronic, excessive intake of zinc induce?

A

Secondary Copper deficiency (by competitive interaction during intestinal absorption)

99
Q

Infants fed human milk may benefit from zinc supplementation at what age?

A

6 months

100
Q

During what age are zinc requirements high?

A

Second half of the first year (6-12 months)

101
Q

True/False: Preterm formulas and HMF’s are a source of Zinc supplementation.

A

True

102
Q

What are some food sources of zinc?

A

Lean beef, Legumes, Fortified cereals

103
Q

Iodine is a ____ _______ essential for the synthesis of the Thyroid hormones T4 and T3.

A

trace mineral

104
Q

Iodine is _______ absorbed and removed from the body

A

rapidly

105
Q

T/F: Can iodine be absorbed through the skin from topical applications?

A

Yes (povidone iodine)

106
Q

Iodine content in food depends on the iodine content of the _____ and _____ that were used to grow them.

A

soil

water

107
Q

Name some sources of iodine

A

Ocean fish, mollusks

Iodized salt

108
Q

Does human milk have iodine?

A

Yes, it is dependent on mother’s intake

109
Q

Human milk, milk-based formulas and cow milk are all ______ sources of iodine

A

good

110
Q

Thyroid hormones are essential for the regulation of:

A

Human growth, development, metabolism, & reproductive function

111
Q

Most iodine is concentrated where?

A

the Thyroid gland

112
Q

What are other target organs of iodine concentration?

A

Brain, Muscle, Heart, Pituitary, Kidney

113
Q

T/F: Iodine deficiency is still a common world-wide deficiency.

A

True

114
Q

What can inadequate Iodine intake result in?

A 
Goiter
Mental retardation
Hypothyroidism
Cretinism
Growth and developmental abnormalities
115
Q

Excessive Iodine intake has not been sufficiently _______.

It is recommended the only source during the 1st yr/life be from _______ & _______.

A

Studied

Food
Formula

116
Q

What dietary mineral is a/w the prevention of dental caries and stimulation of new bone formation?

A

Fluoride

117
Q

T/F: Fluoride enhances re-mineralization of enamel.

A

True

118
Q

_______ is present in saliva and dental plaque.

A

Fluoride

119
Q

In young children, as much as _____% Fluoride can be retained by developing skeleton and teeth.

A

80%

120
Q

____ foods contain fluoride naturally.

What are they?

A

Few

Marine fish and some teas

121
Q

What is our main source of Fluoride?

A

Artificially fluoridated water

122
Q

T/F: the content of Fluoride in individuals varies greatly

A

True

123
Q

The content of Fluoride in breastmilk depends on what?

A

Mother’s intake of Fluoride

124
Q

The content of fluoride in formula depends on what?

A

The water used to reconstitute it

125
Q

Inadequate intake of Fluoride places individuals at risk for?

A

Dental Carries.

126
Q

The earlier children are exposed to Fluoridated water or dietary supplements, the greater _______ of carries in both primary and permanent teeth.

A

decrease

127
Q

Dietary Fluoride supplements are intended to compensate for what?

A

Fluoride deficient drinking water

128
Q

Excessive Fluoride intake can result in varying degrees of?

A

Fluorosis

129
Q

Mild Fluorosis may render the _____ more resistant to carries.

A

Enamel

130
Q

Moderate-severe forms of Fluorosis cause ______ issues due to increased porosity (causes the enamel to appear opaque and mottled)

A

Cosmetic

131
Q

Omega-3 Fatty Acids are important for?

By providing?

A

Visual and Neurological development
Protection from inflammation
Optimal immune function
Decreasing risk of chronic, Dz’s: CV

132
Q

Where are Omega-3 Fatty Acids found?

A

Oils (canola and flaxseed)
Meats
Eggs

133
Q

The Content of Omega-3 Fatty Acids in human milk is dependent on what?

A

Mom’s diet

134
Q

Formula content of Omega-3 Fatty Acids is usually ____.

A

Low–it is made w/corn, coconut, safflower, and soy oils.

135
Q

Some evidence exists that intake of Omega-3 Fatty Acids benefits?

A

Cognitive and Behavioral performance

136
Q

What would excessive Omega-3 Fatty Acid intake lead to?

A

Possible increased risk of conditions a/w oxidative damage (BPD, NEC)

Neonatal Pharmacology (17 decks)

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