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Neo Board Review MAP > Growth and Nutrition > Flashcards

Growth and Nutrition Flashcards

(67 cards)

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1
Q

Highest growth velocity in-utero

A

28-32 weeks

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2
Q

Stage 3 intrauterine growth pattern

A

Hypertrophy: 28-40 weeks, cell growth

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3
Q

Ponderal index

A

PI <10% for GA: growth restricted

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4
Q

Symmetric IUGR

A

Growth inhibition during stage one/hyperplasia
Produces undersized fetus with fewer cells that are normal cell size
Normal PI, weight/length/HC all <10%

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5
Q

Asymmetric IUGR

A

Growth inhibition during stage 2/3 (hypertrophy)
Decreased cell size
Normal cell number
Low PI, weight <10%, length/HC preserved

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6
Q

IGF I

A

Occurs late in gestation

Increased expression associated with increased brain growth

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7
Q

IGF II

A

Predominant IGF for majority of gestation

Important for early growth

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8
Q

IGF binding proteins

A

Balance between IGFs and IGF BPs essential for normal growth

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9
Q

Placenta and growth

A

Direct relationship between growth of the placenta and growth of the fetus
After 20 weeks the placenta produces growth factors and growth regulating hormones

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10
Q

Placental growth hormone

A

Produced by syncyciotrophoblasts
Regulator of maternal insulin resistance

May influence fetal growth by modifying substrate availability

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11
Q

Causes of an LGA infant

A

Maternal diabetes
Beckwith Wiedemann (high IGF2)
SGB
Sotos syndrome

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12
Q

What causes IUGR due to wasting?

A

Post dates

Donahue syndrome

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13
Q

Stage one intrauterine growth pattern

A

Hyperplasia: 4-20 weeks GA, cell division

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14
Q

Stage two intrauterine growth pattern

A

Hyperplasia and hypertrophy: 20-28 weeks GA, division and cell growth

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15
Q

Causes of symmetric IUGR

A 
Genetic abnormalities
Early in-utero infections
Substance abuse
Chronic maternal anemia
Cigarettes
Radiation
Maternal lupus
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16
Q

Causes of asymmetric IUGR

A 
Utero placental insufficiency
Chronic HTN/renal disease
Hemoglobinopathies
Placental infarcts/problems
Altitude
Substance abuse
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17
Q

Combined type IUGR

A

Low PI
Skeletal shortening
Decrease in soft tissue mass

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18
Q

Vitamin B1 (Thiamine) deficiency

A 
Beriberi: 
Fatigue
Irritability
Constipation
Cardiac failure
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19
Q

