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30 year-old female with HPN dependence following traumatic motor vehicle accident and non-compliance with adding IV multi-vitamin to HPN bag complains of difficulty with vision driving home at nighttime after clinic visits. What’s the most likely cause? A. Anemia B. Vitamin A deficiency C. Folate...

30 year-old female with HPN dependence following traumatic motor vehicle accident and non-compliance with adding IV multi-vitamin to HPN bag complains of difficulty with vision driving home at nighttime after clinic visits. What’s the most likely cause? A. Anemia B. Vitamin A deficiency C. Folate...

6 year-old male well-nourished patient receives IV fluids nightly with D10 ½ normal saline 1000 ml over 12 hours. Mother pages on-call provider concerned that Broviac might have come out 3 cm. Patient is asymptomatic. Next visit is scheduled for 1 week. What is the next step? A. Reassurance and...

Answer 10. The correct answer is c. Increase glucose infusion rate by 2 mg/kg/minute to increase calories by 10%. Nutrition should be advanced by enteral route whenever possible. However, PN support should be increased when growth is faltering as evinced by 2-3 consecutive visits with inadequate...

5 year-old male with long-term HPN dependence secondary to short bowel syndrome is seen for routine follow-up. Enteral tolerance is currently maximized. PN currently providing energy 45 kcal/kg/day, protein 1.3 gram/kg/day, IV soybean lipids 1 gram/kg/day, glucose infusion rate 10 mg/kg/minute...

6 month-old female with chronic parenteral nutrition dependence secondary to microvillus inclusion disease presents for routine outpatient visit. History notable for increased stool output after exposure to older sibling with rotavirus. Physical exam is notable for decreased weight, lung sounds...

6 month-old female with chronic parenteral nutrition dependence secondary to microvillus inclusion disease presents for routine outpatient visit. History notable for increased stool output after exposure to older sibling with rotavirus. Physical exam is notable for decreased weight, lung sounds...

Joyce Bischoff, Ph.D.Karp Family Research Laboratories 12th floorBoston Children's HospitalOne Blackfan CircleBoston, MA 02115Phone: 617-919-2192Fax: 617-730-0231 joyce.bischoff@childrens.harvard.edu

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