CSP CSP Enteral & Parenteral Nutrition Support 2

Question 1

Which lipid emulsion is preferred in pediatric PN to reduce the risk of IFALD compared to soy-based emulsions?

Accepted Answer

Fish oil-based lipid emulsion (Omegaven) or mixed emulsions (SMOF)

Answer

Fish oil-based or mixed lipid emulsions (SMOF) contain omega-3 fatty acids and lower phytosterol content, reducing hepatic injury risk.

Question 2

What is the primary purpose of adding carnitine to parenteral nutrition in preterm neonates?

Accepted Answer

To facilitate long-chain fatty acid transport into mitochondria for oxidation

Answer

Carnitine is essential for transporting long-chain fatty acids across the mitochondrial membrane for beta-oxidation, and preterm infants have limited endogenous synthesis.

Question 3

Which clinical finding most strongly suggests catheter-related bloodstream infection (CRBSI) in a child receiving home PN?

Accepted Answer

Fever coinciding with PN infusion that resolves when infusion stops

Answer

Fever that begins during PN infusion and resolves after stopping is a hallmark presentation of CRBSI, indicating the central venous catheter as the infection source.

Question 4

For a pediatric patient requiring cyclic PN, what is the primary clinical benefit of cycling infusion over 12–16 hours nocturnally?

Accepted Answer

Allows periods of fasting that reduce hepatic fat deposition and improve liver function

Answer

Cyclic PN provides fasting periods that lower insulin levels, reduce hepatic lipogenesis, and allow for biliary flow, thereby protecting liver function.

Question 5

A preterm neonate on PN develops hypercalcemia. Which modification to the PN formulation is most appropriate?

Accepted Answer

Reduce calcium and vitamin D content in the PN

Answer

Hypercalcemia in PN-dependent neonates is managed by reducing calcium and vitamin D content to lower the calcium load being infused.

(CSP) Certified Specialist in Pediatric Nutrition Practice Test

(CSP) Certified Specialist in Pediatric Nutrition Practice Test

CSP CSP Enteral & Parenteral Nutrition Support 2