Nutrition Flashcards
What are the functions of vitamin 1,25 (OH) D? (3)
- increase calcium and phosphorus absorption from small intestine
- increase calcium resorption form bone
- increase renal tubular calcium and phosphorus resorption
What is the most likely diagnosis for a patient presenting with muscle atrophy, normal or increased body fat stores, moon facies and periorbital edema, easily plucked out hair, and rash characterized as reddish brown skin, hyperpigmentation, and hyperkeratosis?
Kwashiorkor
due to inadequate protein intake but fair caloric intake
What nutritional deficiency is associated with Pica (persistent craving to eat non-nutritive substances for than 1 month)?
Iron deficiency
decreased serum ferritin and elevated total iron capacity
What is the most likely diagnosis for a premature neonate who develops edema, thrombocytosis, hemolytic anemia during the 2nd month of life?
Vitamin E deficiency
(did not receive the 3rd trimester maternal transfer of vitamin E)
tx: 25-50 units/day of vitamin E
What is the most likely diagnosis for a pt presenting with diarrhea, eczematous and bulbous rash , poor weight gain and reduced taste (hypogeusia)?
Zinc deficiency (acrodermatitis enteropathica)
(breastmilk has zinc, so see after breastfeeding completed)
tx 30-45 mg/day of zinc supplement
What is the most likely diagnosis of an atheletic pt presenting with generalized bone and muscle pain, malaise, anorexia, dry skin and mucous membranes, hair loss, and seborrheic skin changes
Hypervitaminosis A
Xray findings consistent with long, wavy cortical hyperostosis of bones sparing metaphyseal area
An infant who eats primarily corn mash and presents with poor weight gain, diarrhea and rash most likely suffers from …
Niacin Deficiency (Pellagra)
-triad is dementia, diarrhea and dermatitis
A breastfed infant of a vegan mother who presents with anemia most likely suffers from …
Vitamin B12 (cobalamin) deficiency
-due to no meat
Tx: supplement mother
What are characteristic blood smear findings for Vitamin B12 (cobalamin) deficiency?
1) hypersegmented, polymorphonucleated cells
2) large red blood cells (macrocystosis, MCV > 110)
Where in the body is vitamin B12 absorbed?
Ileum
-resection or malfunction of ileum would result in Vitamin B12 deficiency
What is the consequence of goat’s milk being the sole nutrition for an infant?
Folate deficiency related megaloblastic anemia
What is the most likely diagnosis for a pt presenting with yellowish-orange tint of skin, but normal conjunctiva and mucous membranes and otherwise acting normally?
Carotenemia
(Carotene deposits in skin due to increased ingestion of carotene containing veggies like carrots, squash, sweet potatoes)
What are the AAP guidelines for Vitamin D supplementation in infants?
All exclusively and partially breastfed infants should be on 400 IU per day of vitamin D within 1st few days of life
What vitamin deficiency has been correlated to neural tube defects?
Folate deficiency
What dietary change results in increased iron absorption?
ascorbic acid intake
orange juice
What is the most specific lab finding for iron deficiency?
low serum ferritin
What is the treatment for iron deficiency anemia?
3-6 mg/kg/day of elemental iron for 3 months
-check in 4 weeks for at least 1 g/dl increase
What is the most likely diagnosis for a pt who presents with generalized tenderness (focused in lower extremities), poor appetite, low grade fever, swollen/tender/bleeding gums, skin changes (perifollicular hemorrhages), impaired wound healing and Xray showing ground glass appearance, thin bony cortex and sharply outlined epiphyseal ends?
Vitamin C deficiency (Scurvy)
- most likely in alcoholic/ drug abuser who is homeless
- due to lack of fresh fruits and veggies
What is the most likely diagnosis for a patient presenting with fatigue, abdominal discomfort, anorexia, numbness and tingling, muscle atrophy, loss of deep tendon reflexes, ataxia, and cardiac abnormalities (heart failure, cardiomegaly) after gastric by-pass?
Thiamin (Vitamin B1) deficiency
What are the specific potential complications associated with long-term unsupplemented breast milk use for a preterm infant? (3)
- Hypoproteinemia at 8-12 weeks of age
- Hyponatremia at 4-6 weeks of age
- Zinc deficiency at 2-6 months of age
(should use breastmilk fortifiers to prevent)
What is the characteristic radiographic finding associated with rickets (vitamin D deficiency)?
- Rachitic rosary (widening of the growth plates (costochondral junctions) associated with metaphyseal fraying and cupping
- Harrison groove (depression along lower portion of anterior chest due to pulling on softened ribs by diaphragm)
- Craniotabes (distinct areas of softening with palpation of cranial bones)
At what age does an individual have the highest protein requirement on g/kg/day basis?
newborn (1.5-2)
-declines as gets older
What are contraindications to breastfeeding? (4)
- HIV positive mother
- Newborn with galactosemia
- Mother on chemotherapy
- Mother on isotretinoin therapy
What vitamin deficiency is associated with Bitot spots (well defined, triangular/ oval shaped white thickened areas adjacent to the limbus of the eye)?
Vitamin A deficiency
associated with poor night vision, dry skin/ hair/ nails, increased risk for respiratory and GI infections
how do you calculate maintenance IVFs?
100/50/20 rule (ml/day): 100 ml/kg for 1st 10 kg, 50 ml/kg for 2nd 10 kg, 20 ml/kg for additional kgs
4/2/1 rule (ml/hr): 4 for 1st 10 kg, 2 for 2nd 10 kg, 1 for every additional Kg
When should fluoride supplementation begin?
6 months to 3 years old
-if no fluoride in water
What is the potential energy available in dietary fat?
9 kcal/g
What is the potential energy available in dietary carbs and protein?
4 kcal/g
What are the fat soluble vitamins? (4)
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K (bruising)
-common in untreated cystic fibrosis pts or pancreatic deficient pts
What is the characteristic rash associated with Kwashiorkor (chronic protein malnutrition)?
Flaky paint dermatitis
-blanching erythema with overlying reddish-brown scaling and sharply marginated, raised borders that peel off easily
What is the most likely cause of hyponatremia in a newborn?
free water ingestion
An athlete or body builder presenting with malaise, anorexia, dry skin and mucous membranes, hair loss, seborrheic skin changes, hepatomegaly and Xray of long bones showing long, wavy cortical hyperostosis most likely suffers from …
Hypervitaminosis A
What is the appropriate formula substitute for a family that would like to maintain a vegan diet?
Soy formula
also for babies with galactosemia
