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Nutrition y 2 Exam 2 > Pregnancy and paediatrics > Flashcards

Pregnancy and paediatrics Flashcards

1
Q

What is the blastogenesis stage?

A

fertilized ovum divides and implants itself in the uterus

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2
Q

What is the embryonic stage?

A

all rudiments for the principle organs and membranes develop

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3
Q

What is the foetal stage?

A

most rapid period of growth

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4
Q

What is normal weight gain like in pregnancy?

A

11-15kg

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5
Q

What are maternal obesity at risk for?

A

pre-eclampsia, gestational diabetes, infants develop anomalies and neural tube defects

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6
Q

What are the risk when underweight?

A

low birth weight, prematurity, higher miscarriage rates

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7
Q

How many extra calories a day do pregnant women need?

A

100-300 kcal

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8
Q

How much extra protein is needed for pregnant women?

A

6-10g a day

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9
Q

What are some symptoms of pregnancy?

A

cramping, nausea, vomiting, increase in abdominal girth, changes to bowel, increased urinary freq, palpitations, heart murmurs

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10
Q

When is cramping concerning in pregnancy?

A

cramping is worsening or associated with vaginal bleeding as maybe a sign of ectopic pregnancy, threatened abortion or missed abortion

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11
Q

What can we do to reduce the risk of food poisoning in pregnancy?

A

raw or partially cooked eggs, unpasteurised dairy products, do not drink contaminated water, wash hands after touching raw meat, take care with food left uncovered on a warm plate

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12
Q

What is toxoplasmosis?

A

infection caused by a parasite found in cat faeces or raw/uncooked meat or soil left on unwashed fruit and vege

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13
Q

What 5 things can be done to reduce toxoplasmosis?

A

unwashed raw fruit and vege, raw uncooked meat, cured meats (salami), unpasteurised goats milk/cheese, avoid contact with soil or faeces

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14
Q

What is important with vitamin A and pregnancy?

A

Do not supplement as it can result in defects

But beta-carotene is not teratogenic (vit A precursor)

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15
Q

Why is it important to supplement folate or folic acid in pregnancy?

A

folic acid is important for DNA synthesis and cell replication and deficiency is linked with neural tube defects

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16
Q

Why is it important to supplement iron in pregnancy?

A

iron deficiency anaemia is the most common pregnancy complication

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17
Q

What advise is there on fish and pregnancy?

A

fish intake needs to limit to 2 oily fish a week (mercury levels)

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18
Q

What disease has fish oil reduced when the foetus became an adult?

A

asthma

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19
Q

Explain why DHA is important for pregnancy.

A

high in retinal and brain membrane phospholipids which is involved in neural function and neurotransmitter metabolism

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20
Q

Explain what happens when there is vitamin D3 deficiency in pregnancy.

A

Vit D deficiency is linked to maternal skeletal preservation and foetal skeletal formation

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21
Q

What happens when there is iodine/calcium deficiency in pregnancy?

A

low thyroid function due to low iodine intake increases the risk of infant lower IQ and calcium is a major part of the bone

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22
Q

How does zinc deficiency affect pregnancy?

A

zinc deficiency impairs learning and memory by reducing NMDA receptor expression which is responsible for creating plasticity changes in brain

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23
Q

How does magnesium supplement help with pregnancy?

A

reduce risk of foetal growth retardation, pre-elampsia and increased birth weight

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24
Q

What to do if the pregnant women is on a vegetarian and vegan diet?

A

possible deficiencies in vit D3, zinc, iron and B12

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25
Q

What are some lifestyle guidelines for pregnancy?

A

Moderate exercise, avoid contact sport, do not scuba dive

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26
Q

What is the guideline for caffeine and pregnancy?

A

caffeine should be lower than 100mg/d especially in early pregnancy

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27
Q

What else do you need to avoid in pregnancy?

A

chemical solvents and pesticide during pregnancy can increase risk of childhood cancer and primary exposure to radiographs, workplace radiation and environmental exposure so can also lead to cancer in childhood

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28
Q

Why does lead put a pregnant woman at risk?

