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Flashcards in Nutrition Deck (136):
1

Micronutrient deficiencies have ________ impacts during periods of ____ &______ as well as long-term effects on _________ _______.

Negative impacts
Growth & Development
Structural Integrity

2

T/F: Pediatric nutritional supplemental dietary recommendations are fairly well defined.

True

3

Early malnutrition may predispose us to an increased risk for ______ ________ later in life-specifically _______ _______

Chronic Diseases

Cardiovascular Disease

4

What is a supplement?

What forms can they come in?

Is a supplement a food or the sole item of a meal/diet?

A product that supplements the diet

Pill, Capsule, Tablet, Liquid

No

5

What are the most widely used types of dietary supplements?

Vitamins & Minerals

6

Supplement use is a/w what types of people/lifestyles?

1. Higher income
2. Smoke-free environment
3. Lower BMI
4. Less daily TV/Video time

7

Vitamin A is called?

Retinoid

8

Vit A is ___-soluble

Fat

9

Vit A is required for the transduction of light into neural signals necessary for vision. Therefore, intake in some forms have been associated w/decreased risk for:

Macular degeneration
Cataracts
Cancers
Cardiovascular events

10

Vit A plays an important role in?

Also in?

Vision

Vertebrae, spinal cord, limb development, formation of heart, eyes, ears.

11

T/F: Vit A increases macrophage phagocytic activity and increases cytokines that mediate T & B lymphocytic production.

True

12

What foods is Vit A found in?

Fish, Liver, Dairy, colorful Fruits and Vegies, some oily plants

13

What is the daily recommended intake of Vit A in infants based on?

Infants primarily fed breastmilk

14

Is Vit A common in the US?

No-rare. Cows milk, human milk (except preterm), and formulas are all good sources

15

Vit A deficiency might be an issue in children w/what disorder?

Fat-Malabsorption

16

Is preterm breastmilk low in Vit A?

Yes

17

A Cochrane review concluded that VLBW infants who were supplemented w/Vit A had a reduction in ______ or _______ requirement at 1 month of age and reduction of ______ requirement at 36 wks w/BW <1 kg

Death or Oxygen requirement

Oxygen

18

Vitamin A may prevent _____ ______ and promote ________.

Lung injury
Healing

19

Vit A reduced what lung Dz?

BPD

20

Low _____ levels has been shown to be a risk factor for Maternal-Child transmission of HIV

Vit A

21

Is there special recommendation concerning dietary supplementation w/Vit A?

No

22

Preterm infants fed breastmilk will need what?

Fortification of Vit A

23

There is some evidence that supplemental Vit A may be indicated for what type of preterm infants?

LBW

24

What is the other name for Vit D?

Calciferol

25

Vit D is essential for what?

Proper growth and development of skeletal system

26

Vit D works with ______ _____ to maintain serum ____ & ______ concentrations

Parathyroid Hormone
Ca++ & Phosphate

27

Where is Vit D synthesized?

Skin

28

The precursors of Vit D require what to convert to the Active form?

What is the common name for Vit D?

UVB light


the Sunshine Vitamin--deficiency is higher in areas where exposure to sunlight is limited

29

What sources is Vit D found?

Egg yolks, butter, whole milk, fatty fish, fish oils, mushrooms, liquid/dried milk, breakfast cereals

30

Is human milk low or high in Vit D?

Low--unless mom is receiving very high doses of the vitamin

31

Vit D deficiency leads to?

Characterized by?

Rickets

Impaired skeletal mineralization causing deformities and poorer linear growth of long bones

32

What are the clinical signs of Rickets in an infant?

Later in life?

Craniotables, Frontal skull bossing, Widened Ribs, Bowed legs, Muscle Weakness

Osteomalacia, various chronic Dz's: CV, HTN, DM, inflammatory/autoimmune, CA

33

Hyper/Hypo-Calcemia and Hypervitaminosis D disrupts normal _____ function--->polydypsia & polyuria

Hypercalcemia
Kidney Function

34

The AAP recommends that all breastfed babies be supplemented with what vitamin?

