Pedia Handy Notes 1 > Nutrition > Flashcards

Nutrition Flashcards

(50 cards)

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1
Q

amount of nutrient that results in some predetermined physiologic end point

A

Estimated Average Requirement

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2
Q

intake deemed to meet the requirement for that nutrient

A

Recommended Daily Allowance

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3
Q

dietary energy intake predicted to maintain energy balance in a healthy individual

A

Estimated Energy Requirement

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4
Q

observed/ approx. daily intake of that nutrient

A

Adequate intake

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5
Q

iron binding whey protein inhibiting E.coli

A

Lactoferrin

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6
Q

stimulate lipase –> kills G.lamblia & E.histolytica

A

Bile salt

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7
Q 
Water Requirement
0-6 mos:
7-12 mos:
1-3 y/o:
4-8y/o:
A

0-6 mos: 700ml/24hrs
7-12 mos: 800ml/24hrs
1-3 y/o: 1300ml/24hrs
4-8y/o: 1700ml/24hrs

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8
Q
  • Inadequate energy or CHON energy intake
  • Failure to gain wt, irritability, wt loss, listlessness, emaciation
  • Wrinkled & loose skin, shrunken & wizened face
  • Constipated, may have starvation diarrhea
  • Muscle atrophy, hypotonia, abdominal distended/ flat
A

marasmus

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9
Q
  • Inadequate CHON intake
  • Lack of growth & stamina
  • Lethargy, apathy, irritability
  • ↓albumin, enlarged liver
  • ↑infection, diarrhea, vomiting
  • Edema, flabby subcutaneous tissue
  • Dermatitis: depigmentation
  • Hair: sparse, thin, streaky red/gray
A

Kwashiorkor

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10
Q
  1. Initial phase (1-7 days) STABILIZATION PHASE
    - Treat dehydration, oral F75, antibiotics
  2. REHABILITATION PHASE (2-6wks)
    - Iron therapy, oral F100, antibiotics
  3. FOLLOW UP PHASE
    - Catch up growth, emotional & sensory
A

treatment of SCU

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11
Q
  • severe hypophosphatemia <0.5mmol/L
  • Weakness,
  • rhabdomyolysis
  • neutrophil dysfunction
  • cardiorespiratory failure
  • arrhythmia
  • seizure
  • death
A

Refeeding Syndrome

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12
Q
  • chronic necrotizing ulceration of gingival & cheek
  • Fever, malodorous breath, anemia, leukocytosis & sign of malnutrition
  • Preceded by debilitating illness (measles, malaria, TB, diarrhea, ulcerative gingivitis)
  • Fusobacterium Necrophorum & Prevotera Intermedia

TX: wound care, Penicillin, Metronidazole

A

NOMA

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13
Q

Predictor of Obesity

A

1st: increase BW
strongest: parental obesity

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14
Q

BMI

A

kg/m2

NV: 18.5 – 24.9

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15
Q

most important metabolite of Vitamin A

A

retinoic acid

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16
Q
  • dry, scaly, hyperkeratotic patches, bitot’s spot
    Early: delayed adaptation, photophobia, xerophthalmia
    Late: keratomalacia, blindness
A

Vitamin A deficiency

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17
Q

1500 ug/day (latent deficiency)

1500-3000 ug/day (↓measles morbidity & mortality)

A

Treatment for Vitamin A deficiency

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18
Q

Adult: 15,000ug
Child: 6,000ug
Acute toxicity: n/v, drowsiness, diplopia, papilledema, CN palsies, pseudotumor cerebri
Subacute/ chronic toxicity: h/a, vomiting, anorexia, dry, itchy desquamating skin, seborrheic cutaneous lesions, fissuring corners of the mouth, alopecia, coarsening of hair, swelling of the bones, liver & spleen enlargement, diplopia, ↑ICP, irritability, stupor, limited motion, desquamation of palms & soles
Radiograph: hyperostosis of several long bones, middle of shaft

A

Hypervitaminosis A

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19
Q

 Early: fatigue, apathy, irritability, drowsy, anorexia, -nausea, poor mental concentration, abdominal discomfort

  • Late: peripheral neuritis, loss of vibration sense, leg cramps, heart failure, psychic disturbance, ptosis, optic nerve atrophy, ataxia, ↑ICP, coma, hoarseness & aphonia
  • Death: heart involvement

Beriberi
oWet: undernourished, edematous, waxy skin, urine (albumin, cast)
oDry: plump, flabby, hepatomegaly, listlessness

A

Thiamin (B1) deficiency

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20
Q

dx & tx of Thiamin (B1) deficiency

A

dx: ↓RBC transketolase activity (best indicator)
Tx: 10mg PO (IV/IM if w/ heart failure)

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21
Q

-Cheilosis (perleche), glossitis, keratosis, conjunctivitis, photophobia, lacrimation, corneal vascularization, seborrheic dermatitis, anemia

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A

Riboflavin (B2) deficiency

22
Q

dx & tx of Riboflavin (B2) deficiency

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A

Dx: erythrocyte glutathione reductase >1.4
Urine excretion <30ug/d
Tx: 3-10mg/day (2mg TID IM if not effective)

23
Q

Pellagra:
dermatitis (gloves – hand, pellagrous boot, casal necklace)
diarrhea
dementia

