CSP Pediatric Nutrition Disorders & Conditions 2 — Questions and Answers
Question 1: A 3-year-old with celiac disease continues to have poor weight gain despite a gluten-free diet. Which nutrient deficiency should be assessed first?
- Vitamin B12
- Iron (Correct answer)
- Calcium
- Zinc
Correct answer: Iron
Iron deficiency is the most common micronutrient deficiency in celiac disease due to proximal small intestinal villous atrophy impairing absorption.
Question 2: Which formula characteristic is most important when selecting an enteral formula for an infant with short bowel syndrome?
- High fiber content
- Elemental or semi-elemental protein (Correct answer)
- High osmolality
- Intact protein with long-chain triglycerides
Correct answer: Elemental or semi-elemental protein
Elemental or semi-elemental formulas with hydrolyzed protein reduce the digestive burden and improve absorption in infants with short bowel syndrome.
Question 3: A 10-year-old with type 1 diabetes presents with recurrent hypoglycemia at night. Which dietary strategy is most appropriate?
- Eliminate all carbohydrates at dinner
- Provide a bedtime snack with complex carbohydrates and protein (Correct answer)
- Increase fat intake at breakfast
- Restrict total caloric intake by 20%
Correct answer: Provide a bedtime snack with complex carbohydrates and protein
A bedtime snack combining complex carbohydrates and protein slows glucose release overnight, reducing nocturnal hypoglycemia risk.
Question 4: An infant with galactosemia must avoid which primary dietary component?
- Fructose
- Lactose (Correct answer)
- Sucrose
- Maltose
Correct answer: Lactose
Galactosemia requires elimination of lactose (which contains galactose) because the enzyme needed to metabolize galactose is deficient.
Question 5: Which anthropometric finding is most consistent with marasmus in a 2-year-old?
- Edema with normal weight-for-height
- Severely low weight-for-height with muscle wasting and no edema (Correct answer)
- Bilateral pitting edema with adequate weight
- Ascites with normal mid-upper arm circumference
Correct answer: Severely low weight-for-height with muscle wasting and no edema
Marasmus presents as severe wasting with very low weight-for-height, depleted fat and muscle stores, but without edema.
Question 6: A 6-month-old exclusively breastfed infant is diagnosed with vitamin D deficiency rickets. Which supplementation is standard of care in the US?
- 400 IU vitamin D daily from birth (Correct answer)
- 1000 IU vitamin D weekly
- 200 IU vitamin D daily after 2 months
- 600 IU vitamin D daily from 6 months
Correct answer: 400 IU vitamin D daily from birth
AAP recommends 400 IU of vitamin D daily for all breastfed infants beginning shortly after birth to prevent deficiency.
Question 7: In a child with phenylketonuria (PKU), which dietary approach is foundational to management?
- High-protein diet with supplemental phenylalanine
- Phenylalanine-restricted diet with medical formula providing tyrosine (Correct answer)
- Carbohydrate-restricted ketogenic diet
- Fat-restricted diet with amino acid supplementation
Correct answer: Phenylalanine-restricted diet with medical formula providing tyrosine
PKU management centers on restricting dietary phenylalanine while supplying tyrosine (an essential amino acid in PKU) through a medical formula.
CSP Pediatric Nutrition Disorders & Conditions 2
A 3-year-old with celiac disease continues to have poor weight gain despite a gluten-free diet.
Which nutrient deficiency should be assessed first?