Pediatric Nutrition Flashcards
(76 cards)
1
Q
Immunoglobulin that is high in breastmilk?
A
IgA
2
Q
The whey-to-casein ratio in mature human milk
A
3:2
3
Q
Breastmilk is initiated within ____
A
1-4 hours after birth
4
Q
____ mL intake in the first week of life
A
60-90 mL/feeding
6-9 feedings/24 hours
5
Q
[Type of Breastmilk]
High lactose, high protein, watery
A
Foremilk
6
Q
[Type of Breastmilk]
High fat, creamy
A
Hindmilk
7
Q
Colostrum is secreted within ___ days
A
0 to 7 days
8
Q
What are the IgG/protective factors that are high in breastmilk
A
- Lactoferrin
2. Lysozyme
9
Q
Colostrum has low ___
A
- Fat
2. Carbohydrates
10
Q
Mature milk will be produced at ___ DOL
A
10-14
11
Q
[Casein to whey ratio]
Early milk
A
10:90
12
Q
[Casein to whey ratio]
mature milk
A
40:60
13
Q
[Casein to whey ratio]
late lactation
A
50:50
14
Q
Fat globules bound by membranes are rich in ____
A
- Phospholipids
2. Cholesterol
15
Q
Formula milk has a higher ____ compared to breastmilk
A
- Iron
- Vitamin D
- Vitamin K
16
Q
What is the definitive test to diagnose pediatric GERD?
A
esophageal pH probe
17
Q
Esophageal pH monitoring of __ which part of the esophagus
A
distal esophagus
NV: <5-8% of total monitored time
18
Q
Patients with GERD, patient shall be position ____ carried position
A
prone or upright
19
Q
What are the symptoms of GERD in infants
A
- Regurgitation
- Excessive crying
- Irritability
20
Q
What are the symptoms of GERD in children
A
- Vomiting
- Food refusal/feeding disturbances/anorexia
- Persisting hiccups
- Sandifer syndrome
21
Q
What are the contraindications to breastfeeding?
A
- Galactosemia
- Septicemia
- Active TB
- Breast CA
- Malaria
- Substance abuse
- Severe neurosis or psychosis
- HIV
22
Q
Mother is no longer infectious after ____ of TB treatment
A
2 weeks after
23
Q
HIV mother can breastfeed in times where no safer alternative is available provided that
A
- Shortest possible duration
2. Exclusive breastfeeding
24
Q
[Micronutrient deficiency]
Excematous, dry, scaly or psoriasiform, perioral, sacral, perianal areas
A
Zinc
25
[Micronutrient deficiency]
generalized scaly dermatitis
alopecia
Essential fatty acids
26
[Micronutrient deficiency]
edema, erythema, burning of sun exposed skin on the face, neck, hands
diarrhea, dementia
Pellagra/Niacin
27
[Micronutrient deficiency]
alopecia with neurological symptoms
Biotin / Vit B7
28
[Micronutrient deficiency]
Night blindness, xerosis
Vit A
29
[Micronutrient deficiency]
perifollicular erythema and hemorrhage; bleeding swollen gums
Vit C
30
What is the bioavailability of vitamin A in breastmilk?
>90%
31
Bone changes in pediatric patients with Vitamin A deficiency
Faulty epiphyseal bone formation, defective tooth enamel
32
Vitamin ____ in human milk that depends on maternal sunlight exposure
Vitamin D
33
Facial exposure to sunlight of ____ hours for at least once a week is is sufficient for Vit D
2 hours
30 mins with bare arms and legs
34
Rickets appear in children only before ___
fusion of the epiphyses
increase in the circumference of the growth plate and metaphysis
35
___ is a horizontal depression along the lower anterior chest due to pulling of softened ribs by the diaphragm during inspiration due to Vit D deficiency
Harrison groove
36
___ is a result of widening of costochondral junctions due to Vit D deficiency
Rachitic Rosary
37
___ deformity
valgus deformity of 1 leg with varus deformity of the other leg
Windswept deformity
38
What comprise Stoss Therapy?
Vitamin D 300,000-600,000 IU IM or OD 2-4 doses over 1 day
39
Vitamin that has a constant value in mature milk
Vitamin E
0.32 mg tocopherol equivalents/100mL
40
Deficiency in Vitamin E can lead to
1. RBC hemolysis in premature infacnts
2. Loss of neural integrity
3. Posterior column and cerebellar dysfunction
4. Pigment retinopathy
41
What is the vitamin K content of breast milk
0.1-0.4 ug/100mL
42
What are the possible causes of early vitamin K deficiency of the newborn?
