Pediatrics

Question 0

Essential amino acids obtain from diet

Answer 0

Histidine-for growth

Taurine-for vision&hearing

Question 1

Carbohydrates

Answer 1

50% of total calories

Lactose primarily

Preterm, African American , Asian lactase deficient

Question 2

Lipids

Answer 2

Do not restrict fats

Needed for rapid brain development
In first 2 years

Linoleic acid needed

DHA, ARA polyunsaturated fatty acids
For brain and eye development, especially for premature

Question 3

Galactooligosaccarides

Answer 3

Good for beneficial flora growth

May increase diarrhea, flatulence

Question 4

Preterm supplementation

Answer 4

Give multivitamin and minerals

Question 5

Vitamin D

Answer 5

400 IU/day

Concern if 3rd birth
Dark skin
Sun exposure

Question 6

Iron

Answer 6

Deficient at 1 year old.

Fe stores exhausted at 6 months

Give iron-fortified cereal/elemental

VitC enhances Fe absorption

Question 7

Breastfeed

Answer 7

Exclusively for first 6 months

Mother child bond
Better school performance
Cost effective
Decrease risk of obesity, diabetes, asthma, cancer, infections

IgA, lactoferrin, lysozymes

Risk transmission of drugs&diseases

Question 8

Milk based formulas

Answer 8

Nonfat cow milk
Vegetable oil (corn, sunflower for better fat absorption)
Lactose CHO

Question 9

Soy based formula

Answer 9

Vegetarian families
Lactose intolerant
IgE allergy to cows milk

High renal solute load
Aluminum may lead to osteopenia
Manganese may lead to neuro sympts

Not for protein induced enteropathy, preterm infants, cystic fibrosis

Question 10

Pre-thickened milk based formula

Answer 10

Infants with GERD
Thickened with maltodextrin and amylopectin

100x viscous in stomach to keep contents in stomach

Can give H2RA or PPI

Question 11

Casein hydrolysate-based formula

Answer 11

For milk protein enteropathy

Hypoallergenic
Medium chain triglycerides MCTs!

Expensive

Question 12

Enfamil pregestimil

Answer 12

Hydroxylate formula/MCT

For Short bowel syndrome
Steatorrhea
Cystic fibrosis

Question 13

Enfamil nutramigen

Answer 13

Hydrosylate formula with amino acids

For Protein allergy
Severe diarrhea

Question 14

Similac alimentum

Answer 14

Hydrosylate formula

For pancreatic insufficiency including cystic fibrosis

Question 15

Amino acid based

Answer 15

If intolerant to casein-hydrolysate formulas

Hypoallergenic with 100% free amino acids

Question 16

Milk fortifiers

Answer 16

For low birth weight infants

Added protein, calcium, phosphorus

Add to breast milk for premature

Question 17

Underfeeding

Answer 17

Restless, crying, failure to gain weight

Constipation, can’t sleep, dry wrinkled skin

Question 18

Overfeeding

Answer 18

Regurgitation, vomiting, diarrhea

Question 19

Satiety signs

Answer 19

4-12: draw head from nipple, falls asleep, bites nipple

16-24 weeks: fusses or cries
Obstructs mouth with hands

Question 20

Feedings

Answer 20

6-8 in first month

3-4 after 4 months

Quantity of milk/feeding increases with age

Question 21

Formula preparation

Answer 21

Wash hands and tops of formula cans

Boil well water for 5 minutes and cool

Run tap water for 2 minutes to clear lead from pipes

Test temperature on back of hand

Shake bottle before feeding

Can store unused/ready-to-use in refrigerator for up to 48 hours

Question 22

Too concentrated

Answer 22

Diarrhea
Hypernatremia
Renal failure

Question 23

Too diluted

Answer 23

Irritability
Hyponatremia
Coma/brain damage

Question 24

4-7 months

Answer 24

Introduce fruits Cereals Vegetables

Question 25

7-10 months

Answer 25

Mashed fruits and vegetables | Finely cut and chopped meat and poultry

Question 26

9-12 months

Answer 26

Soft combo foods Casseroles, Mac and cheese Spaghetti Yogurt

Question 27

1-2 years

Answer 27

Drink whole cow milk Do not use in first year or else Iron deficiency anemia Impaired development High renal solute load 2% if >2 years (no fat restrictions until 2 years)

Question 28

Year 2

Answer 28

Reduction of caloric intake due to decelerating rate of growth Likes and dislikes form

Question 29

Poor eating habits for children

Answer 29

Poor hygiene, sleep, insufficient meal time (allow 10-20min at table) Causes fatigue, limited attention span and poor performance in school Pale complexion, susceptible to infection

Question 30

Good eating habits

Answer 30

10-20 minutes at the table, not playing or walking Offer milk instead of juice if thirsty Whole milk until 2 years old

Question 31

Overweight

Answer 31

85-95% BMI percentile Or 30kg/m2

Question 32

Obese

Answer 32

BMI>95% > 30kg/m2

Question 33

Infant vitals

Answer 33

Faster respiratory and heart rate | Lower blood pressure 80/45 +/- 15

Question 34

Fever

Answer 34

Oral>99.5F or 37.5C Rectal>100.4 or 38C

Question 35

Sleep position

Answer 35

Remove all fluffy and loose bedding Keep baby's face uncovered

Question 36

Teething

Answer 36

6-36 months Restless, thumb sucking, decreased appetite Give alcohol free topical anesthetic Benzocaine baby gel Chew on firm object wrapped in soft cloth

Question 37

Parents avoid smoking

Answer 37

Increased sudden infant death syndrome Ear infection Asthma Allergy Lower respiratory infection