Core curriculum 2

Question 1

If a mother has chronic mastitis what low dose antibiotice can be prescribed

Answer 1

erythromicin 500 mg a day for duration of lactation

Question 2

according to core curriculum if mastitis symptoms do not improve in 12 -24 hours , what should she do?????

Answer 2

then referral to physician for antibiotics is recommended

Question 3

When would it be appropriate to perform a C&S

Answer 3

No antibiotic response in 2 days
mastitis recurs more then twice
If happens while in the hospital

Question 4

what tare the choices of abx usually prescribed

Answer 4

penicillins or cephalosporins to treat staph A
( diclox, flucloxacillin)
others clindamycin, erythromycin, nafcillin.

Question 5

If bilateral mastitis - this is often due to strep Which abx is preferable

Answer 5

Penicillin based meds. ( erythomycin if allergic)

Question 6

what is the percentage of mastitis infections that develop into abscess

Answer 6

2-11%

Question 7

What is the cause of bilateral, multicolored nipple discharge

Answer 7

duct ectasia

Question 8

what is duct ectasia

Answer 8

An irritating lipid forms in in the ducts and produces an inflammatory reaction and discharge

Question 9

What is a rare benigh chronic inflammatory proces that mimics duct ectasia and inflammatory breast cancer

Answer 9

IGM idiopathic granulomatous mastitis ( treated with corticosteroids)

Question 10

What is intraductal papilloma

Answer 10

a benign tumor or wart like growth on the epithelium of mammary ducts that can bleed as it erodes.

Question 11

If a mother has an eczema like rash on one nipple how would you treat her

Answer 11

referral to Dr to rule out Pagets disease

Question 12

What milk constituent is believed to inhibit growth of C albicans

Answer 12

lactoferrin

Question 13

What 3 iatrogenic factors increase the risk of candida

Answer 13

abx, oral contraceptives and steroids.

Question 14

if treating candida with flucanazole after all topical treatments have been tried., what is the recommended length of time for treatment.

Answer 14

14 - 28 days

Question 15

what is indirect unconjugated hyperbilirubenemia vs Direct conjugated hyperbilirubinemai

Answer 15

INDIRECT - increased biliruin secondary to increased bilirubin production or decreased bilirubin excretion
DIRECT—– result of hepatocellular disorder ie hepatitis or biliary atresia

Question 16

What is enterohepaic circulation

Answer 16

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.

Question 17

when to suspect pathological jaundice

Answer 17

onset within first 24 hours of life, Bili rates rising rapidly or infant jaundiced beyond 3 weeks of life and not thriving.

Question 18

Increased bilirubin where he infant cannot metabolize can be the result of

Answer 18

ABO RH incompatability
Placenta to infant or twin to twin transfusion
birth trauma with bruising.

Question 19

a newborn with white/clay color stools may be an indiction of …………

Answer 19

biliary atresia - medical emergency ( direct bilirubin would be elevated.

Question 20

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

Answer 20

12 hours

Question 21

What is the definition of hypoglycemia in a full term infant

Answer 21

NO number but a continuum of falling blood glucose levels Serum glucose below 36-45 is consdered the trhrshold for intervention.

Question 22

Change in breast VOLUME most closely associated with what hormone

Answer 22

human placental lactogen

Question 23

WHEN DO breasts return to their preconception size

Answer 23

By 15 mos of lactation.

Question 24

Which blood pressure medicine may reduce milk supply by suppressing prolactin

Answer 24

Methyldopa

Question 25

accupunctue can help with milk production most effective if started withi_________ days`

Answer 25

20 days. No resulsts if started after 6 mos. ( can start to increase production in 2-4 hours after treatment.

Question 26

Describe FTT

Answer 26

1. Infant continues to lose wt after 10 days of life
2. does not regain birth wt by 3 weks of age
3. gains at a rate bleow the 10th percentile for wt beyond 1 mos of age.