1. Poor transfer of vitamin K across the placenta
2. Inadequate intake during first few days of life
3. No intestinal synthesis of vitamin K2
43
[Micronutrient deficiency]
angular cheilosis (perleche), glossitis (magenta tongue)
riboflavin (vitamin B2)
44
Vitamin deficiency associated with long term use of high estrogen OCP by mothers
Vitamin B6
45
___ mg/day of B6 supplementation is needed by mothers taking high estrogen OCPs to prevent neonatal deficieny
20 mgday
46
___ is a water soluble vitamin bound to protiens in the whey fraction of breastmilk
Vitamin B12 and B9
47
___ mg of Vitamin C is requried to prevent scurvy
8 mg
48
____ rosary
| seen in Vitamin C at the costochondral junction and depression of the sternum; sharper beads compared to rachitic
Scorbutic rosary
49
[Micronutrient deficiency]
perifollicular hemorrhages, hyperkeratosis of hari follicles, corkscrew hair
XRAY: distal ends of long bones with ground grass appearance
Vitamin C deficieny
50
____ mg of vitamin C supplemented OD/IV are preferable to ensure more rapid and complete cure of deficiency
100 to 200mg
51
Iron in breastmilk is sufficient to meet infants iron needs to how many months
6-12 months
Iron is lesser in milk but is more bioavailable
52
The fetal stores of Zinc that can supply for 6 months are accumulated in the ___ trimester of pregnancy
Third trimester
53
Iodine accumulates in what part of the mother
Mammary gland
54
What vitamins and minerals are significantly affected by maternal status?
1. Vitamin D
| 2. Iodine
55
[Micronutrient deficiency]
Perleche
Vitamin B2
56
[Micronutrient deficiency]
White line on end of shaft
Vit C
57
[Micronutrient deficiency]
Absence of metaphyseal changes
Vit A toxicity
58
[Micronutrient deficiency]
Casal necklace, gloves and boots
Vit B3
59
[Micronutrient deficiency]
brawny swelling, dry skin, seborrhea, pruritus, painful extremities
Hypervitaminosis A
60
[Micronutrient deficiency]
corn as staple
Niacin
61
[Growth Chart]
Height for age measures ___
Linear growth
Cumulative impact
62
[Growth Chart]
Weight-for-height measures
Wasting
Acute malnutrition
63
[Growth Chart]
MUAC cut off for wasting
11.5-12.5
64
[Growth Chart]
MUAC cut off for severe wasting
<11.5
65
What are the parameters that can assess acute malnutrition
1. WFL or WFH
2. MUAC
3. BMI
66
[Diagnose]
```
Growth failure
edema
hair changes
mental changes
flaky pain
fatty liver
```
Kwashiorkor
67
[Diagnose]
```
Growth failure
Wasting
no edema
no mental changes
no dermatosis
good appetite
Monkey-like face
no hepatomegaly
```
Marasmus
68
Severe acute malnutrition is diagnosed by ____
WFL or height below -3SD
based on CGS
69
In children ages 6-59 months, a MUAC of ____ mm denotes extreme thinness
<115mm
70
What are the immediate goals in treating malnourished children?
Prevent hypoglycemia, hypothermia, dehydration
71
What are the criteria for inpatient care of patients with SAM?
1. Severe edema
2. MUAC <115 mm
3. Anorexia
4. Clinically unwell
5. Not alert
72
What is the electrolyte abnormality in patients with refeeding syndrome?
1 Hypokalemia
2. Hypophosphatemia
3. Hypomagnesemia
73
What is the hallmark of refeeding syndrome?
Severe hypophosphatemia
PO4 /< 0.5mmol/L
74
Overweight children belongs to what BMI percentile for age?
>/ 95th
75
At >85th percentile, what are the possible associated diseases of the child
1. Hypercholesterolemia
2. Hypertriglyceridemia
3. Low HDL
4. Abdominal central obesity
76
___ syndrome
Extreme exogenous obesity leading to severe cardiorespiratory distress with alveolar hypoventialtion
Pickwickian syndrome
