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General Flashcards

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1
Q

Pediatric age classifications:

A

1st month = neonate
1-12 months = infant
1-3 years = toddler
3-5 years = pre-schooler

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2
Q

What is the recommendation of the American Academy of Pediatrics (AAP) regarding breastfeeding?

A

The American Academy of Pediatrics (AAP) has
recommended exclusive breastfeeding during the first 6 months of life and continuation of breastfeeding for the second 6 months as optimum nutrition in infancy.

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3
Q

What are the stages of breastfeeding?

A 
Lactogenesis I (2nd trimester - 2 days postpartum): 
Stimulation of milk secretion by prolactin 
Lactogenesis II (3-8 days postpartum): 
Reduction of progesterone, large amount of milk

Galactopoiesis (9 days postpartum - involution):
Maintenance of milk secretion

Involution:
Loss of secretory milk function

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4
Q

What are some triggers of milk secretion (let-down reflex)?

A
  1. Stimulation of the nipple
  2. Sight
  3. Sound
  4. Emotions
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5
Q

What are the stages of lactation?

A
  1. Colostrum (immunologic & trophic function)
  2. Transitional milk (for nutritional & developmental needs)
  3. Mature milk (foremilk & hindmilk)
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6
Q

What are the types of protein in human milk?

A
  1. Casein proteins (30%)

2. Whey proteins (70%)

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7
Q

Which type of protein found in human milk forms curds in acidic media and which is resistant to acid precipitation?

A

Forms curds = casein

Resistant to acid precipitation = whey

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8
Q

Which type of protein found in human milk is digested more easily and promotes gastric emptying?

A

Whey protein

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9
Q

What are the components of whey protein found in human milk?

A

Alpha lactoalbumin
Lactoferrin
Lysozyme
Secretory IgA

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10
Q

What type of fatty acids is mostly found in human milk?

A

Long chain polyunsaturated fatty acids (linoleic acid & alpha-linoleic acid)

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11
Q

What component in human milk is related specifically to the composition of neural and retinal tissue?

A

Lipids

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12
Q

What is the major carbohydrate in human milk?

A

Lactose

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13
Q

What are helpful molecules found in human milk?

A 
Oligosaccharides 
Mucins 
Lactoferrin 
Bifidus factor (lacrobacillus bifidus)
Interferon 
Fibronectin 
Lysozyme
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14
Q

What are the cellular factors in human milk?

A

Leukocytes
Neutrophils (50%)
Macrophages (40%)
Lymphocytes (10%): B = 20% & T = 80%

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15
Q

What are the enzymes that are found in human milk?

A

Lipase
Amylase
Catalase
Protease

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16
Q

What are the hormones that are found in human milk?

A

Prolactin

TSH

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17
Q

What are the growth factors that found in human milk?

A

Insulin-like growth factors

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18
Q

The formation of Harrison sulcus is due to the deficiency of?

A

Vitamin D

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19
Q

The formation of echymosis is due to the deficiency of?

A

Vitamin K

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20
Q

Breastfeeding reduces the risk of what type cancer?

A

Breast and ovarian

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21
Q

What are contraindications to breastfeeding?

A
  1. Metabolic diseases (galactosemia & phenylketonuria)
  2. +ve for human T-cell lymphocytic circus type I or II
  3. Untreated brucellosis
  4. Active infectious untreated TB
  5. Active herpes simplex lesions on breast
  6. Varicella 5 days before to 2 days after delivery (should be separated from their infants)
  7. H1N1 influenza (till afebrile)
  8. HIV +ve mothers (not in developing countries)
  9. Syphilis (should restart breastfeeding after initiating therapy)
  10. Maternal medications: amphetamine, chemotherapy & immunosuppressive agents, ergotamines and street drugs (PCP, cocaine, cannabis)
  11. Exposure to diagnostic radioactive compounds (temporary cessation)
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22
Q

What is the most objective indicator of the adequacy of breastfeeding?

A

Weight gain

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23
Q

What is the recommended frequency of breastfeeding?

