Nutrition/Fluids

Question 1

3 cases where you can have fictitious hyponatremia

Answer 1

hypercholesteremia
hyperglycemia
hyperlipidemia

Question 2

How do you diagnose Essential Fatty Acid Deficiency?

Answer 2

triene /tetratene ratio 0.4, or 0.2 depending on site

Question 3

How Much Na in NA Bolus?

Answer 3

1.5 meq Na per 10 ml/kg

Question 4

Major extracellular buffers, acid-base?

Answer 4

HCO3, phosphates, proteins,
major

buffer system is CO2 that crosses brain, and stimulates chemoreceptors to increase respiratory drive

Question 5

Pitiocin can cause what electrolyte derangement in newborn?

Answer 5

Hypernatremia

Question 6

Signs of Vitamin E deficiency?

Answer 6

anemia, hemolysis, THROMBOCYTOSIS, neurologic deficits

Question 7

Vitamin B1 Deficiency (Thiamine) Is associated with what disorders?

Answer 7

pyruvate dehydrogenase complex deficiency, and maple syrup urine disease

Question 8

what are signs of B12 deficiency?

Answer 8

poor weight gain, anemia, methylmalonic acidemia and homocystinuria

Question 9

What are some benefits of lactose?

Answer 9

Enhances absorption of calcium and magnesium

promotes intestinal growth of lactobacilli

short-chain glucose polymer more easily absorbed than long chain

Question 10

What are the 6 trace elements?

Answer 10

Chromium, Copper, Iron, Manganese, Selenium, zinc

Question 11

What are the major intracellular buffers?

Answer 11

bone apatite
Hgb
orghanic phosphates

Question 12

What are the two essential fatty acids?

Answer 12

Lenoleic acid and Alpha linolenic acid

Question 13

What critical fatty acids are transferred across placenta?

Answer 13

Arachionic acid and docosahexaenoic acid

Question 14

What EKG changes do you see in hyperkalemia?

Answer 14

peaked t waves, loss of p waves, wide QRS, st segment depression

Question 15

what happens to undigested lactose?

Answer 15

20% reaches colon

Question 16

what is another name for triene to tetraene ratio?

Answer 16

Mead acid: arachindonic acid

Question 17

What is average energy expenditure of FETUS per day?

Answer 17

35 to 55 kcal/kg/day

Question 18

What is difference between whey and casein?

Answer 18

Whey has greater cysteine and less methionine

Question 19

What is largest amino acid in human milk?

Answer 19

Glutamine

Question 20

What is only electrolyte that is actually higher in mature breast milk compared to colostrum?

Answer 20

Calcium

Question 21

What is the predominant carbohydrate in breast milk?

Answer 21

Lactose

Question 22

Where are lipids and amino acids absorbed in GI tract?

Answer 22

jejunum

Question 23

Where are sodium, chloride and Potassium absorbed?

Answer 23

Large intestine

Question 24

Why are newborns predisposed to Vitamin K deficiency?

Answer 24

lack of GI microorganisms that synthesize Vitamin K
immature newborn liver
some maternal medications
(some breastfed infants have lower vitamin k, than cow milk formula)

Question 25

Whey to Caesin Ratio of following: Colostrum Mature Milk Casein Formulas Whey Formulas

Answer 25

Colostrum 80:20 Mature milk 55:45 Casein formulas 20:80 Whey formula 80:20

Question 26

Why do amino acid solutions have decreased tyrosine and cysteine?

Answer 26

becaue they both have decreased solubility

Question 27

What are disadvantages of MCTs?

Answer 27

Not important for tissue building Increased MCT decreases availablity of long chain FA's

Question 28

What are signs of essential fatty acid deficiency?

Answer 28

dermatitis, thrombocytopenia, failure to thrive

Question 29

What are the essential amino acids?

Answer 29

Lysine, phenylanaline, threonine, tryptophan, methionine, histidine branched cain: valine, leucine, isoleucine

Question 30

What are the ketogenic amino acids?

Answer 30

leucine and lysine

Question 31

What does Cysteine do in TPN?

Answer 31

optimizes the addition of Calcium and Phos by lowering PH, and allowing more Ca and Phos to be added without precipitating.

Question 32

What is energy content of CHO, protein, FAT

Answer 32

CHO 1g = 3.4kcal Protein 1g = 4kcal FAT 1g = 9kcal

Question 33

What is most important amino acid that assists in metabolism of fat?

Answer 33

Carnitine

Question 34

why is high lipid rate limited in first few days of TPN?

Answer 34

prevent hyperglycemia

Question 35

All enzymes that use phosphorus as energy source require _______ for activation?

Answer 35

Magnesium

Question 36

Why are infants on TPN fasely identified on NBS as having carnitine deficiency?

Answer 36

not enough carnitine can be put in TPN improves after feeds introudced

Question 37

What will happen if you introduce cow's milk early?

Answer 37

iron deficiency anemia, bleeding also lack essential fatty acids and LCPUFas

Question 38

What percent of infant diet should be fat, CHO and protein?

Answer 38

Question 39

What are the essential amino acids?

Answer 39

Question 40

What is the most important man amino acid that aids in metabolism of fat?

Answer 40

Carnitine

Question 41

When do preterm infant deplete their iron stores compared to term infants?

Answer 41

Preterm infants deplete iron stores at 2-3 months Term 4-6 months

Question 42

Water soluble vitamins require what kind of transport across placenta?

Answer 42

active transport

Question 43

Fe content in human milk is less than Fe content in formula, but is preferred, why?

Answer 43

Fe in human milk is better absorbed

Question 44

What happens with vitamin Deficiency in A, B1, B2, B6, Biotin, C, and D

Answer 44

Question 45

Which components of intralipid is associated with liver cholestasis

Answer 45

phytosterols in soy based formula of PN