11, 12

Question 1

4 features of failure to thrive

Answer 1

1. delayed motor skills
2. language acquisition
3. social skills
4. refusal to eat

Question 2

organic causes of failure to thrive (7)

Answer 2

1. infection
2. anemia
3. congenital heart defect
4. malabsorption syndromes
5. heart and renal problems
6. endocrine problems
   7 intellectual development delay

Question 3

non- organic cause if more predominate than organic (4)

Answer 3

1. lack of food
2. poor feeding
3. over- dilute of formula
4. breast milk is not enough if women is under stress and malnutrition

Question 4

non organic causes of FTT (3)

Answer 4

1. abnormal development and behavior of child
2. distorted relationship between care- giver and child
3. may be associated with deprived background or high income parents with distorted health beliefs

Question 5

3 general patterns of FTT

Answer 5

1. decreased head circumference
2. normal HC, weight impaired, height normal
3. normal HC, lower wt and lowered ht

Question 6

tx of extreme FTT

Answer 6

1. hospitalization
2. tube feeding
3. 150% calories
4. individualized medical and social support

Question 7

nutrient needs determined individually according to 3

Answer 7

1. extent and intensity of the pubertal growth spurt
2. gender difference in growth and body composition change
3. differences among individuals in terms of the timing of the pubertal growth spurt

Question 8

Tanner’s sexual maturation rating

Answer 8

standards used clinically to describe the stage of development

Question 9

what is SMR based on

Answer 9

the development of primary and secondary sexual characteristics

Question 10

SMR1

Answer 10

rapid growth but no discernable sexual changes

Question 11

timing of bone mass and skeletal growth

Answer 11

SMR2 in females

SMR3-4 in males with 40% of peak bone mass

Question 12

Tanner breast stage 3

Answer 12

the timing of the pubertal growth spurt

Question 13

peak weight accumulation for female

Answer 13

6-9 mons before peak height velocity (42% of adult mass)

Question 14

peak weight accumulation for male

Answer 14

same time as peak height velocity (51% of adult mass)

Question 15

LBM accumulation in female

Answer 15

peaks at SMR 3-4, shortly after height gain complete

Question 16

LBM accumulation in male

Answer 16

peaks at SMR 5, after stature gain is complete

Question 17

female growth characteristics (5)

Answer 17

1. sexual maturation takes place earlier, then growth stops
2. timing depends on environmental factors (menarche timing decreased by 3-4 months/ decade)
3. menarche tends to occur 1 year after breast development
4. later menses associated with longer period of growth
5. sexual maturation stops, linear growth stops

Question 18

male growth characteristics (4)

Answer 18

1. growth can continue after sexual maturation has ended
2. greater growth spurt: more prolonged, more intense, occurs at a later year –> longer total period of growth
3. great increase in lungs, heart and abdominal viscera
4. combined actions of several hormones

Question 19

how much weight can be reached in adolescence

Answer 19

50% of adult weight

Question 20

final stage of skeletal growth

Answer 20

epiphyses fuse at the end of long bone with main portion of bone and growth in stature ceases

Question 21

why does male require high nutrient and calorie during growth spurt

Answer 21

1. LBM/ muscle increase in males –> muscle has higher metabolism rate
2. they have intense, prolonged, growth period

Question 22

what is the critical female body mass and body fat composition for onset of menses

Answer 22

47.8kg (105lb)

17% of body fat

Question 23

what is time of peak height velocity corresponded to

Answer 23

maximum fat loss and muscle mass increase in upper arm

Question 24

12 external factors on influencing the eating behavior

Answer 24

1. fast food
2. food fads
3. poor nutrition knowledge
4. sociocultural
5. neurochemical
6. psychological
7. food availability
8. skipped meal
9. role of mass media
10. parenting practise
11. personal experience
12. smoking

Question 25

6 internal factors on influencing the eating behavior

Answer 25

1. physiological needs and characteristics 2. body image 3. self- concept 4. personal values and beliefs 5. psychosocial development 6. health

Question 26

vicious cycle on obesity (8)