Formula-fed infants need to consume at least ___ Liter/day Vit D fortified formula

Vitamin D


1 L/day

35

Vit E functions as a _____ breaking ___________ to prevent free radical damage--especially important for cells exposed to ________ like the lungs and RBC's.

Chain-breaking
Antioxidant
Oxygen

36

Name dietary sources of Vit E

Whole grains, nuts, vegetable oils, meats, what germ, safflower oil, sunflower oil

37

Does breatmilk supply adequate amounts of Vit E in Term and Preterm infants?

Yes, both

38

T/F: Vit E deficiency is common in the US


What are signs of Vit E deficiency?

False, it's rare except situations r/t fat-malabsorption

Peripheral neuropathy, Hemolytic Anemia, Abnormalities in Platelet Fxn

39

Does the AAP recommend pharmacologic doses of Vit E for prevention or treatment of ROP, BPD, or IVH?

NO

40

When is the only time Vit E supplementation will be required?

Situations of Fat-malabsorption

41

What Vitamin functions as the coenzyme for synthesis of proteins involved in blood coagulation and bone metabolism?

Vitamin K

42

Which proteins are dependent on Vit K?

Plasma Prothrombin (factor 2), 7, 9, 10
& Protein C and Protein S

43

Where is Vit K sourced from?

Diet
Intestinal Flora

44

What are dietary sources of vit K?

Green leafy vegetables, vegetable oil, margarine

45

Are there high or low levels of Vitamin K in human breastmilk?

Low

46

Are oral Vit K supplements licensed in the US?

No

47

Vit K deficiency is a/w bleeding during the first few ______s of life

Weeks

48

Vit K deficiency bleeding is categorized as?

Early
Classic
Late

49

Is Vit K toxicity rare or common?

Rare-and no adverse effects have been reported

50

Is there a relationship between Vit K at birth and childhood CA/Leukemia?

No

51

NB's have __________ stores of Vit K at birth d/t ______ _________ transfer.

Inadequate
Poor Placental transfer

52

Serum Vit K level is ____ or ____________ in cord blood.

Low
Undetectable

53

Early Vit K deficiency happens when?

What are some sequellae?


Early Vit K deficiency is sometimes noted in which infant's?

First 24 hrs life

ICH, Cephalic hematomas, intra-abdominal hemorrhages

Infants w/mom's tx'd w/anti-hypertensives or anti-convulsants during pregnancy

54

When does Classic Vit K deficiency happen?

What signs might you see?

Day 2-7

Bleeding from umbilical stump, GI tract, or circ site

55

When does Late Vit K deficiency happen?

What often results?

Day7-3 months of age.

ICH and sometimes death

56

T/F: In babies w/ fat-malabsorption, Vit K supplement may be needed.

True

57

What might be an option of supplementation for families who do not want their infant to receive a dose of Vit K at birth?

Maternal Vit K supplement (although not seen in practice)

58

What is the most abundant mineral in the body?

Ca++

59

What mineral is the main structural component of the skeletal system?

Ca++

60

What mineral is regulated by several hormones including PTH,and Calcitonin?

Ca++

61

Low/High Ca++ concentrations generally imply abnormal _______ function or _____ failure

Low
Parathyroid
Kidney

62

In what foods is Ca+ found?

Dairy products
Dark green veggies
Legumes
Fortified food

63

___% Ca++ is found in bones and teeth. The other % is also crucial for health.

99%

64

Where is the remaining 1% Ca++ found?

How does it function?

