Nutrition/electrolytes Flashcards
Essential FA
linoleic and linolenic acid
What are symptoms of essential FA deficiency?
rash, thrombocytopenia, infection, increased triene:tetraene ratio or mead:ARA ratio
– linoleic acid –> ARA (tetraene) is essential, so ratio will increase without it
Essential AA (there are 10)
Which are branched chain?
Which are basic?
Which are ketogenic?
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
What is Beriberi?
- What other diseases is it associated with?
Thiamine (B1) deficiency
- neurologic and cardiac problems
- associated with MSUD and pyruvate dehydrogenase deficiency
Enough B1 in EBM so rarely seen in newborns
In addition to the 10 essential AA, what are the 4 essential AA of prematurity? (there’s one repeat)
Cysteine
Arginine
Tyrosine
Taurine
Two biggest sources of fetal energy?
50% from maternal glucose via facilitated diffusion
25% from placental lactate (moves backward via pyruvate to gluconeogenesis)
If there is cholestasis, what must you omit from TPN?
Manganese and copper
If there is renal dysfunction, what must you omit from TPN?
Selenium and chromium
What’s good about EBM?
What’s in hind milk? Foremilk?
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
What is B2 and its deficiency?
Riboflavin deficiency
- blurred vision, dematitis and mucositis
- associated with glutaric aciduria type I
What is B6 and its deficiency?
Pyridoxine deficiency
- dermatitis and mucositis
- seizures
- associated with homocystinuria
What is B7 and its deficiency?
Biotin deficiency
- alopecia, dermatitis and mucositis
- associated with proprionic acidemia, pyruvate carboxylase deficiency
What is zinc deficiency?
- acrodermatitis enteropathica
- alopecia
- diarrhea
- nail hypoplasia
- poor wound healing
What is selenium deficiency?
cardiomyopathy
What is copper deficiency?
anemia, neutropenia, depigmentation of hair and skin
Menkes - problem of copper transport
As gestational age of fetus increases, what decreases?
Na, Cl, ECF, and TBW
If you see an exclusively breast fed infant with fissures, what should you think of?
iron deficiency
Brown fat:
- increased or decreased mitochondria compared to white fat?
- where is it located?
- mediated by?
- increased mitochondria compared to white fat
- all over except abdominal wall and flanks
- UCP1
Which LCPUFA’s come from the essential fatty acids
Linoleic —> ARA (omega 6)
Linolenic —> DHA (omega 3)
What vitamin deficiency could be a cause of transient tyrosinemia?
Vitamin C
Which of the following is lost in donor EBM?
lipase, lactoferrin, oligosaccharides, vitamins A/D/E, lysozyme, IgM, LCPUFA, cytokines
Lost in pasteurization: lipase, lactoferrin, lysozyme, lymphocytes, IgM, cytokines
Preserved: oligosaccharides, vitamins A/D/E, LCPUFA’s,
What vitamin could prevent wheezing in preterm infants?
Vitamin D
hypochromic anemia in a short gut infant on prolonged TPN - what nutritional deficiency?
copper
Which immunoglobulin is wiped out by pasteurization and which one is decreased 50%?
IgM wiped out, IgA diminished
IgG depends on subclass
At birth/preterm, which are high and which are low: pancreatic, gastric, and lingual lipase?
Pancreatic lipase is low, gastric and lingual lipase is high
MC ELBW nutritional deficiency for bone mineralization?
Vit D and phosphorous
what happens to protein levels as breast milk matures and infant grows?
protein levels decrease
Vitamin E deficiency symptoms?
anemia, increased retics
X-ALD has too much what?
VLCFA’s
most abundant fatty acid in EBM?
oleic acid
most abundant whey protein in EBM vs. cows milk?
α-Lactalbumin in EBM, β-Lactoglobulin in cows milk