Answer 26

1. passivity, dependence 2. teased by peers and adults 3. little physical activity 4. food as source of comfort 5. social isolation 6. minimal energy expenditure 7. real or imagined rejection 8. poor self- image

Question 27

malnutrition in female

Answer 27

absence of >= 3 menstrual cycles

Question 28

five characteristic of anorexia nervosa

Answer 28

1. intense fear of weight gain 2. disturbed self- image 3. denial of recognizing food needs 4. desired body image of extreme thinness 5. anxious, fearful and dependent personality

Question 29

anorexia nervosa diagnostic criteria

Answer 29

15-20% of below expected weight

Question 30

two types of anorexia nervosa

Answer 30

1. restrictive type: no purging behavior (no vomiting, mo laxatives) 2. binging/ purging type: binging followed by vomiting, diuretics, or laxatives

Question 31

DSM-5 of anorexia nervosa

Answer 31

1. restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health 2. intense fear of gaining weight, becoming fat, even though underweight 3. disturbance in way in which one's body weight or shape is experienced, undue influence of body shape or weight on self- evaluation, or denial of the seriousness of the current low body weight

Question 32

15 health risk of anorexia

Answer 32

1. decreased blood pressure 2. growth cessation 3. atrophy of GI tract 4. defective thermoregulation 5. kidney dysfunction 6. starvation mode: brittle thin hair, dry skin, hair loss, hirsutism, dehydration and edema 7. increased risk of osteoporosis 8. osteopenia 9. premature bone loss 10. electrolytes imbalance --> cardiovascular abnormalities 11. GI symptom disorder (inflammatory disease, diarrhea, fever, camping) 12. amenorrhea 13. death due to Wernicke's encephalopathy 14. muscle wasting 15. decreased BMR

Question 33

what is the only effective txt of osteoporosis

Answer 33

weight gain. | could increase the bone mass

Question 34

exercise in anorexia nervosa?

Answer 34

no

Question 35

what is the hormonal change in anorexia nervosa

Answer 35

increased cortisol, decreased IFG-1 and leptin | slow down bone formation and increase loss

Question 36

cycle of the osteoporosis

Answer 36

``` eating disorder (restrictive dieting, overexercising, lack of body fat, weight loss) cause osteoporosis and amenorrhea. amenorrhea (diminished hormones) cause osteoporosis ```

Question 37

binging

Answer 37

eating in a discrete period of time an excessive amount of food and lack of control while eating

Question 38

purging

Answer 38

regular self- induced vomiting, laxatives, diuretics, enemas

Question 39

bulimia diagnostic criteria

Answer 39

>1/ week binging followed by purging for 3 months

Question 40

bulimia is primarily in which age group

Answer 40

adolescent female | late adolescence or early adulthood, after a series of unsuccessful weight reducing diet

Question 41

bulimarexia

Answer 41

non- purging type of bulimia

Question 42

6 characteristics of bulimia

Answer 42

1. compulsion to eat not a response to hunger 2. distorted/ ill- formed attitudes regarding food and nutrition 3. self- evaluation according to body size and weight 4. fear of gaining too much weight 5. usually normal weight, weight fluctuation 6. emotional states: anticipation, anxiety, urgency to begin, rapid and uncontrolled intake of food, relief and relaxation, disappointment and shame

Question 43

13 health risks bulimia

Answer 43

1. hypokalemia --> muscle weakness, twitching, cramping 2. excess bicarbonate --> short breathe, low pH 3. irritation and infection of esophagus, salivary glands 4. erosion of teeth and dental caries 5. electrolyte/ fluids imbalance --> abnormal heart rhythms 6. kidney injury (urinary tract infection) 7. increased risk of sub- clinical malnutrition 8. dizziness 9. low BP 10. decreased urine 11. dry mouth 12. confusion 13. perception problem: broken eye syndrome, person think they are bigger than really are

Question 44

what can non- specified eating disorders cause

Answer 44

1. delayed sexual maturation | 2. deteriorating linear growth

Question 45

criteria of diagnosis of BED binge eating disorders (3)

Answer 45

1. loss of control over amount of eating 2. marked distress over binge episode 3. occurs at least once per week for 3 months