Plasma & Soft tissues

Vasoconstriction, Vasodilation, Muscle contraction, Nerve impulse transmission, Hormone secretion

65

Intake of Ca++ from fromula may need to be ______ in order to achieve the same retention as infants who are fed human milk (term infants)

Greater

66

LBW infants are at risk for these biochemical abnormalities when deficiencies of Ca++ exist:

Rickets
Low rates of bone mineralization
Reduced linear growth
Low net mineral retention
Hypophosphatemia
Reduced bone mass and subsequent Osteoporosis

67

T/F: Effects of excessive intake are not known in infants/children

True

68

In term infants, Human milk is thought to be a __________ source of Ca++ for the first ___ months of life.

Sufficient

6 months

69

Preterm infants have _______ Ca++ needs than Term infants

Higher

70

T/F: AAP recommends supplementation of Ca++ in preemies?

True
via: HMF, premature formulas, multivitamin preparations

71

In adults w/excessive Ca++ intake what might they have?

Poor muscle tone, Kidney stones, Hypercalcemia, Renal insufficiency, Constipation, Excessive urine loss, Nausea, Coma, Death

72

Iron is an essential _______

Mineral

73

Iron constitutes several classes of ______
Including:

Protein
-Heme proteins (hemoglobin)
-Iron-sulfur
-Nonheme enzymes (flavoproteins)
-Enzymes involved in iron storage and transport

74

Iron plays a role in _____ synthesis

DNA

75

___ proteins are required for the transport of oxygen from lungs to tissues

Heme proteins

76

____ deficiency is the best known nutritional deficiency in the world.
The best known consequence from it is_____.

Iron


Anemia

77

___% of the word's Anemia is from Iron deficiency accounting for >840,000 deaths/year.

50%

78

__-__% of Full Term infants will develop iron deficiency Anemia.

Preemies are at higher/lower incidence.

3-30%


Higher

79

Iron deficiency anemia causes ______ & ______ developmental delays

Mental
Motor

80

Iron supplemented in kids >2y/o, resulted in what?

Increased cognition and enhanced physical performance

81

Homeostasis of Iron is primarily maintained through the coordinated _________ of absorption and __________.

regulation
transport

82

What are dietary sources of iron?

Heme-based: animal-based foods
None-heme based: grain, fruits, vegetables
Human milk: highly bioavailable source
Cow milk-based formula is less well absorbed, recommended >1 yr. age

83

AAP: healthy, full-term babies should receive Iron supplemented sources starting at ___-___ months from complimentary foods.

4-6 months

84

Preterm or LBW infants should begin iron supplementation at ___ month of age

1 month
in NICU- at 2 wks of age if on full feeds

85

What are adverse effects of Excess iron administration?

Promotion of cellular oxidation
Impaired resistance to infection
Interference w/absorption or metabolism of other nutrients
GI abnormalities
Behavioral disturbances

86

Zinc is an essential _____ ________.

trace mineral

87

Zinc has numerous ______ and ________ functions.

Physiologic
Biochemical

88

Zinc is a structural and/or regulatory component of nearly 300 _______ in which it maintains structural integrity and plays a role in regulation of gene ____________.

enzymes

expression

89

Like iron, Zinc is absorbed greater from a _____-based diet vs. _____-based.

Animal
Plant

90

Name some animal food sources of Zinc

Red meat
Oysters
Poultry
Liver

91

Name some plant food sources of Zinc

Beans
Nuts
Whole grains
Fortified cereals
Legumes

92

T/F: Zinc is highly bioavailable in human milk

True

93

Zinc concentrations ________ as lactation progresses

Decline

94

Zinc concentration is ______ in human milk vs. cow milk (just like iron)

Higher

95

Absorption of Zinc is _____ in Soy formulas compared to cow milk-based formulas and human milk

Less

96

Name some signs of Zinc deficiency

Growth retardation
Alopecia
Diarrhea
Delayed sexual maturation and impotence
Eye and skin lesions
Loss of appetite
Behavior (ADHD)

97

Excess Zinc intake causes:

Suppression of immune response
Decreased HDL cholesterol
Reduced Copper
Acute toxicity: epigastric pain, diarrhea, N&V

98

What does chronic, excessive intake of zinc induce?

