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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
A

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
Q

14 mo. FTT. met acidosis. pH 7.31. Bicarb 14. K 3.5. Na 140. Cl 118. Urine pH 6.3

A

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
Q

T or F: by changing to WHO growth charts the formula get babies look like FTT in the first 6 months?

A

True

27
Q

3 y.o. only gained 2 kg last year. Okay or not?

A

Okay. Reassure.

Increase 2kg/yr and min. 5 cm/year until puberty.

28
Q

13 y.o. BMI 31. At risk for:

  • T2DM
  • delayed menarche
  • AVN femoral head
  • Pancreatitis
A

T2DM

early puberty, SCFE, gallbladder dx, dyslipidemia

29
Q

What BMI is considered overweight?

A

85-95th percentile

30
Q

Why BMI is considered obese?

A

> 95th percentile

31
Q

chance of child being obese if 1 parent is? what if 2 parents are?

A

1 parent is= 1/2

2 parents= 2/3 (practice Quest quote 80%)

32
Q

Adopted. Edema. Yellow tinged rusty hair.

  • Kwashiorkor
  • Marasmus
  • B1 deficiency
A

Kwashiorkor= protein deficiency= edema

Marasmus= wasting

33
Q

Thick costochondral junction in baby adopted who look malnourished. Dx? P/E?

A

Dx: Rickets

P/E: frontal bossing, craniotabes, delayed AF closure, rachitic rosary, protruding abdo, enlarged wrist and ankle, bowing of tibia and femur

34
Q

BF. Rash around orifices. Also has glossitis, stomatitis, corneal dystrophy. Lacking:

  • Vit C
  • Vit A
  • Vit B12
  • Zinc
A

Zinc deficiency

35
Q

Keratinization of MM and skin (dry scaly patches). Poor teeth enamel. Blind. Deficiency in?

A

Vitamin A

36
Q

DD. Hyper pigmentation, Megaloblastic anemia. Deficiency in?

A

Vitamin B12

37
Q

Tender swollen leg. Bleeding spongy gums. Poor wound healing. Vitamin Deficiency?

A

Vit C

38
Q

vesicobullous and eczematous skin in perioral, anal and perineal area. Deficiency in?

A

Zinc

= Acrodermatitis Enteropathica

39
Q

All are features of iron deficiency anemia:

  • pica
  • koilonychia
  • angular cheilitis
  • mild scleral icterus
  • psychomotor retardation
A

Mild sclera icterus

= hemolytic!

40
Q

List 3 complications of iron deficiency anemia:

A
  • 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
Q

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
A

B12

42
Q

How can you remember Kwashiorkor and Marasmus:

A

Kwashiorkor results form protein deficient MEAL:

  • Malnutrition
  • Edema
  • Anemia
  • Liver (fatty)

Marasmus= Muscle wasting

43
Q

T or F: triglycerides require hydrolysis to free f.a.

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
Q

New ataxia after post-kasai for biliary atresia. Vit issue:

  • A
  • D
  • E
  • K
A

E

45
Q

Crohn’s disease. Ileal resection. Nutritional deficiency at risk:

  • folic acid
  • B12
  • Vit k
  • zinc
A

Vitamin B12

RC: Specialties Woo Hoo (31 decks)

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