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RC: Specialties Woo Hoo > Nutrition > Flashcards

Nutrition Flashcards

1
Q

T or F: you must drink high carb drink if involved in competitive sports + nutrition.

A

False

Well balanced diet!

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2
Q

T or F: you change a child’s diet as per sport they are involved with.

A

False.

Well balanced diet!

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3
Q

What does a well balanced diet look like in % of carb, protein, fat?

A

Carb: 50% = near
Protein: 20%
Fat: 30%.

“1/4 fat, 1/4 protein, 1/2 carb”

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4
Q

What fluids does CPS recommend for athletes?

A
  • cold water 2-3h pre activity
  • during: fluids every 20 min.
    water fine if < 1h
    if > 1h or hot= sports drink (carb, salt)
  • replace sweat after via water
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5
Q

What timing of meals does CPS recommend for athletes?

A
  • meal 3h pre event

- recover food 1-2h after (include protein + carb)

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6
Q

How do you optimize nutrition for prem with BPD?

A
  • fortified human milk or preterm formula to increase caloric density
  • ensure supplement Na or K if on diuretics
  • Ensure normal Ca2= to prevent osteopenia of prematurity
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7
Q

What is the best dietary advice for competitive athletes:

  • eat a well balanced diet
  • components depend on sport
  • increase protein intake to 1.5 g/d
  • vitamin d and ca2+ supp
  • balanced diet
A

Well balanced diet!

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8
Q

Work north of 55th parallel. How much vitamin D for 8 month old bottle fed BB IN THE WINTER?

A

Goal: 800 IU from all sources.

400 IU from formula + 400 IU outside.

If BF= 800 IU supp

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9
Q

Use well water. What do you do about vitamins? Fluoride?

A

Vitamins: 400 IU if BF (none if formula and less than 55th parallel)

Fluoride:

  • variable level in well water
  • doesn’t matter till have teeth
  • once teeth if 0.3 ppm in water= great!
  • if less= brush w/ fluoride paste BID = great!
  • if brush < BID then need topical fluoride
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10
Q

Phytoestrogen in SOY contraindicated for:

  • all male
  • immunodeficiency
  • galactosemia
  • congenital hypothyroid
A

Congenital hypothyroidism (interfere w/ uptake of thyroid hormone)

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11
Q

T or F: galactosemia is an indication for soy formula.

A

True

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12
Q

Best nutrition for short gut syndrome:

  • BF
  • TPN long term
  • elemental formula + MCT
  • soy + MCT
  • whey hydrolysate
A

BF

If that is not option= Elemental formula with MCT!

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13
Q

Which part of the bowel absorbs carb/protein/iron? Which does B12?

A

Carb, protein, Fe= Jejunum.

B12 + Na= Ileum

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14
Q

3 wk old going to be formula fed. Suggest Fe-fortified one. Mother ask about anticipated problem. You counsel:

  • colic
  • constipation
  • black stool
  • no problem
A

No problems

Misconception about GI distress but none.

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15
Q

CPS contraindication to BF:

A
  • HIV
  • Active untreated TB (< 2 wk of tx)
  • Untreated maternal brucellosis
  • Human T-cell lymphotrophic virus type 1 or 2
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16
Q

T or F: SSRI is contraindicated in BF.

A

False.

Contraindication: antineoplastic (chemo), drugs of abuse, some anticonvulsant, infant with classic galactosemia

Note: if on high dose flagyl d/c for 12-24h after taken to allow med excretion.

Note: primaquine, quinine contraindicated unless neither mom or BB G6PD

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17
Q

BF preterm. What is true re: Iron supplementation:

  • do not use
  • start sup at 1 mo. age
  • start only if non-iron fortified supplemental formula
A

Prem:

  • supp from 1-12 mo
  • total need= 2mg/kg/d
  • IF VLBW (<1500g) = 2-3 mg/kg/day
  • may need sup on top of formula

Term BF: okay until 4-6 mo. Sup 1mg/kg/d if no 2 iron rich food

Term non BF: Iron fortified formula and then switch to solid

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18
Q

What is the risk of giving honey if < 1 y.o.

A

Infant Clostridium Botulism

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19
Q

Vegan mom and want stop BF her baby. Which sup do you recommend:

  • B12
  • C
  • folate
  • irone
A

B12

“BM in strict can be low in B12 therefore their infants should be supplemented”

Note: if > 7 month zinc supplement if BF only from vegan mom.

20
Q

What nutritional deficiency is a 12 year old vegan child at risk for?