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A

Niacin (B3) deficiency

24
Q

dx & tx of Niacin (B3) deficiency

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A

Dx: confirmatory test: rapid response to niacin
Tx: 50-300mg/day

25
- d/t INH, Penicillamine, corticosteroids, OCP, dialysis, anticonvulsants - Peripheral neuritis, dermatitis, irritability, convulsion, anemia, seborrheic dermatitis, cheilosis, glossitits, hyperglycinemia, lymphopenia & ↓Ab formation
Pyridoxine (B6) deficiency
26
dx & tx for Pyridoxine (B6) deficiency
- Dx: ↓erythrocyte & glutamic pyruvic transaminases -Tx: 100mg for seizure 2-10mg IM or 10-100mg PO for pyridoxine dependent
27
- dermatitis, conjunctivitis, alopecia, CNS abnormalities | - Avidin: biotin antagonist
Biotin (B7) deficiency
28
- d/t NSAID, Phenobarbital, methotrexate, diphenylhyantoin - Malabsorption, dse w/ high cell turnover rate (sickle cell anemia, psoriasis), inborn error of folate metabolism, autoantibodies against cerebral folate receptor
Folate (B9) deficiency
29
tx for Folate (B9) deficiency
-Tx: folinic acid | Prevention of NTD, spina bifida & anencephaly: 400ug
30
- Vegan diet, undiagnosed pernicious anemia & malabsorption syndrome - Leber optic atrophy should not be given cyanocobalamin
Cobalamin (B12) deficiency
31
* *Infants & young children - Onset of manifestation: 6-24 mos - Low grade fever, irritability, tachypnea, digestive disturbance, generalized tenderness, pseudoparalysis - Edematous swelling, subperiostal hemorrhage, “rosary” @ the costochondral junction - Bluish purple, spongy welling of mucous membrane - Anemia, Sicca syndrome of Sjogren (xerostomia, keratoconjunctivitis sicca, enlarged salivary gland) * *Infants, older children & adolescents - Swollen joints, purpura & ecchymoses, poor wound & fracture healing, petechiae, perifollicular hemorrhages, hyperkeratosis, arthralgia & muscle weakness
Scurvy
32
degeneration of skeletal muscles, heart hypertrophy, BM depletion, adrenal atrophy
severe Vitamin C deficiency
33
tx of Vitamin C deficiency
Tx: daily intake of 3-4oz of orange/ tomato juice | Vitamin C: 100-200mg orally/ parenterally
34
- Dse of growing bone – before fusion of epiphyses - Vit D disorder, Ca & phosphorus deficiency & distal renal tubular acidosis - Craniotabes, widening of the costochondral junctions (rachitic rosary), growth plate widening – enlargement at wrist and ankle, Harrison groove - ↑ risk of pneumonia - Phenobarbital & phenytoin: ↑degradation
Rickets
35
tx of Rickets
* stoss therapy: 300,000-600,000 IU vit D (PO/IM) 2-4x x 1 day * alternative: 2,000 – 5,000 IU/day Vit D daily over 4-6wks ff by daily vitamin D intake of 400 IU/day
36
triad: 1. Polyostotic Fibrous Dysplasia, 2. hyperpigmented macules, 3. polyendocrinopathy - low 1,25 D & elevated alkaline phosphatase - renal phosphate wasting & inhibition of 1,25 D synthesis are related to the polyostotic fibrous dysplasia
McCune-Albright Syndrome
37
- generalized dysfunction of the renal proximal tubule - renal loss of phosphate, amino acid, bicarbonate, glucose & urate - most clinically relevant consequences: hypophosphatemia & proximal renal tubular acidosis
Fanconi Syndrome
38
- severe progressive neurologic disorder in prolong deficiency - CM don’t appear until after 1 y/o - Loss of DTR: usually the initial finding - Limb & truncal ataxia, dysarthria, ophthalmoplegia, nystagmus, ↓proprioception, ↓vibratory sensation - Hemolysis during the second month of life in premature
Vitamin E deficiency
39
tx of Vitamin E deficiency
o neonates: Vitamin E 25-50 u/day for 1 wk | o Severe malabsorption: 20-25 u/kg/day
40
Vit K synthesizes what clotting factors
clotting factors II, VII, IX & X
41
Vitamin K1
phylloquinone
42
-1-14 days of age -Low stores of vit K @ birth; inadequate intake of breastmilk -MC site of bleeding: GIT mucosal & cutaneous tissue umbilical stump post circumcision site
Early VKDB (classic hemorrhagic dse of newborn)
43
- MC @ 2-12wks of age up to 6 mos - Almost all cases are breastfed infants - RF: occult malabsorption of Vitamin K (cystic fibrosis or cholestatic liver dse) - MC site: intracranial - Initial manifestation: cutaneous & GI bleed
Late VKDB
44
Vitamin K Deficiency Bleeding (VKDB) of newborn secondary to maternal intake of what medications
o Warfarin o Phenobarbital o Phenytoin
45
dx of vitamin K deficiency
-Diagnosis established by presence of prolonged PT that corrects rapidly after Vit K administration
46
mutation in the gene coding for CHON that facilitates interstitial copper absorption Copper deficiency
Menkes dse
47
recessive d/o 2o malabsorption of Zinc
Acrodermatitits enteropathica
48
↓growth, dermatitis of extremities & around orifices, impaired immunity, poor wound healing, hypogonadism, diarrhea
Acrodermatitits enteropathica
49
cardiomyopathy 2o Selenium deficiency
Keshan Dse
50
↓wt for length
wasting
Pedia Handy Notes 1
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