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Flashcards in 11, 12 Deck (45):

4 features of failure to thrive

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


organic causes of failure to thrive (7)

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


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

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


non organic causes of FTT (3)

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


3 general patterns of FTT

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


tx of extreme FTT

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


nutrient needs determined individually according to 3

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


Tanner's sexual maturation rating

standards used clinically to describe the stage of development


what is SMR based on

the development of primary and secondary sexual characteristics



rapid growth but no discernable sexual changes


timing of bone mass and skeletal growth

SMR2 in females
SMR3-4 in males with 40% of peak bone mass


Tanner breast stage 3

the timing of the pubertal growth spurt


peak weight accumulation for female

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


peak weight accumulation for male

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


LBM accumulation in female

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


LBM accumulation in male

peaks at SMR 5, after stature gain is complete


female growth characteristics (5)

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


male growth characteristics (4)

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


how much weight can be reached in adolescence

50% of adult weight


final stage of skeletal growth

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


why does male require high nutrient and calorie during growth spurt

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


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

47.8kg (105lb)
17% of body fat


what is time of peak height velocity corresponded to

maximum fat loss and muscle mass increase in upper arm


12 external factors on influencing the eating behavior

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


6 internal factors on influencing the eating behavior

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


vicious cycle on obesity (8)

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


malnutrition in female

absence of >= 3 menstrual cycles


five characteristic of anorexia nervosa

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


anorexia nervosa diagnostic criteria

15-20% of below expected weight


two types of anorexia nervosa

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


DSM-5 of anorexia nervosa

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


15 health risk of anorexia

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


what is the only effective txt of osteoporosis

weight gain.
could increase the bone mass


exercise in anorexia nervosa?



what is the hormonal change in anorexia nervosa

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


cycle of the osteoporosis

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



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



regular self- induced vomiting, laxatives, diuretics, enemas


bulimia diagnostic criteria

>1/ week binging followed by purging for 3 months


bulimia is primarily in which age group

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



non- purging type of bulimia


6 characteristics of bulimia

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


13 health risks bulimia

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


what can non- specified eating disorders cause

1. delayed sexual maturation
2. deteriorating linear growth


criteria of diagnosis of BED binge eating disorders (3)

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