A

Vitamin B12

(5ug-10ug daily sup)

Other:

  • vitamin B
  • iron
  • folic acid
  • linolenic acid
  • calcium
21
Q
  1. 5 y.o. vegetarian diet. Risk of low:
    - C
    - Ca2+
    - Folate
    - Zinc
    - Iron
22
Q

Goat milk to baby. What do you need to supplement?

  • Ca
  • Iron
  • Folate
  • Multivitamin
A

Folic Acid/ Folate

** it is deficient!

23
Q

4 things that increase cholestasis incidence in BB on TPN.

A
  • Low BW
  • longer duration of tx (TPN
  • complicated med course (resp distress, hypoxia, acidosis)
  • short bowel syn
24
Q

List 4 complication of TPN:

A
  • high TG
  • low Mg
  • cholestasis (bili)
  • Hypernatremia

…

  • High BG
  • Low K
  • Low Albumin
  • Low Ca
25
14 mo. FTT. met acidosis. pH 7.31. Bicarb 14. K 3.5. Na 140. Cl 118. Urine pH 6.3
Non AG Metab Acidosis = R/O renal met acidosis with urine > 5.5 = less H+ out = Distal RTA Versus Bartter= low K and metabolic ALKALOSIS versus Organic= AG metab Acidosis + normla/high ammonia
26
T or F: by changing to WHO growth charts the formula get babies look like FTT in the first 6 months?
True
27
3 y.o. only gained 2 kg last year. Okay or not?
Okay. Reassure. Increase 2kg/yr and min. 5 cm/year until puberty.
28
13 y.o. BMI 31. At risk for: - T2DM - delayed menarche - AVN femoral head - Pancreatitis
T2DM | early puberty, SCFE, gallbladder dx, dyslipidemia
29
What BMI is considered overweight?
85-95th percentile
30
Why BMI is considered obese?
> 95th percentile
31
chance of child being obese if 1 parent is? what if 2 parents are?
1 parent is= 1/2 | 2 parents= 2/3 (practice Quest quote 80%)
32
Adopted. Edema. Yellow tinged rusty hair. - Kwashiorkor - Marasmus - B1 deficiency
Kwashiorkor= protein deficiency= edema Marasmus= wasting
33
Thick costochondral junction in baby adopted who look malnourished. Dx? P/E?
Dx: Rickets P/E: frontal bossing, craniotabes, delayed AF closure, rachitic rosary, protruding abdo, enlarged wrist and ankle, bowing of tibia and femur
34
BF. Rash around orifices. Also has glossitis, stomatitis, corneal dystrophy. Lacking: - Vit C - Vit A - Vit B12 - Zinc
Zinc deficiency
35
Keratinization of MM and skin (dry scaly patches). Poor teeth enamel. Blind. Deficiency in?
Vitamin A
36
DD. Hyper pigmentation, Megaloblastic anemia. Deficiency in?
Vitamin B12
37
Tender swollen leg. Bleeding spongy gums. Poor wound healing. Vitamin Deficiency?
Vit C
38
vesicobullous and eczematous skin in perioral, anal and perineal area. Deficiency in?
Zinc = Acrodermatitis Enteropathica
39
All are features of iron deficiency anemia: - pica - koilonychia - angular cheilitis - mild scleral icterus - psychomotor retardation
Mild sclera icterus | = hemolytic!
40
List 3 complications of iron deficiency anemia:
- angular cheilitis - glossitis (inflam tongue) - koilonychia (spoon nails) - irreversible behavioural and IQ deficiency - breath holding spell association Tx: < 16 oz/day of homo milk. PO sup 6 mg/kg/d x 3 mo.
41
Some vitamins are stored in large amt and no biochemical or clinical sign for many months. Which is that: - Thiamine (B1) - Vit C - Vit B12 - Riboflavin (B2) - Folate
B12
42
How can you remember Kwashiorkor and Marasmus:
Kwashiorkor results form protein deficient MEAL: - Malnutrition - Edema - Anemia - Liver (fatty) Marasmus= Muscle wasting
43
T or F: triglycerides require hydrolysis to free f.a.
True Fat absorbed in proximal jejunum. - pancreatic enzyme and other break down TG into components - bile salt enhance solubilization via micelles (- coated with phospholipid) - Micelles absorbed - Note MCT diffuse passively so don't need the above.
44
New ataxia after post-kasai for biliary atresia. Vit issue: - A - D - E - K
E
45
Crohn's disease. Ileal resection. Nutritional deficiency at risk: - folic acid - B12 - Vit k - zinc
Vitamin B12

RC: Specialties Woo Hoo (31 decks)

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