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NICU > Nutrition/electrolytes > Flashcards

Nutrition/electrolytes Flashcards

1
Q

Essential FA

A

linoleic and linolenic acid

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2
Q

What are symptoms of essential FA deficiency?

A

rash, thrombocytopenia, infection, increased triene:tetraene ratio or mead:ARA ratio

– linoleic acid –> ARA (tetraene) is essential, so ratio will increase without it

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3
Q

Essential AA (there are 10)
Which are branched chain?
Which are basic?
Which are ketogenic?

A

Essential: phenylalanine, valine, threonine, tryptophan, isoleucine, methionine, histidine, arginine, leucine, lysine

Branched: leucine, isoleucine, valine (metabolized in muscle)

Basic: histidine, arginine, lysine

Ketogenic: leucine, lysine

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4
Q

What is Beriberi?

- What other diseases is it associated with?

A

Thiamine (B1) deficiency

  • neurologic and cardiac problems
  • associated with MSUD and pyruvate dehydrogenase deficiency

Enough B1 in EBM so rarely seen in newborns

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5
Q

In addition to the 10 essential AA, what are the 4 essential AA of prematurity? (there’s one repeat)

A

Cysteine
Arginine
Tyrosine
Taurine

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6
Q

Two biggest sources of fetal energy?

A

50% from maternal glucose via facilitated diffusion

25% from placental lactate (moves backward via pyruvate to gluconeogenesis)

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7
Q

If there is cholestasis, what must you omit from TPN?

A

Manganese and copper

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8
Q

If there is renal dysfunction, what must you omit from TPN?

A

Selenium and chromium

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9
Q

What’s good about EBM?

What’s in hind milk? Foremilk?

A

High concentrations of:

  • LCPUFA’s from essential FA’s (eg, ARA, DHA) that are constituents of brain and neural tissue and needed early in life for mental and visual development
  • the C’s: carnitine, choline (good for CNS), and cholesterol
  • principal carb is lactose, principal fat is TG’s (dependent on mother’s intake)

Hind milk: high fat
Foremilk: high lactose
- both are same in protein content

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10
Q

What is B2 and its deficiency?

A

Riboflavin deficiency

  • blurred vision, dematitis and mucositis
  • associated with glutaric aciduria type I
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11
Q

What is B6 and its deficiency?

A

Pyridoxine deficiency

  • dermatitis and mucositis
  • seizures
  • associated with homocystinuria
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12
Q

What is B7 and its deficiency?

A

Biotin deficiency

  • alopecia, dermatitis and mucositis
  • associated with proprionic acidemia, pyruvate carboxylase deficiency
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13
Q

What is zinc deficiency?

A
  • acrodermatitis enteropathica
  • alopecia
  • diarrhea
  • nail hypoplasia
  • poor wound healing
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14
Q

What is selenium deficiency?

A

cardiomyopathy

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15
Q

What is copper deficiency?

A

anemia, neutropenia, depigmentation of hair and skin

Menkes - problem of copper transport

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16
Q

As gestational age of fetus increases, what decreases?

A

Na, Cl, ECF, and TBW

17
Q

If you see an exclusively breast fed infant with fissures, what should you think of?

A

iron deficiency

18
Q

Brown fat:

  • increased or decreased mitochondria compared to white fat?
  • where is it located?
  • mediated by?
A
  • increased mitochondria compared to white fat
  • all over except abdominal wall and flanks
  • UCP1
19
Q

Which LCPUFA’s come from the essential fatty acids

A

Linoleic —> ARA (omega 6)

Linolenic —> DHA (omega 3)

20
Q

What vitamin deficiency could be a cause of transient tyrosinemia?

A

Vitamin C

21
Q

Which of the following is lost in donor EBM?

lipase, lactoferrin, oligosaccharides, vitamins A/D/E, lysozyme, IgM, LCPUFA, cytokines

A

Lost in pasteurization: lipase, lactoferrin, lysozyme, lymphocytes, IgM, cytokines

Preserved: oligosaccharides, vitamins A/D/E, LCPUFA’s,

22
Q

What vitamin could prevent wheezing in preterm infants?

A

Vitamin D

23
Q

hypochromic anemia in a short gut infant on prolonged TPN - what nutritional deficiency?

A

copper

24
Q

Which immunoglobulin is wiped out by pasteurization and which one is decreased 50%?

A

IgM wiped out, IgA diminished

IgG depends on subclass

25
Q

At birth/preterm, which are high and which are low: pancreatic, gastric, and lingual lipase?

A

Pancreatic lipase is low, gastric and lingual lipase is high

26
Q

MC ELBW nutritional deficiency for bone mineralization?

A

Vit D and phosphorous

27
Q

what happens to protein levels as breast milk matures and infant grows?

A

protein levels decrease

28
Q

Vitamin E deficiency symptoms?

A

anemia, increased retics

29
Q

X-ALD has too much what?

A

VLCFA’s

30
Q

most abundant fatty acid in EBM?

A

oleic acid

31
Q

most abundant whey protein in EBM vs. cows milk?

A

α-Lactalbumin in EBM, β-Lactoglobulin in cows milk

NICU (16 decks)

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