Study These Flashcards
A

Newborns: every 1-2 hrs (8-10 feeds/day)
1 month: every 2-3 hrs
2-4 months: every 4 hrs
4 months - 1 year: 3-4 feeds/day

24
Q

What is the type of fat that is mostly found in protein hydrolysate formulas?

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A

Medium chain triglycerides

25
What type of formula should be given to infants who have renal or cardiovascular dysfunction?
Low-solute formula
26
What type of formula should be given to infants with inborn errors of metabolism?
Amino acid based formulas
27
When is the recommended time to introduce solid feedings?
6 months
28
Anthropometrics (weight)
At birth = 3-3.5 kg At 4 m = 6-7 kg (doubles) At 1 year = 9-10 kg (triples) After 1 year = (age in years x 2) + 8
29
What is the most common cause of low birth weight?
Prematurity
30
What is the most common cause of large birth weight?
GDM (mother)
31
Anthropometrics (height)
``` At birth = 50cm 1st 6 m = (+2.5 cm/month) 2nd 6 m = (+1.25 cm/month) At 1 year = 75 cm After 1 year = (age in years x 5) + 80 ```
32
Anthropometrics (head circumference)
``` At birth = 35 cm At 6 m = 43 cm At 1 year = 47 cm (Total so far is an increase by 12 cm) At 2 years = 49 cm (+2) At 5 years = 50 cm (+1) At 12 years = 55 cm (+5) ```
33
Anthropometrics (mid arm circumference)
(Valid in the first 4 years of life only) Normal = 12-14 cm Impending malnutrition = 10-12 cm Established malnutrition = 9-10 cm Severe malnutrition = < 9 cm
34
When do the carpal bones ossify?
1st carpal bone ossifies at 6 months. 2nd carpal bone ossifies at the end of the 1st year. Then every year, 1 carpal bone ossifies. Bone age = chronological age + 1
35
How many milk teeth are in total?
20
36
How many permanent teeth are in total?
32
37
When does the first milk tooth appear?
At 6 m
38
When does the first permanent tooth appear?
At 6 years
39
When is it considered delayed teething?
After 1 year with no tooth
40
When does the anterior fontanel usually close?
At 18 m
41
When does the posterior fontanel usually close?
It usually closes at birth or at the 2nd month (no more than 0.5 cm)
42
What is the most common secondary cause of failure to thrive?
Non-organic (caloric failure)
43
What is the most important organic cause of FTT?
GIT (mainly malabsorption syndrome)
44
What is microcephaly?
Head circumference 2 deviations below the mean or below the 3rd percentile for GA.
45
What is macrocephaly?
Head circumference 2 standard deviations above the mean or above the 95th percentile for GA.
46
What is the direction of development?
Cephalocaudal
47
What are the domains of development?
``` Gross motor Fine motor Speech and language Social Cognitive ```
48
If an infant has hand preference before the age of 2 years, what does that suggest?
Cerebral palsy
49
What are causes of developmental delay?
``` Antenatal: Infections (esp. TORCH) Cerebrovascular hemorrhage Ischemia Structural maldevelopment Syndrome (i.e. Down syndrome) ``` Perinatal: Hypoxic/ischemic injury before or during delivery Preterm infants ``` Postnatal: Meningitis and encephalitis Head trauma Symptomatic hypoglycemia Hydrocephalus Hyperbilirubinemia ```
50
Differential diagnosis of speech or language delay:
1. Global developmental delay 2. Hearing impairment 3. Environmental deprivation 4. ASD 5. Intellectual disability (mental retardation)
51
What is the most common cause of global developmental delay?
Genetic/chromosomal problems
52
What is the most common cause of mental retardation?
Hypothyroidism
53
What is the single best indicator of intellectual potential?
Language
54
Changes in weight should be assessed in relation to what?
Height (length) and HC
55
What can be used to distinguish the cause of FTT?
Growth velocity and height-for-weight
56
What is the most common cause of FTT?
Non-organic causes (80%) = caloric failure
57
What is the most important organic cause of FTT?
GIT (mostly malabsorption syndrome) In America and western countries: renal tubular acidosis

Pediatrics (9 decks)

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