Secondary Copper deficiency (by competitive interaction during intestinal absorption)

99

Infants fed human milk may benefit from zinc supplementation at what age?

6 months

100

During what age are zinc requirements high?

Second half of the first year (6-12 months)

101

True/False: Preterm formulas and HMF's are a source of Zinc supplementation.

True

102

What are some food sources of zinc?

Lean beef, Legumes, Fortified cereals

103

Iodine is a ____ _______ essential for the synthesis of the Thyroid hormones T4 and T3.

trace mineral

104

Iodine is _______ absorbed and removed from the body

rapidly

105

T/F: Can iodine be absorbed through the skin from topical applications?

Yes (povidone iodine)

106

Iodine content in food depends on the iodine content of the _____ and _____ that were used to grow them.

soil
water

107

Name some sources of iodine

Ocean fish, mollusks
Iodized salt

108

Does human milk have iodine?

Yes, it is dependent on mother's intake

109

Human milk, milk-based formulas and cow milk are all ______ sources of iodine

good

110

Thyroid hormones are essential for the regulation of:

Human growth, development, metabolism, & reproductive function

111

Most iodine is concentrated where?

the Thyroid gland

112

What are other target organs of iodine concentration?

Brain, Muscle, Heart, Pituitary, Kidney

113

T/F: Iodine deficiency is still a common world-wide deficiency.

True

114

What can inadequate Iodine intake result in?

Goiter
Mental retardation
Hypothyroidism
Cretinism
Growth and developmental abnormalities

115

Excessive Iodine intake has not been sufficiently _______.

It is recommended the only source during the 1st yr/life be from _______ & _______.

Studied


Food
Formula

116

What dietary mineral is a/w the prevention of dental caries and stimulation of new bone formation?

Fluoride

117

T/F: Fluoride enhances re-mineralization of enamel.

True

118

_______ is present in saliva and dental plaque.

Fluoride

119

In young children, as much as _____% Fluoride can be retained by developing skeleton and teeth.

80%

120

____ foods contain fluoride naturally.
What are they?

Few
Marine fish and some teas

121

What is our main source of Fluoride?

Artificially fluoridated water

122

T/F: the content of Fluoride in individuals varies greatly

True

123

The content of Fluoride in breastmilk depends on what?

Mother's intake of Fluoride

124

The content of fluoride in formula depends on what?

The water used to reconstitute it

125

Inadequate intake of Fluoride places individuals at risk for?

Dental Carries.

126

The earlier children are exposed to Fluoridated water or dietary supplements, the greater _______ of carries in both primary and permanent teeth.

decrease

127

Dietary Fluoride supplements are intended to compensate for what?

Fluoride deficient drinking water

128

Excessive Fluoride intake can result in varying degrees of?

Fluorosis

129

Mild Fluorosis may render the _____ more resistant to carries.

Enamel

130

Moderate-severe forms of Fluorosis cause ______ issues due to increased porosity (causes the enamel to appear opaque and mottled)

Cosmetic

131

Omega-3 Fatty Acids are important for?
By providing?

Visual and Neurological development
Protection from inflammation
Optimal immune function
Decreasing risk of chronic, Dz's: CV

132

Where are Omega-3 Fatty Acids found?

Oils (canola and flaxseed)
Meats
Eggs

133

The Content of Omega-3 Fatty Acids in human milk is dependent on what?

Mom's diet

134

Formula content of Omega-3 Fatty Acids is usually ____.

Low--it is made w/corn, coconut, safflower, and soy oils.

135

Some evidence exists that intake of Omega-3 Fatty Acids benefits?

Cognitive and Behavioral performance

136

What would excessive Omega-3 Fatty Acid intake lead to?

Possible increased risk of conditions a/w oxidative damage (BPD, NEC)