Nutrition/Fluids Flashcards
3 cases where you can have fictitious hyponatremia
hypercholesteremia
hyperglycemia
hyperlipidemia
How do you diagnose Essential Fatty Acid Deficiency?
triene /tetratene ratio 0.4, or 0.2 depending on site
How Much Na in NA Bolus?
1.5 meq Na per 10 ml/kg
Major extracellular buffers, acid-base?
HCO3, phosphates, proteins,
major
buffer system is CO2 that crosses brain, and stimulates chemoreceptors to increase respiratory drive
Pitiocin can cause what electrolyte derangement in newborn?
Hypernatremia
Signs of Vitamin E deficiency?
anemia, hemolysis, THROMBOCYTOSIS, neurologic deficits
Vitamin B1 Deficiency (Thiamine) Is associated with what disorders?
pyruvate dehydrogenase complex deficiency, and maple syrup urine disease
what are signs of B12 deficiency?
poor weight gain, anemia, methylmalonic acidemia and homocystinuria
What are some benefits of lactose?
Enhances absorption of calcium and magnesium
promotes intestinal growth of lactobacilli
short-chain glucose polymer more easily absorbed than long chain
What are the 6 trace elements?
Chromium, Copper, Iron, Manganese, Selenium, zinc
What are the major intracellular buffers?
bone apatite
Hgb
orghanic phosphates
What are the two essential fatty acids?
Lenoleic acid and Alpha linolenic acid
What critical fatty acids are transferred across placenta?
Arachionic acid and docosahexaenoic acid
What EKG changes do you see in hyperkalemia?
peaked t waves, loss of p waves, wide QRS, st segment depression
what happens to undigested lactose?
20% reaches colon
what is another name for triene to tetraene ratio?
Mead acid: arachindonic acid
What is average energy expenditure of FETUS per day?
35 to 55 kcal/kg/day
What is difference between whey and casein?
Whey has greater cysteine and less methionine
What is largest amino acid in human milk?
Glutamine
What is only electrolyte that is actually higher in mature breast milk compared to colostrum?
Calcium
What is the predominant carbohydrate in breast milk?
Lactose
Where are lipids and amino acids absorbed in GI tract?
jejunum
Where are sodium, chloride and Potassium absorbed?
Large intestine
Why are newborns predisposed to Vitamin K deficiency?
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)
Whey to Caesin Ratio of following:
Colostrum
Mature Milk
Casein Formulas
Whey Formulas
Colostrum 80:20
Mature milk 55:45
Casein formulas 20:80
Whey formula 80:20
Why do amino acid solutions have decreased tyrosine and cysteine?
becaue they both have decreased solubility
What are disadvantages of MCTs?
Not important for tissue building
Increased MCT decreases availablity of long chain FA’s
What are signs of essential fatty acid deficiency?
dermatitis, thrombocytopenia, failure to thrive
What are the essential amino acids?
Lysine, phenylanaline, threonine, tryptophan, methionine, histidine
branched cain:
valine, leucine, isoleucine
What are the ketogenic amino acids?
leucine and lysine
What does Cysteine do in TPN?
optimizes the addition of Calcium and Phos by lowering PH, and allowing more Ca and Phos to be added without precipitating.
What is energy content of CHO, protein, FAT
CHO 1g = 3.4kcal
Protein 1g = 4kcal
FAT 1g = 9kcal
What is most important amino acid that assists in metabolism of fat?
Carnitine
why is high lipid rate limited in first few days of TPN?
prevent hyperglycemia
All enzymes that use phosphorus as energy source require _______ for activation?
Magnesium
Why are infants on TPN fasely identified on NBS as having carnitine deficiency?
not enough carnitine can be put in TPN
improves after feeds introudced
What will happen if you introduce cow’s milk early?
iron deficiency anemia, bleeding
also lack essential fatty acids and
LCPUFas
What percent of infant diet should be
fat, CHO and protein?
What are the essential amino acids?
What is the most important man amino acid that aids in metabolism of fat?
Carnitine
When do preterm infant deplete their iron stores
compared to term infants?
Preterm infants deplete iron stores at 2-3 months
Term 4-6 months
Water soluble vitamins require what kind of transport across placenta?
active transport
Fe content in human milk is less than Fe content in formula, but is preferred, why?
Fe in human milk is better absorbed
What happens with vitamin Deficiency in
A, B1, B2, B6, Biotin, C, and D
Which components of intralipid is associated with liver cholestasis
phytosterols in soy based formula of PN
