Pedia: Nutrition, IMCI, Neuro, Infectious, Derma

Question 1

Energy requirements

Sufficient to prevent ketosis and hypoglycemia

Answer 1

5g/kg/day

Question 2

Energy requirements

Sufficient to prevent ketosis and hypoglycemia

Answer 2

5g/kg/day

Question 3

Energy requirements

Essential fatty acids

Answer 3

0.5-1.0g/kg/day

Question 4

Function of LC-PUFA DHA?

Answer 4

Retinal photoreceptor membranes

Visual and cognitive development

Question 5

What amino acids are essential for LBW infants?

Answer 5

CAT

Cystine, arginine, taurine

Question 6

Water requirement for infants

Answer 6

75-100ml/kg/day

Question 7

Stages of lactation

Answer 7

Day 0-7: Colostrum
Day 7-10: Transitional milk
Day 10 onwards: Mature milk
Upon breastfeeding decrease: Involutionary milk

Question 8

Breastmilk characteristics

High yield card

Answer 8

Low casein-whey ratio
Bioactive components: IgA, WBCs, Lysozyme, milk lipids, lactoferrin
Maturative components: EGF, Cytokines, BSSL, Amylase, hormones

Question 9

Breastmilk characteristics

Most abundant fatty acid

Answer 9

palmitic acid & oleic acid

Question 10

Breastmilk characteristics
function of B-casein

Answer 10

improves absorption by forming micelles in the stomach

Question 11

Breastmilk characteristics

Nucleotides and carbohydrates

Answer 11

Nucleotides 20% of NPN

Carb: lactose - enhances absorption of Ca, Fe, Mn

Question 12

Breastmilk characteristics

Bifidus factor

Answer 12

Nitrogen containing carbohydrate

Promotes gut colonization by lactobacillus

Question 13

Oval or triangular spot of keratinized tissue in the conjunctiva

Answer 13

Bitot’s spots

Question 14

Energy requirements

Essential fatty acids

Answer 14

0.5-1.0g/kg/day

Question 15

Function of LC-PUFA DHA?

Answer 15

Retinal photoreceptor membranes

Visual and cognitive development

Question 16

What amino acids are essential for LBW infants?

Answer 16

CAT

Cystine, arginine, taurine

Question 17

Water requirement for infants

Answer 17

75-100ml/kg/day

Question 18

Stages of lactation

Answer 18

Day 0-7: Colostrum
Day 7-10: Transitional milk
Day 10 onwards: Mature milk
Upon breastfeeding decrease: Involutionary milk

Question 19

Breastmilk characteristics

High yield card

Answer 19

Low casein-whey ratio
Bioactive components: IgA, WBCs, Lysozyme, milk lipids, lactoferrin
Maturative components: EGF, Cytokines, BSSL, Amylase, hormones

Question 20

Breastmilk characteristics

Most abundant fatty acid

Answer 20

palmitic acid & oleic acid

Question 21

Breastmilk characteristics
function of B-casein

Answer 21

improves absorption by forming micelles in the stomach

Question 22

Breastmilk characteristics

Nucleotides and carbohydrates

Answer 22

Nucleotides 20% of NPN

Carb: lactose - enhances absorption of Ca, Fe, Mn

Question 23

Breastmilk characteristics

Bifidus factor

Answer 23

Nitrogen containing carbohydrate

Promotes gut colonization by lactobacillus

Question 24

Progressive neurodegenerative condition with colorless friable hair with seizures and MR

Answer 24

Menkes Kinky Hair Syndrome

Pathophysiology: Copper deficiency

Question 25

Disease of bone growing before fusion of epiphyses

Answer 25

Rickets

Question 26

Rickets
Widening of costochondral junction:
Horizontal depression along the low ant. chest:

Answer 26

Rachitic rosary

Harrison’s groove

Question 27

Treatment of Rickets

Answer 27

Stoss therapy

Vit. D 300,000 - 600,000 IU orally or IM then daily vit. D intake.

Question 28

Loss of neural integrity, RBC hemolysis in premature infants, and pigmentary retinopathy are seen in deficiency of what vitamin?

Answer 28

Vit. E

Question 29

Scorbutic rosary + bluish swelling of incisors + corkscrew hair

Answer 29

Scurvy (Vit. C deficiency)

Question 30

Breastmilk is known to transmit what viruses

Answer 30

CMV
Rubella
Hep. B
HTLV-1
HSV
HIV

Question 31

Adequacy of breastfeeding when the infant…

Answer 31

1) is satisfied
2) sleeps for 2-4 hours after
3) gains weight adequately
4) wets at least 6 diapers a day

Question 32

Guidelines for storing milk

Answer 32

Room temp: 4-6 hours only
Ref (<4C): 3-8 days
Freezer (-20 to -18C): 6-12 months

Question 33

Warming milk

Answer 33

DO NOT REFREEZE after thawing
Freezer: put in ref overnight
Ref: warm under running water

Question 34

WHO Z-Scores:

Height for age

Answer 34

Assesses skeletal growth

Abn: stunting/chronic malnutrition

Question 35

WHO Z-Scores:

Weight for height

Answer 35

Measure of acute malnutrition

Wasting

Question 36

WHO Z-Scores:

Weight for age

Answer 36

Less clinical significance compared to other 2.

Question 37

Marasmus vs. Kwashiorkor

Answer 37

M: loss of skin turgor, wrinkled skin, loss of SQ fat,
inadequate caloric intake
starvation type diarrhea

K: insufficienct intake of protein
more serious and prevalent
secondary immunodeficiency
hyperchromotrichia
decreased albumin = edema

Question 38

Criteria for failure to thrive

Answer 38

Child < 5th percentile
Growth patterns crossing two major percentiles within 6 months
Growth velocity less than normal for age

Question 39

Role of medications in childhood obesity?

Answer 39

Marginal value with potential and unclear risks

Question 40

IMCI Main symptoms

Answer 40

1) Cough
2) Diarrhea
3) Throat problem
4) Ear problem
5) Fever, measles, malaria

Question 41

Dehydration PLAN C

Answer 41

PLR/PNSS 100ml/kg IV
Infants: 30ml/kg in 1 hour then 70ml/kg in 5 hours
Children: 30ml/kg in 30 minutes then 70ml/kg in 2 1/2 hours
Reassess every hour

Question 42

Dehydration PLAN B

Answer 42

ORS over a 4 hour period
weight x 75 mL
give extra fluid, zinc, continue feeging

Question 43

Dehydration PLAN A

Answer 43

Home treatment
ORS + Extra fluid
Zinc 20mg/tab: 2 years: 1 tab x 14 days