NEWEST VERSION 2026WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
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what is osteopenia
-a process of bone thinning or demineralization that precedes
fractures
-diminshed bone mineral density secondary to a reduction in the
thickness of bone cortex and trabeculae
Describe maternal diseases associated with a small left colon or
microcolon
-Hypermagnesemia -infants of diabetic mothers: neonatal smaller
colon or micro colon or lazy colon is a narrowing of colon and the
clinical presentation is often as a GI obstruction
-barrium studies suggests Hirschsprung's though these infants have
normal innervation and will ultimately have normal bowel function
Describe most likely change in neonatal carbohydrate physiology soon
after birth
,-glucagon and catecholamine levels increase and insulin levels fall due
to decreased delivery of glucose
-anabolism to catabolism through glycogenolysis and gluconeogenesis
-glycogen breakdown plays the largest role in meeting glucose needs
in the firs 24 hours of life
-glycogenolysis is the conversion of glycogen to glucose that occur in
the liver and it is stimulated or promoted by glucagon. There's approx.
10 hours worth of glycogen in a term infant. Gluocagon release is
stimulated by the adrenergic mechanisms an catecholamine release.
Hepatic glucose output is the most significant source of glucose to
meet metabolic needs through glycogenolysis and supplies the
endogenous gluconeogenic precursors in the normal endocrine
system. That will be until an exogenous source of glucose is provided
to the infant, and that would be either with enteral feeds or by IV
fluids
osteopenia of prematurity
-metabolic bone disease of prematurity
-describes early and late changes
-bone thinning/demineralization preceding fractures
-increased incidence in <1500 and <1000 gram infants. Onset 6-12
postnatal weeks
,rickets
-changes at the growing end of the long bones
-results from undermineralization of the bone matrix or osteoid in
growing bone; it involves both the growth plate and newly formed
trabecular and cortical bone
-Early development leads to craniotabes, characterized by softening
of the skull with the "ping-pong ball" sign. Widened cranial sutures;
frontal bossing, swollen epiphyses of wrists
-Manifestation of muscle weakness may include dilated
cardiomyopathy and ventricular dysfunction which responds to
vitamin D therapy
Radiographic features results from expansion of the cartilaginous
growth plate and delayed mineralization
What is needed to facilitate active transport of calcium
Calcium exists in three forms
-Protein bound to albumin
-Complexed calcium bout to anions
-Ionized calcium which is the physiologic active form.
, Calcium is absorbed in the small intestine and excreted by the
kidneys.
-Absorption is increased by acidity, bile salts, pancreatic enzymes,
vitamin D (needs normal renal function), and PTH
-Absorption is decreased by alkalinity, excess phosphorous, vitamin D
deficiency, magnesium or PTH.
Hypoalbuminemia and calcium
-Decreased albumin leads to a falsely low serum calcium; ionized
calcium is usually normal.
-Binding of albumin to calcium is pH dependent.
--->Acute acids is decreases calcium binding which increases ionized
calcium
--->Acute alkalosis May increase albumin binding or citrate chelation
decreasing ionized calcium.