A

high levels lead to stillbirths and abortion found in lead based paints, leaded petrol

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29
Q

Explain how mercury can affect pregnancy?

A

can affect CNS

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30
Q

Where is cadmium found?

A

graphic art material, paint, ceramics, solder, fish and cigarette smoke

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31
Q

Where is manganese found?

A

tea, cloves, and some grains

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32
Q

What can be done to help morning sickness?

A

frequent, smaller meals and snacks, B6 (25mg 3 times a day), ginger or peppermint tea, prevent blood sugar drops to reduce symptoms

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33
Q

What is hyperemesis?

A

severe nausea, vomiting, weight loss

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34
Q

Explain why pregnant women get heartburn.

A

increased progesterone and decreased motilin, decreased lower oesophageal sphincter tone leads to excess gastric acid in oesophagus

35
Q

What craving indicate iron deficiency?

A

dust, charcoal, dirt and ice

36
Q

What is pre-eclampsia?

A

new-onset hypertension and proteinuria

37
Q

What is done for pre-eclampsia?

A

delivery, reducing risk factors (maternal obesity and oxidative markers), magnesium sulcate to prevent seizures, diet rich in fruit and vege for antioxidants and magnesium

38
Q

What does gestational diabetes do to the baby?

A

increases risk of birth weight babies, complicates delivery and increases risk of caesarean section

39
Q

What are 5 risk factors of GD?

A

BMI of 30 or above, previous heavy baby (10lbs +), GD previously, family history of GD

40
Q

Whats the treatment for GD?

A

Diet and exercise, low GI/GL diet, regular meals, increased fruit and vege, avoid sugars and refined foods

41
Q

Explain what is meant by a birth plan?

A

document that states the mothers wishes, not fixed but a guideline. Things to think of include: who will be there, pain relief options, heart rate monitoring, different inductions

42
Q

How is lactation stimulated or inhibited?

A

prolactin and oxytocin stimulate lactation

dopamine inhibit lactation

43
Q

What induces oxytocin?

A

direct suckling

44
Q

What is the link between stress and lactation?

A

stress will down-regulate milk synthesis by increasing dopamine, nor epinephrin which inhibit PRL synthesis

45
Q

What does breast milk contain?

A

protein, carbohydrates, fats, enzymes, immunoglobulins especially secretory immunoglobulin (sLgA)

46
Q

What in breast milk can affect pathogenic bacteria?

A

Lactoferrin - binds to iron making it unavailable to pathogen bacteria.
Lysozyme - enhances sIgA bactericidal activity
Oligosaccharides - intercept bacteria
Milk lipids - damage membranes of viruses
Mucins - adhere to bacteria/viruses and eliminates them
Interferon/fibronectin - antiviral activity

47
Q

What are some common breastfeeding problems?

A

mammary vascular engorgement (frequent breastfeeding around the clock), sore nipples, cracked nipples, mastitis (emptying breast helps recovery), yeast infection of breast (can be passed to infant as oral thrush)

48
Q

What are galactagogues?

A

herbs that increase milk production

49
Q

What is the best example of a galactagogue?

A

fennel seeds brewed as a tea or fenugreek

50
Q

What is important about vitamin D?

A

If mother is deficient then baby can be deficient as well so supplement in a multi if necessary

51
Q

What is postpartum depression?

A

rapidly fluctuating mood, tearfulness, irritability and anxiety after 4/5 days after delivery

52
Q

What is some self-care tips for the mother?

A

mobilise a community, try to get lots of sleep, integrate baby into everyday life, take a shower and get dressed everyday, do some gentle exercise with baby

53
Q

What are some supplements for after birth?

A

multivit with iron, omega 3, folate, B12, calcium, selenium, zinc

54
Q

What is the main tip with children and nutritional therapy?

A

Do not cut out any food groups. If you do then have justification for it and make sure they are getting adequate nutrition

55
Q

What do you need to consider with children and supplements?

A

Go for powders, liquids and easily ingested supplements not pills

56
Q

What affects microbial colonisation?

