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Pediatrics > Pediatric Nutrition > Flashcards

Pediatric Nutrition Flashcards

1
Q

Immunoglobulin that is high in breastmilk?

A

IgA

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2
Q

The whey-to-casein ratio in mature human milk

A

3:2

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3
Q

Breastmilk is initiated within ____

A

1-4 hours after birth

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4
Q

____ mL intake in the first week of life

A

60-90 mL/feeding

6-9 feedings/24 hours

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5
Q

[Type of Breastmilk]

High lactose, high protein, watery

A

Foremilk

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6
Q

[Type of Breastmilk]

High fat, creamy

A

Hindmilk

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7
Q

Colostrum is secreted within ___ days

A

0 to 7 days

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8
Q

What are the IgG/protective factors that are high in breastmilk

A
  1. Lactoferrin

2. Lysozyme

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9
Q

Colostrum has low ___

A
  1. Fat

2. Carbohydrates

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10
Q

Mature milk will be produced at ___ DOL

A

10-14

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11
Q

[Casein to whey ratio]

Early milk

A

10:90

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12
Q

[Casein to whey ratio]

mature milk

A

40:60

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13
Q

[Casein to whey ratio]

late lactation

A

50:50

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14
Q

Fat globules bound by membranes are rich in ____

A
  1. Phospholipids

2. Cholesterol

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15
Q

Formula milk has a higher ____ compared to breastmilk

A
  1. Iron
  2. Vitamin D
  3. Vitamin K
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16
Q

What is the definitive test to diagnose pediatric GERD?

A

esophageal pH probe

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17
Q

Esophageal pH monitoring of __ which part of the esophagus

A

distal esophagus

NV: <5-8% of total monitored time

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18
Q

Patients with GERD, patient shall be position ____ carried position

A

prone or upright

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19
Q

What are the symptoms of GERD in infants

A
  1. Regurgitation
  2. Excessive crying
  3. Irritability
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20
Q

What are the symptoms of GERD in children

A
  1. Vomiting
  2. Food refusal/feeding disturbances/anorexia
  3. Persisting hiccups
  4. Sandifer syndrome
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21
Q

What are the contraindications to breastfeeding?

A
  1. Galactosemia
  2. Septicemia
  3. Active TB
  4. Breast CA
  5. Malaria
  6. Substance abuse
  7. Severe neurosis or psychosis
  8. HIV
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22
Q

Mother is no longer infectious after ____ of TB treatment

A

2 weeks after

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23
Q

HIV mother can breastfeed in times where no safer alternative is available provided that

A
  1. Shortest possible duration

2. Exclusive breastfeeding

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24
Q

[Micronutrient deficiency]

Excematous, dry, scaly or psoriasiform, perioral, sacral, perianal areas

A

Zinc

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25
Q

[Micronutrient deficiency]

generalized scaly dermatitis
alopecia

A

Essential fatty acids

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26
Q

[Micronutrient deficiency]

edema, erythema, burning of sun exposed skin on the face, neck, hands

diarrhea, dementia

A

Pellagra/Niacin

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27
Q

[Micronutrient deficiency]

alopecia with neurological symptoms

A

Biotin / Vit B7

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28
Q

[Micronutrient deficiency]

Night blindness, xerosis

A

Vit A

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29
Q

[Micronutrient deficiency]

perifollicular erythema and hemorrhage; bleeding swollen gums

A

Vit C

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30
Q

What is the bioavailability of vitamin A in breastmilk?

A

> 90%

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31
Q

Bone changes in pediatric patients with Vitamin A deficiency

A

Faulty epiphyseal bone formation, defective tooth enamel

32
Q

Vitamin ____ in human milk that depends on maternal sunlight exposure

A

Vitamin D

33
Q

Facial exposure to sunlight of ____ hours for at least once a week is is sufficient for Vit D

A

2 hours

30 mins with bare arms and legs

34
Q

Rickets appear in children only before ___

A

fusion of the epiphyses

increase in the circumference of the growth plate and metaphysis

35
Q

___ is a horizontal depression along the lower anterior chest due to pulling of softened ribs by the diaphragm during inspiration due to Vit D deficiency

A

Harrison groove

36
Q

___ is a result of widening of costochondral junctions due to Vit D deficiency

A

Rachitic Rosary

37
Q

___ deformity

valgus deformity of 1 leg with varus deformity of the other leg

A

Windswept deformity

38
Q

What comprise Stoss Therapy?

A

Vitamin D 300,000-600,000 IU IM or OD 2-4 doses over 1 day

39
Q

Vitamin that has a constant value in mature milk

A

Vitamin E

0.32 mg tocopherol equivalents/100mL

40
Q

Deficiency in Vitamin E can lead to

A
  1. RBC hemolysis in premature infacnts
  2. Loss of neural integrity
  3. Posterior column and cerebellar dysfunction
  4. Pigment retinopathy
41
Q

What is the vitamin K content of breast milk

A

0.1-0.4 ug/100mL

42
Q

What are the possible causes of early vitamin K deficiency of the newborn?

