Infant Nutrition: Cow's Milk and Iron Deficiency

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Questions and Answers

Why are infants who are fed cow’s milk at an increased risk for developing anemia or other iron deficiency disorders?

Cow's milk has lower iron content compared to breast milk and formula (correct)

Cow's milk has higher iron content compared to breast milk and formula

Cow's milk is easier to digest than breast milk and formula

Cow's milk contains essential nutrients for iron absorption

What is the comparative iron content of cow’s milk, breast milk, and formula?

Breast milk has the highest iron content (correct)

Formula has the highest iron content

Cow’s milk has the highest iron content

All have equal iron content

What can happen to infants who are fed cow’s milk in terms of iron deficiency disorders?

Increased risk of developing iron deficiency disorders (correct)

Reduced risk of iron deficiency disorders

No impact on the risk of iron deficiency disorders

Increased risk of better iron absorption

Which type of milk is a safer option for infants in terms of iron intake?

Breast milk Signup and view all the answers

How long do the anticoagulant effects of warfarin persist after it is discontinued?

2 to 5 days Signup and view all the answers

What should Asian patients be aware of regarding the starting and maintenance doses of warfarin?

They may require lower doses Signup and view all the answers

How much does INR values lower than 2.0 increase the risk of stroke?

Sixfold Signup and view all the answers

Which diuretic type should patients with serious sulfa allergies avoid?

Thiazide diuretics Signup and view all the answers

According to the Eighth Joint National Committee (JNC 8), which diuretic is longer acting and more 'effective' than HCTZ?

Chlorthalidone Signup and view all the answers

What should be avoided by patients with serious sulfa allergies as an alternative to thiazide and loop diuretics?

Salt substitutes containing potassium Signup and view all the answers

What adverse effect should be monitored when prescribing Captopril?

Agranulocytosis Signup and view all the answers

When does the ACEI cough typically occur?

Within the first few months of treatment Signup and view all the answers

For which condition are ACEIs and ARBs preferred drugs?

Diabetic nephropathy Signup and view all the answers

When is the physiologic increase in blood pressure most likely to occur?

Early morning (3 to 5 a.m.) Signup and view all the answers

What time of day do most heart attacks occur in the United States?

Morning hours (6 a.m. to 12 p.m.) Signup and view all the answers

Which antihypertensive medications do some experts recommend taking in the evening?

All antihypertensive medications except diuretics Signup and view all the answers

What is the normal response in acute blood loss?

Normal reticulocyte count Signup and view all the answers

At what percentage of blood volume loss does tachycardia and tachypnea occur?

15% to 20% Signup and view all the answers

When does a significant drop in blood pressure typically manifest?

30% to 40% blood loss Signup and view all the answers

What are the most common causes of mild neutropenia in adults?

Benign ethnic neutropenia and drug-induced neutropenia Signup and view all the answers

What is a characteristic of neutropenia with an absolute neutrophil count (ANC) >1,000 cells/µL?

Increased susceptibility to viral infections Signup and view all the answers

What is the expected increase in heart rate during class II hemorrhage?

80-100 beats/minute Signup and view all the answers

What is the initial evaluation for a patient suspected of neutropenia?

Complete blood count with differential, blood smear, health history, and physical examination Signup and view all the answers

Which medication may cause neutropenia?

Nonsteroidal anti-inflammatory drugs (NSAIDs) Signup and view all the answers

What is characteristic of Hodgkin's Lymphoma?

Presence of Reed–Sternberg cells Signup and view all the answers

Which condition is associated with symptoms of night sweats, fever, and weight loss?

Non-Hodgkin’s Lymphoma Signup and view all the answers

What is a common symptom of multiple myeloma?

Proteinuria with Bence–Jones proteins Signup and view all the answers

What is the definition of thrombocytopenia?

A platelet count of Signup and view all the answers

Which group has a higher incidence of Hodgkin's Lymphoma?

Young adults (20–40 years) and older adults (>60 years) Signup and view all the answers

Study Notes

Iron Deficiency in Infants

Cow’s milk has low iron content, making infants fed cow’s milk susceptible to iron deficiency anemia.
Breast milk contains higher iron compared to cow’s milk, and it is readily absorbed by infants.
Formula has higher iron content than cow’s milk, but lower than breast milk; however, iron absorption from formula may be less efficient.
Infant iron deficiency can lead to delayed cognitive development, impaired growth, and fatigue.
Breast milk is the safest option for infants in terms of iron intake, followed by iron-fortified formula.

Warfarin

Warfarin’s anticoagulant effects can persist for several days after discontinuation.
Asian patients may require lower starting and maintenance doses of warfarin due to genetic variations affecting metabolism.
INR values below 2.0 significantly increase the risk of stroke, emphasizing the importance of maintaining therapeutic INR ranges.

Diuretics

Patients with serious sulfa allergies should avoid sulfonamide diuretics (e.g., HCTZ).
Spironolactone, a potassium-sparing diuretic, is recommended for patients with serious sulfa allergies as an alternative to thiazide and loop diuretics.
According to JNC 8, spironolactone is longer-acting and more effective than HCTZ.

ACE Inhibitors (ACEIs)

Captopril, an ACE inhibitor, can cause a persistent dry cough as an adverse effect.
ACEI cough typically occurs within the first few weeks of starting therapy.
ACEIs and ARBs are preferred drugs for patients with heart failure and hypertension.

Blood Pressure

The physiologic increase in blood pressure is most likely to occur during the early morning hours.
Most heart attacks in the United States occur during the morning hours.
Some experts recommend taking antihypertensive medications in the evening to better manage blood pressure fluctuations.

Blood Loss

The normal response to acute blood loss is an increase in heart rate and vasoconstriction to maintain blood pressure.
Tachycardia (increased heart rate) and tachypnea (increased respiratory rate) occur at approximately 15% of blood volume loss.
Significant drop in blood pressure typically manifests at a 30% blood volume loss.

Neutropenia

The most common causes of mild neutropenia in adults include infections, medications, and autoimmune disorders.
Neutropenia with an absolute neutrophil count (ANC) greater than 1,000 cells/µL is usually asymptomatic.
Expected increase in heart rate during Class II hemorrhage is around 100-120 bpm.

Diagnosing Neutropenia

Initial evaluation for suspected neutropenia includes a complete blood count (CBC) with differential.
Some medications, like chemotherapy drugs, can cause neutropenia as a side effect.

Hematologic Cancers

Hodgkin's Lymphoma is characterized by the presence of Reed-Sternberg cells in lymph nodes.
Night sweats, fever, and weight loss are common symptoms of Hodgkin's Lymphoma.
Multiple myeloma, a cancer of plasma cells, often presents with bone pain.

Thrombocytopenia

Thrombocytopenia refers to a low platelet count in the blood.
Hodgkin's Lymphoma has a higher incidence in young adults, particularly those aged 15 to 35 years.

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Description

Test your knowledge about the differences in iron content between cow's milk, breast milk, and formula, and the potential risks for infants fed with cow's milk. Learn about the impact of cow's milk on the development of anemia and iron deficiency disorders in infants.