A

Babies are sterile and it becomes colonised by the mothers bacterial balance, mothers use of probiotics, type of birth, gestational age, primary source of nutrition, stress levels

57
Q

What bacteria do breastfed babies have more of?

A

bifidobacteri in their stool and a higher proportion of lactobacillus to e.coli

58
Q

When is important to introduce solid food?

A

not before 4 months but later than 6 months of age

59
Q

What can protect against allergies and intolerance?

A

Breast feeding and not introducing solid food to early. Avoid allergenic food until later (6-7 months when baby is still breastfed) e.g. eggs, wheat, peanuts, milk, soy fish

60
Q

What can be done to support children immunity?

A

zinc, lactobacillus rhamnosus, vit A, echinacea, propolis

61
Q

What are some common childhood illness?

A

common cold, scabies, chicken pox, tonsillitis, GIT infections

62
Q

What is otitis media?

A

infection between area between tympanic membrane and inner ear including Eustachian tube

63
Q

What are symptoms of otitis media?

A

earache, irritability, fever, red bulging eardrum, typically after cold/bacterial infection. Can lead to chronic infection (hearing loss)

64
Q

What are some orthodox treatments of otits media?

A

antibiotics, analgesics, anti-histamines; vertical procedure to drain fluid

65
Q

What are some common risk factors for glue ear?

A

cigarette smoke, food allergies, day care, lack of breast feeding

66
Q

What can be done for otitis media?

A

remove food allergies, vitamin C, probiotics

67
Q

What is colic?

A

uncontrollable crying in a baby that seems to have no cause.

68
Q

What is the cause of colic?

A

bloating, gas, cramping and babies cry because of not being able to release gas

69
Q

What are some nutritional treatments of colic?

A

remove gassy food from mother diet, remove food sensitivities for mothers diet, remove cow protein from babies diet, digestive aid teas (chamomile), probiotics

70
Q

What is ADHD?

A

behavioural disorder that begins in early childhood and common in boys

71
Q

whats the orthodox treatments for ADHD?

A

ritalin, therapy, behavioural interventions

72
Q

What are 5 signs and symptoms of ADHD?

A

hyperactivity, short attention span, poor memory and thinking, listening problems, specific learning disabilities

73
Q

What are some contributing factors of ADHD?

A

glucose control, nutrient deficiencies (Omega 3, zinc, iron, magnesium, vitamin D), exposure to heavy metals, food additives sensitivities

74
Q

What is the opioid theory?

A

peptides from gluten and casein react with opiate receptors in the brain thus mimicking effects of opiate drugs

75
Q

How can you spot an opioid reaction?

A

child develops a picky appetite and addicted to gluten and dairy, silly or spacey behaviour, hyperactive or aggressive behaviour, sensory issues, lack of attention, mood swings

76
Q

How can you test for an opioid reaction?

A

urinary peptides to ascertain if casein or gluten is in urine

77
Q

What is the nutritional care of ADHD?

A

nutrients deficiencies - address them, high levels of oxidative stress, omega 3 are beneficial, support gut heating, calming supplements

78
Q

What is the pathophysiology of autism?

A

genetic factors involved, abnormalities in the brain (enlarged amygdala)

79
Q

What are some symptoms of ASD?

A

seizures, cognitive defects, sensorimotor abnormalities, immune impairments, disordered sleep and Gi distress

80
Q

What do 70% of children with autism have?

A

Low faecal chymotrysin - indicators for low pancreatic enzyme release

81
Q

What are some common GIT problems with autism children?

A

diarrhoea, constipation, abdominal pain, gas and bloating, oesophageal reflux, low carb digesting enzymes

82
Q

What problems do children with autism have in terms of toxicity and detox?

A

impaired sulfation, decreased activity of phenylsulfotransferase, impaired methylation, efflux disorder

83
Q

What is the GAPs diet?

A

SCD removes all carbohydrates that require digestion to ease pressure on intestines. Only monoaccharides are allowed because they are easy to digest.

Nutrition y 2 Exam 2 (7 decks)

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