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Studying > CPS GI + nutrition > Flashcards

CPS GI + nutrition Flashcards

1
Q

Effect of endocrinopathy on growth

A
  • affects height more than weight

vs. weight first in nutritional problems or systemic disease

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2
Q

Mid parental height

A

Males: (mother ht + father ht + 13) / 2
Females (mother ht + father height - 13) / 2
SD = +/- 8.5cm

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3
Q

FTT step 1 basic investigations

A
  • CBC
  • ESR or CRP
  • lytes, venous blood gas, glucose
  • BUN, Cr
  • serum protein and albumin
  • serum iron, TIBC, t sat, ferritin
  • Ca, PO4, ALP
  • liver enzymes
  • serum immunoglobulins
  • TTG with IgA
  • TSH
    Urinalysis
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4
Q

FTT step 2 investigations

A
  • sweat chloride
  • vitamin levels
  • fecal elastase
  • bone age
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5
Q

Benefits of dietary fibre

A
  • decrease risk for constipation
  • improved intestinal microbiome
  • decreased body fat/metabolic syndrome (displacing high energy, low-nutrient foods)
  • decreased post-prandial glucose and insulin
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6
Q

Topical fluoride 3 ways it prevents caries

A
  1. inhibits plaque
  2. inhibits demineralization
  3. enhances remineralization
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7
Q

Indications for fluoride supplementation

A
  1. > 6 months
  2. drinking water fluoride is <0.3ppm
  3. child does not brush (or have teeth brushed)2x/day
  4. child is susceptible to high caries (fam history, community or geographic trends)
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8
Q

Benefits of WHO vs. CDC growth charts

A
  • WHO = more diverse, multiple countries

- only children with optimal growth

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9
Q

WHO: Underweight and severe underweight for age

A

0-10: wt for age <3rd percentile
10-19: BMI < 3rd percentile

severe underweight = < 0.1%ile

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10
Q

WHO: stunting and severe stunting for age

A

0-19: length/ht for age < 3rd percntile

severe stunting = <0.1%ile

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11
Q

WHO wasting and severe wasting for age

A

0-2: weight: length percentile < 3rd
2-19: BMI < 3rd percentile
severe = <0.1%

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12
Q

WHO: risk of overweight by age

A

0-2: wt for length > 85th %ile
2-5: BMI >85th %ile
5-19: NA

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13
Q

WHO overweight by age

A

0-2: wt for length> 97%ile
2-5: BMI > 97%
5-19: BMI > 85%ile

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14
Q

WHO obesity by age

A

0-2: wt for length > 99.9%ile
2-5: BMI > 99.9
5-19: BMI > 97%ile
Severe obesity 5-10 = BMI > 99.9

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15
Q

Infantile colic

A

> 3hrs / day
3days per week
1 week
No failure to thrive

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16
Q

Dietary changes for infantile colic

A
  • for infantile colic: can consider 2 week trial of hypoallergenic diet
  • use of soy formula should be avoided, no evidence for lactase, insufficient evidence for prebiotics or probiotics
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17
Q

Risk factors for iron deficiency anemia before age of 2 yrs

- Baby/delivery factors

A
  • preterm
  • birthweight < 2500g
  • male sex
  • early umbilical cord clamping
  • chronic infection
18
Q

RFs for iron deficiency before age 2

- Mother/environment factors and feeding factors

A

Mother/enviornment: mothers with anemia or obesity, low SES, lead exposure
Feeding: exclusive breastfeeding longer than 6 months, cow’s milk intake, prolonged bottle use, low dietary intake of iron-rich foods

19
Q

Significance of non-anemia iron deficiency and iron deficiency anemia

A
  • lower neurodevelopmental scores
  • compromised immune response
  • low cognitive and motor function
20
Q

Iron supplementation for term SGA or preterms

A

BWt 2-2.5kg: 1-2mg/kg/day
BWt < 2kg: 2-3mg/kg/day
supplement for first 6 months
(if formula fed ensure iron-rich formula)

21
Q

Risks of unpasteurized human donor milk

A
  • Donor health: Hep B, Hep C, HIV, HTLV, syphilis
  • donor substance use
  • donor medications/herbs
  • donor having inter-current illness
  • safe handling and storage practices
22
Q

