Nutrition, Fluids, and Metabolic Disorders Flashcards

A neonate of a diabetic mother is at increased risk for hypoglycemia primarily because of:

Answer: Fetal hyperinsulinism from chronic fetal hyperglycemia

Maternal hyperglycemia causes fetal hyperglycemia, leading to pancreatic beta cell hyperplasia and hyperinsulinism, causing hypoglycemia after birth when maternal glucose supply stops.

What is the blood glucose threshold below which treatment is recommended for a symptomatic neonate in the US per AAP guidelines?

Answer: 50 mg/dL

Per AAP guidelines, symptomatic neonates with blood glucose <50 mg/dL should receive IV dextrose, while asymptomatic thresholds vary by age in the first 24-48 hours.

A premature neonate develops metabolic bone disease of prematurity. Which supplementation is most important?

Answer: Calcium and phosphorus

Premature infants miss the third-trimester fetal bone mineralization phase, requiring supplemental calcium and phosphorus to support bone development.

Galactosemia, if untreated, can lead to which life-threatening complication in the newborn period?

Answer: Liver failure, sepsis (especially E. coli), and hypoglycemia

Untreated galactosemia causes hepatocellular damage, coagulopathy, hypoglycemia, and predisposes to E. coli sepsis, which can be rapidly fatal.

In the first 24 hours of life, what is the primary reason insensible water loss is high in extremely premature neonates?

Answer: Thin, poorly keratinized skin with large surface area-to-volume ratio

Extremely premature neonates have thin, minimally keratinized skin with a high surface area-to-weight ratio, resulting in dramatically increased transepidermal water loss.

Neonatal hypocalcemia is defined as a total serum calcium below which threshold in term neonates?

Answer: 8 mg/dL

Neonatal hypocalcemia in term infants is defined as total serum calcium <8 mg/dL (or ionized calcium <1.0 mmol/L), requiring evaluation and possible supplementation.