MMT: clinical cases in pediatric nutrition Flashcards
(31 cards)
What are the stages of development of iron deficiency anemia?
- Iron depletion
- Iron deficient erythropoiesis
- Iron deficiency anemia
What is a major culprit of iron deficiency in young kids?
Cow’s milk
Explain how cow’s milk is associated with anemia.
Calcium and casein inhibit iron absorption from other foods, and cow’s milk may cause occult intestinal blood loss in infancy.
How much iron do preterm infants need?
2-4 mg
How much iron do term infants need?
0.27 mg
How much iron do kids 6-12 months old need?
11 mg
How much iron do toddlers need?
7 mg
What are health risks of iron deficiency?
Growth retardation, poor immune response, poor neurodevelopment, increased lead poisoning risk.
When do we give supplemental iron?
All preterm babies for the first 12 months, term babies starting at 4 months until they start eating iron-rich foods.
When do we start screening for iron deficiency anemia?
12 months
What is a sign of longer-term deficient protein intake?
Low albumin
What are clinical consequences of protein deficiency?
Low oncotic pressure leading to edema/effusions, hypogammaglobulinemia.
What are signs of kwashiorkor?
Hypopigmented hair, fatty liver, edema, muscle atrophy, growth retardation.
How can severe malnutrition impact the cardiovascular system?
SV and output are reduced.
How can malnutrition impact the liver?
Gluconeogenesis is reduced, metabolism of toxins is reduced, protein synthesis is reduced.
How can malnutrition impact the GI tract?
Impaired digestion, electrolyte abnormalities, slow motility, diminished gut barrier leads to bacterial translocation.
How can malnutrition impact the immune system?
Diminished T cell immunity, IgA, complement, and phagocytosis.
How can malnutrition impact the endocrine system?
Low insulin and increased cortisol.
Describe starvation in the first 3 days.
Glycogen will be depleted, insulin decreases.
Describe starvation around day 7.
Fat catabolism and protein used for gluconeogenesis.
Describe starvation around days 8-10.
Source of energy shifts from fat to ketone bodies.
Describe starvation after 30 days and beyond.
Catabolism of lean muscle that may lead to death.
What are features of refeeding syndrome?
Hypophosphatemia, hypokalemia, salt and fluid retention, thiamine deficiency.
What are risky manifestations of refeeding syndrome?
Arrhythmia, heart failure from fluid shifts, encephalopathy.
