Nutrition

Front 1

B6 (pyridoxine)

Back 1

infantile seizures, peripheral neuritis, dermatitis, glossitis, microcyic anemia

Front 2

B1 (thiamine)

Back 2

beriberi (peripheral neuritis, loss of vibration sense, cramping legs)
CHF
Wernicke's, Korsadoff's
lactic acidosis

Front 3

B5 (niacin)

Back 3

pellagra (rough skin), dermatisis, diarrhea, dementia, glossitis, stomatitis, vaginitis, achlorhydria

Front 4

folate

Back 4

megaloblastic anemia, neutropenia, diarrhea, poor growth

Front 5

vitamin E def

Back 5

creatinuria, necrosis of voluntary muscle, ataxia, peripheral neuropathy, hemolytic anemia, ophthalmoplegia (), weakness, hyporeflexia

Front 6

Ca

Back 6

ostemalacia, osteoporosis, tremor, seizure, tetany, arrhytmia

Front 7

biotin

Back 7

dermatitis, alopecia, organic acidemia, seizures, ataxia

Front 8

Iron

Back 8

microcytic anemia, malabsorption

Front 9

vitamin D

Back 9

Rickets (craniotabes, rachitic rosary, thickened wrists, ankles, bowing lower extremities), infantiles tetany,

Front 10

Zinc

Back 10

growth failure (dwarfism), skin/nail lesions, poor wound healing, alopecia, delayed puberty, impaired immune system

Front 11

vitamin A

Back 11

night blindness, conjunctival drying, Bitot spots (silvery grey spots on conjunctiva), photophobia

Front 12

vitamin C

Back 12

tenderness in legs, pseudoparalysis, spongy blue gums

Front 13

vitamin K

Back 13

hypoprothrombinemia, hemorrhagic diesase of newborn

Front 14

magnesium

Back 14

tremor, tingling, weakness, siezure, arrhythmia

Front 15

preterm infant formula, fat content

Back 15

medium chain triglycerides, easier to absorb. no bile required. transported directly to liver, do not need to be esterified into chylomicrons

Front 16

preterm infant Ca:Phos ratio

Back 16

2:1 to 4:1

Front 17

preterm formula, carbs

Back 17

glucose polymers. Not lactose, relatively lactase deficient.

Front 18

preterm formula, protein

Back 18

whey (lactalbumin) more than casein. 60:40. similar to breast milk. term formulat might be 20:80.

Front 19

nonprotein energy goal for VLBW infant

Back 19

nonprotein >30kcal/kg prevents neg nitrogen balance. later >70kcal/kg

Front 20

use of Na in VLBW infant

Back 20

no Na for first week, then 3-6meq/kg daily

Front 21

protein requirement of newborn

Back 21

3.5-4g/kg/day

Front 22

vit K cofactors

Back 22

II, VII, IX, X both PT and PTT

Front 23

vit K deficiency sx, complications

Back 23

bleeding in breastfed infants, 1st week. GI and intracranial bleeds.

Front 24

metronidazole in breastfeeding

Back 24

discontinue BF for 24hrs after single dose therapy for trichomonas. If on 7 day therapy, no BF for that week.

Front 25

TPN, fats start and max

Back 25

1g/kg up to 4g/kg. Stop if hyperbili present (they can bump off protein bound bili)

Front 26

high polyunsaturated fats in preterm infants

Back 26

causes hemolytic anemia, reticulocytosis, throbocytosis if not mixed wtih enough vit E.

Front 27

nutritional differences breastmilk vs cow

Back 27

same caloric density. human milk has less protein. whey:casein humans 80:20. formula 40:60. lactose same in both. more fat in cow milk

Front 28

most common complication of enteral feeds

Back 28

diarrhea.

Front 29

diet modification in liver failure

Back 29

increase fat sol vitamens. med chain fatty acids (more easily absorbed than long chain.

Front 30

folate deficiency anemia cytology

Back 30

macrocytic, hypersementation of neutrophils.

Front 31

vit A toxicity

Back 31

HA, extremity pain, HSmeg. tibial eedema. seen in teens on isotretinoin.

Front 32

percent increase in calories req for each degree of temp elevation

Back 32

12% of maintenance req per degree centigrade over 37.

Front 33

familial hypophosphatemia

Back 33

most common non-nutitional form of rickets. xlinked. renal leak of phosphate. calcitriol does not treat. elevated alk phos. nl Ca and parathyroid hormone.

Front 34

vit D deficiency

Back 34

inadequate intake of vit D. or not enough sunlght. rickets associated with low phosphate, low-nl Ca, hi alk phos.decreased renal tubular reabsorption of phos and hyperparathyroidism 25-hydroxyD is low

Front 35

vit D-independent rickets, type I

Back 35

no 1 alpha-hydroxylase enzyme in prox tubule. 25-hydroxyvit D is nl. 1,25 dihydroxy D is 0. (type I is analogous to DM)

Front 36

vit D dependent rickets, type II

Back 36

end-organ resistance to vit D. high 1,25 dihydroxyvit D. (type II analgous to DM)

Front 37

percent of infants with cross allergy to soy protein from milk protein

Back 37

50%

Front 38

most common cause of anemia in CRF on epo

Back 38

Fe Deficiency

Front 39

composition of colostrum vs mature milk

Back 39

Colostrum: more protein (mostly whey), little fat. 50kcal/dL
Mature: lots of fat (very long chain), 70kcal/dL
lactose is same in both. Ca 30mg/dL is same, phos 14mg/dL same.

Front 40

major component of whey

Back 40

alpha lactalbumen

Front 41

vitamin supp for BF

Back 41

4-6 mo of age. Fe 1mg/kg
Vit D for dark skin or low sunlight 400IU

Front 42

how long can express milk be used

Back 42

48hrs refrigerated. frozen if used later

Front 43

contraindications to BF

Back 43

galactosemia, tyrosinemia, HIV mother, mother undergoing cancer therapy or other drug therapy contraindicated.

Front 44

weight gain in 1st yr

Back 44

0-3mo: 20-30g/day
3-6mo: 15-20g/day
6-12mo: 10-15g/day

Front 45

VLBW energy req

Back 45

100-120kcal/kg to achieve 15g/day growth

Front 46

VLBW protein intake

Back 46

3.5-4g/kg/day

Front 47

VLBW fat intake

Back 47

50% of calories, medium chain TG and vegi oils. no very long chain fats (DHA, arachadonic acid)

Front 48

VLBW carb req

Back 48

10-14g/kg/day 40-50% of calories

Front 49

refeeding syndrome

Back 49

giving too much carbs to chronicly malnourished can induce resp failure.

Front 50

preterm osmole needs

Back 50

immature kidneys do not retain or concentrate as well. more Na, K, and everything needed so higher osmolality to preterm formula.

Front 51

decreased sense of taste.

Back 51

zinc def. common in Chron's

Front 52

best way to improve nutrition in CHF like hypoL

Back 52

NG feeds continuous.

Front 53

purpose of lactose derived oligosaccharaides in milk

Back 53

inhibit bacterail adhesion to mucosal surfaces

Front 54

change in AA and DHA over time with milk

Back 54

same in preterm milk and term. declines with evolving lactation.

Front 55

change in Zn over lactation

Back 55

decreases with time

Front 56

complications of increasing to 30kcal/oz with standard formula and fat in kids iwth chronic illness

Back 56

diarrhea from incraeased solute load. electrolyte imbalance rare if done correctly.