A
  1. Poor transfer of vitamin K across the placenta
  2. Inadequate intake during first few days of life
  3. No intestinal synthesis of vitamin K2
43
Q

[Micronutrient deficiency]

angular cheilosis (perleche), glossitis (magenta tongue)

A

riboflavin (vitamin B2)

44
Q

Vitamin deficiency associated with long term use of high estrogen OCP by mothers

A

Vitamin B6

45
Q

___ mg/day of B6 supplementation is needed by mothers taking high estrogen OCPs to prevent neonatal deficieny

A

20 mgday

46
Q

___ is a water soluble vitamin bound to protiens in the whey fraction of breastmilk

A

Vitamin B12 and B9

47
Q

___ mg of Vitamin C is requried to prevent scurvy

A

8 mg

48
Q

____ rosary

seen in Vitamin C at the costochondral junction and depression of the sternum; sharper beads compared to rachitic

A

Scorbutic rosary

49
Q

[Micronutrient deficiency]

perifollicular hemorrhages, hyperkeratosis of hari follicles, corkscrew hair

XRAY: distal ends of long bones with ground grass appearance

A

Vitamin C deficieny

50
Q

____ mg of vitamin C supplemented OD/IV are preferable to ensure more rapid and complete cure of deficiency

A

100 to 200mg

51
Q

Iron in breastmilk is sufficient to meet infants iron needs to how many months

A

6-12 months

Iron is lesser in milk but is more bioavailable

52
Q

The fetal stores of Zinc that can supply for 6 months are accumulated in the ___ trimester of pregnancy

A

Third trimester

53
Q

Iodine accumulates in what part of the mother

A

Mammary gland

54
Q

What vitamins and minerals are significantly affected by maternal status?

A
  1. Vitamin D

2. Iodine

55
Q

[Micronutrient deficiency]

Perleche

A

Vitamin B2

56
Q

[Micronutrient deficiency]

White line on end of shaft

A

Vit C

57
Q

[Micronutrient deficiency]

Absence of metaphyseal changes

A

Vit A toxicity

58
Q

[Micronutrient deficiency]

Casal necklace, gloves and boots

A

Vit B3

59
Q

[Micronutrient deficiency]

brawny swelling, dry skin, seborrhea, pruritus, painful extremities

A

Hypervitaminosis A

60
Q

[Micronutrient deficiency]

corn as staple

A

Niacin

61
Q

[Growth Chart]

Height for age measures ___

A

Linear growth

Cumulative impact

62
Q

[Growth Chart]

Weight-for-height measures

A

Wasting

Acute malnutrition

63
Q

[Growth Chart]

MUAC cut off for wasting

A

11.5-12.5

64
Q

[Growth Chart]

MUAC cut off for severe wasting

A

<11.5

65
Q

What are the parameters that can assess acute malnutrition

A
  1. WFL or WFH
  2. MUAC
  3. BMI
66
Q

[Diagnose]

Growth failure
edema
hair changes
mental changes
flaky pain
fatty liver
A

Kwashiorkor

67
Q

[Diagnose]

Growth failure
Wasting
no edema
no mental changes
no dermatosis
good appetite
Monkey-like face
no hepatomegaly
A

Marasmus

68
Q

Severe acute malnutrition is diagnosed by ____

A

WFL or height below -3SD

based on CGS

69
Q

In children ages 6-59 months, a MUAC of ____ mm denotes extreme thinness

A

<115mm

70
Q

What are the immediate goals in treating malnourished children?

A

Prevent hypoglycemia, hypothermia, dehydration

71
Q

What are the criteria for inpatient care of patients with SAM?

A
  1. Severe edema
  2. MUAC <115 mm
  3. Anorexia
  4. Clinically unwell
  5. Not alert
72
Q

What is the electrolyte abnormality in patients with refeeding syndrome?

A

1 Hypokalemia

  1. Hypophosphatemia
  2. Hypomagnesemia
73
Q

What is the hallmark of refeeding syndrome?

A

Severe hypophosphatemia

PO4 /< 0.5mmol/L

74
Q

Overweight children belongs to what BMI percentile for age?

A

> / 95th

75
Q

At >85th percentile, what are the possible associated diseases of the child

A
  1. Hypercholesterolemia
  2. Hypertriglyceridemia
  3. Low HDL
  4. Abdominal central obesity
76
Q

___ syndrome

Extreme exogenous obesity leading to severe cardiorespiratory distress with alveolar hypoventialtion

A

Pickwickian syndrome

Pediatrics (15 decks)

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