Peds Board Review - Nutrition

Front 1

By CDC and AAP definition, anemia (ages 9 mo – 24 mo) is a hemoglobin less than _______

Back 1

11 g/dL

Front 2

Normal hearing threshold is at what minimal decibels?

Back 2

20 dB

Front 3

Type II Diabetes screening should be initiated for:

BMI greater than or equal to _____ %
Beginning at age _____ years or at the start of puberty
At a frequency of every _____ years
If TWO or more of the following risk factors are present
______________________
______________________
______________________

Back 3

BMI > 85%
Age 10 yrs every 2 yrs
Risk factor 1: ethnicity (American Indian, black, Hispanic, Pacific Islander)
Risk factor 2: Family History (1st/2nd degree relative with Type II DM)
Risk factor 3: Signs of insulin resistance (acanthosis, HTN, dyslipidemia, PCOS)

Front 4

What is a normal Ear Canal Volume for interpreting a tympanogram?

Back 4

0.2 – 2.0

Front 5

Vitamin A deficiency puts you at risk for severe infections. In developing countries, the top two most common infections in Vitamin A deficient persons are ____ and ____.

Back 5

Measles and diarrhea

Front 6

By CDC definition, overweight is from _______ to ______ % BMI?

Back 6

85 – 95%

Front 7

By CDC definition, obese is a BMI greater than ______ %

Back 7

95%

Front 8

What medical conditions would lead to
Vitamin A deficiency through malabsorption?

Back 8

Celiac disease, hepatic disease, low protein or low fat diets

Front 9

Name 4 clinical features of Vitamin A deficiency.

Back 9

Night blindness (nyctalopia)
Xerophthalmia (dry eyes from keratinization of conjunctiva)
Follicular hyperkeratosis (dry skin on extensor surfaces)
Bitot spots (silvery patches on conjunctiva)

Front 10

True or False: Breastfeeding is protective for Vitamin A deficiency.

Back 10

TRUE

Front 11

Name 3 clinical features of Vitamin A excess.

Back 11

Increased ICP
Carotenemia
Painful joints
Hair loss
Drowsiness

Front 12

Vitamin D3 (cholecalciferol) is hydroxylated in two places in the body to form the physiologically active form. Name the two organs.

Back 12

Liver converts D3 into 25-hydroxyl-D3

Kidney: next into 1,25-dihydroxy-D3

Front 13

List 4 reasons for Vitamin D deficiency.

Back 13

Unsupplemented exclusive breastfeeding with inadequate light exposure
Darkly pigmented children.
Rapidly growing children and teens.
Malabsorption states (celiac, CF, anticonvulsants)

Front 14

Name 3 clinical signs of Vitamin D deficiency

Back 14

Bowlegs, kyphosis, delayed dentition, widened wrists, visible rachitic rosary, FTT, frontal bossing, widened sutures, seizures/tetany

Front 15

What daily volume of formula is adequate to prevent Vitamin D deficiency?

Back 15

500 cc per day

Front 16

What is the daily recommended dose of Vitamin D for newborns?

Back 16

400 IU Vitamin D

Front 17

Name clinical features of Vitamin D excess.

Back 17

Kidney stones, polyuria, polydipsia, hypotonia, anorexia, HTN, corneal clouding

Front 18

What medical conditions predispose to Vitamin D deficiency?

Back 18

short bowel syndrome
Cholestatic liver disease
VLBW preemies
Any malabsorption state
Abetalipoproteinemia

Front 19

What autosomal-recessive inborn error of metabolism has Vitamin E deficiency and presents with steatorrhea from birth, pigmented retinopathy, and progressive ataxia?

Back 19

Abetalipoproteinemia

Front 20

What are the clinical features of Vitamin E deficiency?

Back 20

hyporeflexia
Ophthalmoplegia
Muscle weakness
Ataxia
Hemolytic anemia

Front 21

Where is Vitamin K made in the human body?

Back 21

Made by bacteria in intestines and absorbed in jejunum

Front 22

What are the 3 nutritional chemical components of all formulas?

Back 22

Protein, Carboyhydrate, Lipid

Front 23

What are the two main proteins in human milk, formula, and cow milk?

Back 23

Casein and whey

Front 24

What is the percentage casein and whey:
Breast milk ___% casein ____% whey
Cow’s milk ___% casein ____% whey

Back 24

Breast milk
30% casein 70% whey
Cow milk
80% casein 20% whey

Front 25

Which milk protein is more digestible
Casein or whey?

Back 25

Whey

Front 26

Of the milk whey proteins, what are the two predominant protein species?

Back 26

Alpha-lactoglobulin
Beta – lactoglobulin

Front 27

Which of the whey proteins (alpha-lactoglogulin or beta-lactoglobulin) is more prevalent in:
Human milk vs. Cow milk

Back 27

Human milk: alpha lactoglobulin predominates
Cow milk: beta lactoglobulin predominates

Front 28

TRUE or FALSE: Formula contains 50% more protein than breast milk

Back 28

TRUE

Front 29

The predominant protein in preterm formula is casein or whey?

Back 29

Whey

Front 30

Lipids provide ____ % of the caloric content of breast milk

Back 30

50%

Front 31

What substance do premature infants lack in their intestines to absorb/digest lipids?

Back 31

They do not have adequate bile acids

Front 32

Name the type of lipid that can be absorbed directly into the portal system rather than being emulsified by bile acids.

Back 32

Medium chain triglycerides

Front 33

What is the major carbohydrate in human milk

Back 33

Lactose (glucose + galactose)

Front 34

What is the major carbohydrate of standard cow-milk formulas?

Back 34

Lactose (glucose + galactose)

Front 35

What is the major carbohydrate in soy formulas?

Back 35

Corn syrup solids (glucose polymers) or sucrose (glucose + fructose)

Front 36

Preterm formulas predominantly contain what type of carbohydrate?

Back 36

Glucose polymers 60%
Lactose 40%

Front 37

Name 3 biologically active products found in breast milk NOT found in formula.

Back 37

Oligosaccharides (reduce bacterial attachment)
Nucleotides (enhances immune response)
Growth factors (Epidermal GF, Nerve GF)
Cellular components than enhance immune system (lactoferrin, lysozyme)
Secretory IgA
Cytokines

Front 38

Preterm formula contains a higher or lower osmolality for the immature kidneys?

Back 38

Higher osmolality

Front 39

In galactosemia, which formula is preferred?

Back 39

Soy formula

Front 40

Describe the metaphyses in this xray

Back 40

metaphyseal cupping and fraying from Vitamin D deficiency