Syndromes associated with thiamine deficiency

A

Pyruvate dehydrogenase complex deficiency

Maple syrup urine disease

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20
Q

Vitamin B2 (riboflavin) deficiency

A

Failure to thrive
Photophobia/blurred vision
Dermatitis
Mucositis

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21
Q

Syndromes associated with vitamin B2 (riboflavin) deficiency

A

Glutaric aciduria type 1

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22
Q

Vitamin B6 (pyridoxine) deficiency

A

Dermatitis
Mucositis
Hypochromic anemia
Possible seizures

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23
Q

Syndromes associated with vitamin B6 deficiency

A

Homocystinuria

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24
Q

Biotin (vitamin B7) deficiency

A

Alopecia
Dermatitis
Scaling
Seborrhea

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25
Syndromes associated with biotin (vitamin B7) deficiency
3-methylcrotonyl glycinuria Propionic acidemia Biotinidase deficiency Pyruvate dehydrogenase complex deficiency/pyruvate carboxylase deficiency “Baby Michelangelo painted bad pantyhose”
26
Vitamin C deficiency
Poor wound healing | Bleeding gums
27
Syndromes associated with vitamin C deficiency
Transient tyrosinemia
28
Function of chromium
Regulates insulin levels 2/2 role in insulin metabolism
29
Chromium deficiency
Humans -> diabetes
30
Copper
Critical for production of RBCs Absorption of iron A/w multiple enzyme activities
31
Copper deficiency
``` Anemia Osteoporosis Depigmentation of hair/skin Neutropenia Poor weight gain Hypotonia, ataxia later in life ```
32
Iron
Component of hemoglobin Absorbed in duodenum and proximal jejunum Vitamin C enhances absorption
33
Iron deficiency
Microcytic, hypochromic anemia | Failure to thrive
34
Manganese
Enzyme activation Important for normal bone structure Role in carbohydrate metabolism
35
Selenium
Cofactor for glutamine peroxidase
36
Selenium deficiency
Humans - muscle disease | Animals - cardiomyopathy
37
Zinc
Important component of several enzymes (carbonic anhydrase and carboxypeptidase) Important for growth
38
Acrodermatitis enteropathica
Autosomal recessive | Abnormality of zinc absorption or transport
39
Zinc deficiency
``` Failure to thrive Alopecia Diarrhea Dermatitis Ocular changes Rash (crusted, erythematous) Nail hypoplasia/dysplasia ```
40
Trace elements and TPN cholestasis
Decrease manganese and copper | Increase zinc
41
Trace elements and renal disease
Decrease chromium and selenium
42
Essential fatty acids
Linoleic acid | Linolenic acid
43
Essential amino acids
PVT TIM HaLL ``` Phenylalanine Valine Threonine Tryptophan Isoleucine Methionine Histidine Leucine Lysine ```
44
Conditionally essential amino acids
GG PATT ``` Glutamine Glycine Proline Arginine Taurine Tyrosine ```
45
Calcium:phosphorus ratio in TPN
1.3:1
46
What is the concern with giving high amounts of calcium and phosphorus in TPN?
Precipitation
47
Preterm breastmilk versus term breastmilk
``` Pretterm breastmilk has more: Protein Sodium Chloride Long chain polyunsaturated FAs (LC PUFAs) ``` It has less lactose
48
Hindmilk versus foremilk
Foremilk has higher lactose but lower fat | Both have the same amount of protein
49
Symptoms of essential fatty acid deficiency
``` Hemorrhagic dermatitis Skin atrophy Weakness Impaired vision Edema Hypertension Poor growth Thrombocytopenia ```
50
Triene:Tetraene Ratio (Hollman ratio)
T:T ratio >0.4 considered essential fatty acid deficiency | Characterized by a decrease of arachidonic acid and increase in mead’s acid (produced in excess during EFAD)
51
Goals for TPN
30-50% calories as fat 35-65% calories as carbohydrate 7-15% calories as protein
52
Whey:casein 80:20
Colostrum
53
Whey:casein 50:50
Mature human milk
54
Whey:casein 60:40
Preterm breastmilk, formulas
55
What is the most important amino acid that assists in the metabolism of fat?
Carnitine
56
What is the most prevalent fat in human milk?
Triglycerides
57
What are some whey proteins?
Alpha lactalbumin Lactoferrin Secretory IgA
58
Iron absorption
Human milk 50% Preterm infants 33% Human milk has less iron than formula but more is absorbed
59
Neonatal nitrogen absorption is
Normal
60
How does hyponatremia lead to poor growth
Inhibition of Na/H antiporter 
61
Human breast milk has more ____ than cows milk formula
Long chain polyunsaturated FAs Carnitine Cholesterol DHA
62
Human breast milk has less ____ than cows milk formula
Protein
63
In human milk palmitic acid is present in the ___ Position which makes it more easily absorbed
Beta
64
Syndromes associated with vitamin B12 (cobalamin) deficiency
Methylmalonic acidemia
65
Folate
Vitamin B9
66
Effects of pasteurization on breastmilk
Fats, fat soluble vitamins, lactose all retained Lymphocytes, Alk Phos, cytokines, growth factors, lipoprotein, lipases are destroyed All of IgM is destroyed
67
Cholesterol in breastmilk
Doesn’t depend on maternal diet

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