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Question 1
Correct
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A 5 month old boy presents with pallor but otherwise appears well and healthy. The clinical examination was normal and his mother reported a good appetite. His blood results showed: Hb: 9.0 g/dl (11 – 16 g/dl)MCV: 66fl (76 – 96 fl)WBC : 5x109/L (4 – 11x109/L)Ferritin : 9ug/L (12 – 200ug/L)Serum iron : 7umol/l (14 – 31umol/l)What is the most likely diagnosis?
Your Answer: Iron deficiency anaemia
Explanation:Iron deficiency anaemia has the following laboratory characteristics: low haemoglobin, a low serum iron, a low serum ferritin, a low transferrin saturation, and a high total iron-binding capacity.
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This question is part of the following fields:
- Nutrition
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Question 2
Incorrect
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A well preterm baby in a thermo-neutral environment requires how much energy to maintain essential body functions?
Your Answer: 120kcal/kg/day
Correct Answer: 50kcal/kg/day
Explanation:The average amount of energy required by a well preterm baby in a thermo-neutral environment is 50/kcal/kg to maintain essential body functions while it takes about 70 kcal/kg/day for optimal growth. It is important to ensure that enough proteins are given per calorie to limit catabolism and promote cell building. Caloric need usually increases when the baby is ill.
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This question is part of the following fields:
- Nutrition
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Question 3
Correct
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Mature human milk contains how many calories?
Your Answer: 70kcal/100ml
Explanation:Human breast milk composition changes with the progressive age of the infant. Breastmilk produced for a preterm baby often has a higher caloric content than breastmilk for a term baby. After the production of colostrum in the first days of life, the milk continues to mature. by week 4-6 milk can be considered fully mature. The average calories found in mature breastmilk are about 70kcal/100ml
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This question is part of the following fields:
- Nutrition
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Question 4
Incorrect
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What is the ideal growth rate of a new-born baby when receiving appropriate nutritional input?
Your Answer: 25g/kg/day
Correct Answer: 15g/kg/day
Explanation:The general target of weight gain in the neonatal intensive care unit is to replicate the intrauterine growth in the third trimester, which equates to the daily weight gain of nearly 15 g/kg/day with infants receiving 120 kcal/kg/day
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This question is part of the following fields:
- Nutrition
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Question 5
Incorrect
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A strict gluten-free diet is a dietary treatment for coeliac disease.Which one of the following statements concerning the gluten-free diet is correct?
Your Answer: Oats can be included freely in the gluten-free diet
Correct Answer: Buckwheat is suitable in a gluten-free diet
Explanation:Buckwheat is not wheat. It’s a seed rather than a grain, which means it’s gluten-free and safe for people with celiac disease and non-celiac gluten sensitivity. It is an excellent source of fibre and nutrients.
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This question is part of the following fields:
- Nutrition
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Question 6
Incorrect
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A 17-year-old boy, who had developed shortness of breath and a loss of appetite over the last month, was referred to a haematologist because he presented with easy bruising and petechiae. His prothrombin time, platelet count, partial thromboplastin and bleeding time were all normal. Which of the following would explain the presence of the petechiae and easy bruising tendency?
Your Answer: Uraemia
Correct Answer: Scurvy
Explanation:Scurvy is a condition caused by a dietary deficiency of vitamin C, also known as ascorbic acid. Humans are unable to synthesize vitamin C, therefore the quantity of it that the body needs has to come from the diet. The presence of an adequate quantity of vitamin C is required for normal collagen synthesis. In scurvy bleeding tendency is due to capillary fragility and not coagulation defects, therefore blood tests are normal.
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This question is part of the following fields:
- Nutrition
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Question 7
Incorrect
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A 12-year old boy with cystic fibrosis is here for his annual review. Which of the following diets is most appropriate for this patient?
Your Answer: High calorie and low fat with pancreatic enzyme supplementation for evening meal
Correct Answer: High calorie and high fat with pancreatic enzyme supplementation for every meal
Explanation:The management of cystic fibrosis requires a multidisciplinary approach, starting with a planned diet.The critical points of this management approach are:Chest physiotherapy and postural drainage – the parents are usually taught to do this.Deep breathing exercises,High calorie, high fat intake with vitamin supplementation.Pancreatic enzyme supplements with meals.Heart-lung transplantation would be the definitive treatment.Note: Previously, a high-calorie, low-fat diet was recommended to reduce steatorrhea. However, it is no longer the desired approach.
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This question is part of the following fields:
- Nutrition
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Question 8
Incorrect
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A 17-year-old girl presents with multiple non-healing ulcers, poor dentition, bleeding gums and pale conjunctivae. She also complains of easy fatiguability.What is the most probable diagnosis?
Your Answer: Vitamin B12 deficiency
Correct Answer: Vitamin C deficiency
Explanation:The clinical scenario presented is highly suggestive of vitamin C deficiency (Scurvy).Vitamin C is found in citrus fruits, tomatoes, potatoes, Brussel sprouts, cauliflower, broccoli, cabbage and spinach. Deficiency leads to impaired collagen synthesis and disordered connective tissue. Scurvy is associated with severe malnutrition as well as drug and alcohol abuse, and those living in poverty with limited access to fruits and vegetables.Symptoms and signs include:- Follicular hyperkeratosis and perifollicular haemorrhage- Ecchymosis- Gingivitis with bleeding and receding gums- Sjogren’s syndrome- Arthralgia- Oedema- Impaired wound healing- Generalised symptoms such as weakness, malaise, anorexia and depression
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This question is part of the following fields:
- Nutrition
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Question 9
Correct
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Which of the following facts and figures is true regarding vitamin A?
Your Answer: Children with measles should receive additional vitamin A supplementation
Explanation:Vitamin A is a fat-soluble compound occurring in various forms. The RDA for 0-12 months old babies is 400-600micrograms/day. Most of the vitamin A is stored in the liver, making animal liver an excellent source of vitamin A. Vitamin A deficiency is characterized by the deposits of keratin in the conjunctiva, known as Bitot’s spots, keratomalacia, night blindness, and anaemia.Vitamin A toxicity or excess is characterized by hyperkeratosis, hypothyroidism, hypo/hyperpigmentation, etc.According to WHO guidelines, children under two years of age who develop measles should be given two additional doses of vitamin A supplementation 24 hours apart, which is necessary for preventing eye damage, blindness, and reducing mortality by 50%.
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This question is part of the following fields:
- Nutrition
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Question 10
Correct
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A midwife calls you from the postnatal ward. A baby has been born to a mother who had not booked at the hospital. Her notes are not available and she does not speak English. However, her partner has managed to communicate that Zika virus had been confirmed in pregnancy. The midwife wants to know if it is safe for the mother to breastfeed the baby in the meantime.What is the MOST appropriate course of action?
Your Answer: Encourage breastfeeding
Explanation:Possible Zika virus infections have been identified in breastfeeding babies, but Zika virus transmission through breast milk has not been confirmed. Additionally, we do not yet know the long-term effects of Zika virus on young infants infected after birth. Because current evidence suggests that the benefits of breastfeeding outweigh the risk of Zika virus spreading through breast milk, CDC continues to encourage mothers to breastfeed, even if they were infected or lived in or travelled to an area with risk of Zika.
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This question is part of the following fields:
- Nutrition
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SESSION STATS - PERFORMANCE PER SPECIALTY
