Pediatrics - Israel

Question 1

how much should infant weight increase in 4-6 months?

Answer 1

birth weight should double

Question 2

how much should infant weight increase in 12 months

Answer 2

birth weight should triple

Question 3

how much should infant length increase by 12 months

Answer 3

birth length should increase by 50%

Question 4

What growth chart should be used for age <2?

Answer 4

World Health Organization

Question 5

What growth chart should be used for ages 2-20?

Answer 5

CDC

Question 6

malnutrition definition

Answer 6

deficiencies OR excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization

Question 7

results of malnutrition

Answer 7

wasting, stunting, underweight, obesity, micronutrient deficiencies, refeeding syndrome

Question 8

how to recognize failure to thrive (growth faltering)

Answer 8

fall of 2 major percentiles, and weight below the 3-5th percentile

Question 9

what are causes of malnutrition

Answer 9

inadequate caloric intake, inadequate absorption, or excessive energy expenditure

Question 10

what is the caloric requirement for an infant?

Answer 10

85-120+ kcal/kg/day
(85-105 for <6 months) (100-120+ for preterm infant)

Question 11

what is the caloric requirement for a 7-12 year old

Answer 11

50-75 kcal/kg/day

Question 12

what is the caloric requirement for a 12-18 year old

Answer 12

30-50 kcal/kg/day

Question 13

what is the caloric requirement for a 6-12 month old?

Answer 13

80-100 kcal/kg/day

Question 14

what is the caloric requirement for a 1-7 year old?

Answer 14

75-90 kcal/kg/day

Question 15

what is the protein requirement for a low birth weight/ pre-term infant

Answer 15

3-4g/kg/day

Question 16

what is the protein requirement for an infant (1-12 months)

Answer 16

2-3g/kg/day

Question 16

what is the caloric requirement for children?

Answer 16

1-10 years old:
1-2 g/kg/day

Question 17

what is the caloric requirement for adescolents?

Answer 17

0.8-1.5 g/kg/day

Question 18

AAP recommendations for breastfeeding (WHO recommendations?)

Answer 18

exclusive bf for 6 months, continue up to 1 year old (WHO suggests up to 2 years)

Question 19

Breastfeeding advantages for newborns

Answer 19

optimal nutrients, decreased risk oof infections and immune-mediated diseases, psychological and cognitive advantages

Question 20

breastfeeding advantages for mothers

Answer 20

decreased post-partum bleeding, faster time to pre-pregnancy weight, decreased risk of breast and ovarian cancer, increase child spacing, mother-infant bond

Question 21

what is the caloric density of breast milk?***

Answer 21

20 kcal/ounce

Question 22

What are contraindications to breast feeding?

Answer 22

active maternal TB, HIV positive, human t-lymphotropic virus, untreated brucellosis, ebola infection, use of illicit drugs, and medications

Question 23

Drugs to avoid in breastfeeding

Answer 23

immunosuppressants, chemo, radioactive agents, others that can harm the infant

Question 24

drugs that reduce milk production

Answer 24

ergots, decongestants, antihistamines

Question 25

what are characteristics of drugs that increase absorption into breastmilk?

Answer 25

non-ionized
small molecular weight
low protein binding
high lipid solubility
long t1/2
low Vd

Question 26

what are characteristics of drugs that decrease absorption into breastmilk?

Answer 26

ionization
large molecular weight
high protein binding
low lipid solubility
short t1/2
high Vd

Question 27

what are indications for formula feeding?

Answer 27

substitute or supplement for mothers who cannot/ do not breastfeed
infants with human milk intolerance
maternal infection transmissible through breastfeeding
maternal chemotherapy
infants failing to gain weight

Question 28

what are human milk fortifiers

Answer 28

increase calories, minerals, vitamins, and protein
available as liquid and powder
increase calorie content to 22-28 kcal/oz

Question 29

term formulas info

Answer 29

provide 19-20 kcal/oz
carb source is lactose
contains cows milk protein
all infants should get iron-fortified formula

Question 30

what is a typical feeding schedule for term-healthy infants

Answer 30

6-9 feedings per day
initial breastfeeding 8-12 times per day

Question 31

Vitamin D3 (Cholecalciferol) concentration

Answer 31

400 IU = 10mcg

Question 32

indications for cholecalciferol for premature babies

Answer 32

premature neonates <1.5kg = 5 mcg daily
premature neonates >1.5 kg = 5-10mcg daily

Question 33

indications for D3 in term infants

Answer 33

breastfed: 10mcg daily
formula fed: 10mcg daily until receiving 1000mL formula/day

Question 34

iron supplementation indications

Answer 34

premature: 2mg/kg/day
term infants: not required
term infants w/ deficiency: 3mg/kg/day

Question 35

zinc deficiency symptoms

Answer 35

dermatitis, diarrhea, infections, altered wound healing

Question 36

zinc concentration in zinc sulfate

Answer 36

44mg zinc sulfate = 10mg elemental

Question 37

what patients may need zinc supplementation

Answer 37

premature, prolonged exclusive breastfeeding >6 months, parenteral nutrition, IBD, vegan or veggie diet, malnutrition

Question 38

when to initiate complementary foods?

Answer 38

~6 monthsh

Question 39

do’s of introducing new foods

Answer 39

1 food every 4-5 days
emphasize all food groups
gradually increase servings

Question 40

don’ts of introducing new foods

Answer 40

never put anything other than breast milk or formula in a bottle
never give to children <1 year: honey, cows milk, choking hazards, potential allergens

Question 41

fluid requirements

Answer 41

up to 10kg = 100ml/kg
10-20kg = 1000mL + 50 mL/kg for every kg >10
>20 = 1500mL to 20mL/kg for every kg>20

Question 42

mL/oz conversion

Answer 42

1 ounce is 30mL

Question 43

how to calculate caloric need for patients with failure to thrive

Answer 43

use 50th percentile weight to calculate caloric need