Core curriculum 2 Flashcards
If a mother has chronic mastitis what low dose antibiotice can be prescribed
erythromicin 500 mg a day for duration of lactation
according to core curriculum if mastitis symptoms do not improve in 12 -24 hours , what should she do?????
then referral to physician for antibiotics is recommended
When would it be appropriate to perform a C&S
No antibiotic response in 2 days
mastitis recurs more then twice
If happens while in the hospital
what tare the choices of abx usually prescribed
penicillins or cephalosporins to treat staph A
( diclox, flucloxacillin)
others clindamycin, erythromycin, nafcillin.
If bilateral mastitis - this is often due to strep Which abx is preferable
Penicillin based meds. ( erythomycin if allergic)
what is the percentage of mastitis infections that develop into abscess
2-11%
What is the cause of bilateral, multicolored nipple discharge
duct ectasia
what is duct ectasia
An irritating lipid forms in in the ducts and produces an inflammatory reaction and discharge
What is a rare benigh chronic inflammatory proces that mimics duct ectasia and inflammatory breast cancer
IGM idiopathic granulomatous mastitis ( treated with corticosteroids)
What is intraductal papilloma
a benign tumor or wart like growth on the epithelium of mammary ducts that can bleed as it erodes.
If a mother has an eczema like rash on one nipple how would you treat her
referral to Dr to rule out Pagets disease
What milk constituent is believed to inhibit growth of C albicans
lactoferrin
What 3 iatrogenic factors increase the risk of candida
abx, oral contraceptives and steroids.
if treating candida with flucanazole after all topical treatments have been tried., what is the recommended length of time for treatment.
14 - 28 days
what is indirect unconjugated hyperbilirubenemia vs Direct conjugated hyperbilirubinemai
INDIRECT - increased biliruin secondary to increased bilirubin production or decreased bilirubin excretion
DIRECT—– result of hepatocellular disorder ie hepatitis or biliary atresia
What is enterohepaic circulation
Conjugated bilirubin can be deconjugated by an enzyme in the gut, then abosrbed by the gut mucosa and returend to the liver via portal circulation - this happens with delayed stooping.
when to suspect pathological jaundice
onset within first 24 hours of life, Bili rates rising rapidly or infant jaundiced beyond 3 weeks of life and not thriving.
Increased bilirubin where he infant cannot metabolize can be the result of
ABO RH incompatability
Placenta to infant or twin to twin transfusion
birth trauma with bruising.
a newborn with white/clay color stools may be an indiction of …………
biliary atresia - medical emergency ( direct bilirubin would be elevated.
Glucose is the primary nutrient for brain metabolism and the placentally derived supply terminates at birth. What is the timeframe before baby is dependent on dietary intake for glucose
12 hours
What is the definition of hypoglycemia in a full term infant
NO number but a continuum of falling blood glucose levels Serum glucose below 36-45 is consdered the trhrshold for intervention.
Change in breast VOLUME most closely associated with what hormone
human placental lactogen
WHEN DO breasts return to their preconception size
By 15 mos of lactation.
Which blood pressure medicine may reduce milk supply by suppressing prolactin
Methyldopa