Effect of pasteurization on human breast milk

A
  • inactivates bacterial and viral contaminants
  • 13% of protein content is denatured
  • beneficial immune cells are inactivated/reduced
  • some water-soluble vitamins may degrade

Unchanged: carbs, fats, salts, fat-soluble vitamins,

23
Q

Breastfeeding benefits

A
  • cognitive development

- protection against: GI infections, AOM, resp tract infections, SIDS

24
Q

7 principles for feeding from birth to 6 months

A
  1. breastfeeding exclusive for first 6 months
    2 active protection support and promotion of breastfeeding
  2. vitamin D 400 IU
  3. iron-rich complementary foods to be introduced first
  4. routine growth monitoring
  5. feeding changes are unnecessary for most colic, GER etc.
  6. rare contraindications for breastfeeding
25
Q

7 principles for feeding from 6-24 mo

A
  1. breastfeeding is impt (up to 2 yrs or beyond)
  2. supplemental vitamin D
  3. complementary feeding along with breastfeeding (lumps by 9 mo)
  4. responsive feeding
  5. iron-rich complementary foods
  6. safe food, prep and storage
  7. regular schedule of meals and snacks from 1 year and beyond
26
Q

Long term AEDs associated with specific micronutrient deficiencies (2)

A
  • folate
  • vitamin B12
  • impaired bone health
27
Q

Measurements for children with neurologic impairment

A
  • weight
  • height if possible (not segmental measurements)
  • body composition e.g. skin fold
28
Q

When to use condition specific growth charts

A
  • consider for CP
29
Q

Infant’s microflora influenced by…

A
  • type of delivery
  • diet
  • environment
  • gestational age
  • presence of abx
30
Q

Consider recommending probiotics for these reasons:

A
  • prevent abx- associated diarrhea
  • shorten duration of acute infectious viral diarrhea
  • prevent NEC in prem infants who are at risk
  • decrease sx of colic (there may be a role but insufficient evidence)
  • decrease sx of IBS (preliminary results favorable)
31
Q

Role for sports drinks

A
  • may have a role for young athletes for prolonged and vigorous activities but generally UNNECESSARY
  • for average child, water should be first choice
32
Q

Risks of caffeine in children

A
  • tachycardia, hypertension, ECG changes, vomiting, diarrhea, impulsive behavior, agitation, delusions, CV collapse, death
  • higher risk of caffeine dependence
    (with alcohol, increase risk of substance abuse and high risk behaviours)
33
Q

Ideal macronutrient component of diet

A

45-65% CHO
10-30% protein
25-35% fat

34
Q

Who recommendation re: free sugars

A

free sugars < 10% of total energy

~50g daily

35
Q

Overweight and obesity are significant risk factors for nutrition-related chronic diseases:

A
  • HTN
  • dyslipidemia
  • T2DM
  • Coronary heart disease
  • Stroke
  • some cancers
  • NAFLD
  • sleep apnea
  • OA
36
Q

Health consequences of excess sodium

A
  • hypertension
    -obesity
    (sodium sensitivity more common in HTN, African American, women, metabolic syndrome)
37
Q

Sodium intake recommendations

  • 9-13 yrs
  • 14+ yrs
A

9-13: 1200mg/day (reduce if above 1800)

14+: 1500mg/day (reduce if above 2300)

38
Q

Potential impacts of school nutrition programs

A
  1. increasing access to nutritious foods
  2. improving dietary behaviours
  3. lowering BMI
  4. impacts on academic performance
39
Q

Breastfeeding decreases infectious diseases:

A
  • bacterial meningitis
  • bacteremia
  • diarrhea
  • resp tract infections
  • otitis media
  • UTIs
40
Q

Breastfeeding benefits (non-infectious)

A
  • decreases SIDS
  • enhanced neurocognitive testing
  • decrease in breast and ovarian cancers for mothers
  • economical
41
Q

5 reasons to initiate G - tube discussion

A
  • poor oral intake and inadequate weight gain despite calorie boosting
  • recurrent aspiration or prolonged feeding times
  • GERD if insufficient oral intake
  • if long-term G-tube feeding (>3-6 months is anticipated)
  • dysmotility despite medical tx
42
Q

Risks of G-tube feeding

A

Short term: peritonitis, bleeding, infection, anesthesia-related problems, abdominal organ puncture, death
Long-term: blockage, dislodgement, breakage, issues with stoma - bleeding, infections, irritation, worsening of GERD

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