Fitzgerald Pediatrics Study Guide Exam
With All Solved Solutions Graded A+.
What percent of breast mild is macrophages? - Answer 80%. Cells that kill bacteria, fungi, and
viruses
How often to breastfeed? - Answer 8-12 times per 24hrs
Should you supplement breastfeeding with dextrose, water, or formula? - Answer No, because
this will interfere with the newborn's hunger drive to breastfeed and will delay and reduce
breast milk production
When does physiologic jaundice occur? - Answer 3-5 days postpartum
Why does physiologic jaundice occur? - Answer Normal breakdown of fetal hemoglobin and
immature liver metabolism = elevation of unconjugated bilirubin.
When a newborn jaundice is a concern? - Answer If there is an increase in conjugated bilirubin
or jaundice occurs in the first 24 hours of life, pathological etiologies need to be considered,
such as an ABO incompatibility,
familial Gilbert syndrome, or other anomaly.
What is Gilbert syndrome? - Answer It is a common, harmless liver condition in which the liver
doesn't properly process bilirubin. aka constitutional hepatic dysfunction and familial
nonhemolytic jaundice
What are the contraceptive options postpartum? - Answer - progestin-only pill (POP) and
- medroxyprogesterone acetate
(Depo-Provera, Depo-SubQ Provera 104).
Is progestin-only pill (POP) contraceptive safe for breastfeeding? - Answer is highly effective
and does not alter the quality or quantity of breast milk.
,How often do you give medroxyprogesterone acetate in a depot injection and how effective is
it? - Answer - q 90 days
- 99.7% effective
Frequency of feeding during months 1 and 2 - Answer - Breastfed infants: A minimum of 10
minutes at each breast every 1.5 to 3 hours
- Bottle-fed infants: 2-3 oz (60-90 mL) every 2 to 3 hours
When infant is ready for solid food? - Answer - Doubled birth weight PLUS at least 4 to 6
months of age
- Eats more than 32 oz (946 mL) formula per day or more than 8 to 10 feedings (breast or bottle)
per day
Anticipated Weight Gain and Caloric Requirements in the First 3 Years of Life? - Answer - 0-3
mo 30 g/day 120 kcal
- 3-6 mo 20 g/day 115 kca
- 6-9 mo 15 g/day 105 kcal
- 9-12 mo 9 g/day 105 kcal
- 1-3 yr 7g day 100 kcal
When progestin-only oral contraceptive can be started postpartum? - Answer - For
breastfeeding - as early as 3 wks postpartum if she is
- Not breastfeeding - immediately postpartum
What could happen to milk if you start progestin-only oral contraceptive in less than 3 weeks
postpartum? - Answer Could diminish the quantity, but not quality, of breast milk.
When combined oral contraceptives (estrogen and progesterone) can be introduced to
breastfeeding women? - Answer - 6 months or longer PLUS breastfeeding is well established.
- if started earlier than 6mo = could affect milk flow
Combined oral contraceptives (estrogen and progesterone) risks? - Answer increase
thromboembolic risk in women with other risk factors for venous thrombosis (VTE):
- aged 35 or older
, - BMI ≥30 kg/m2
- postpartum hemorrhage
- postcesarean delivery
- preeclampsia
- smoking.
When COCs can be started fro women with low VTE risk and non breastfeeding? - Answer 21
days postpartum
What % of drugs from mom (if she takes them) nursing infants get through milk? - Answer 1%
from maternal dose
Is "pump-and-dump" procedure for breastfeeding mom effective? - Answer - No, as it creates
low concentration in breast milk vs high concentration of maternal serum for the drug to diffuse
from high to low.
- If med is problematic for the infant = stop med and "pump and discard" for 3-4 T1/2 of the
drug.
Alcohol effects when brestfeeding - Answer - low molecular weight and is highly lipid soluble =
easy to pass to milk
- small amounts ingested by mom = smaller amount of milk produced by mom, reduction in the
let-down reflex, less rhythmic and frequent sucking by the infant (i.e., smaller amount of milk
ingested)
Smoking effects when breastfeeding - Answer - nicotine is highly lipid-soluble substance with a
low molecular weight (passes easily to milk)
- can reduce milk supply
- passive smoking exposure for infant
- Infant Sx when heavy maternal smoking = crankiness, diarrhea, tachycardia, and vomiting
When to screen for autism - Answer between 18 and 24 months. Look for developmental red
flags
Developmental "Red Flags" in the Young Child. - Answer Persistent presence of ≥1 of the
indicators
With All Solved Solutions Graded A+.
What percent of breast mild is macrophages? - Answer 80%. Cells that kill bacteria, fungi, and
viruses
How often to breastfeed? - Answer 8-12 times per 24hrs
Should you supplement breastfeeding with dextrose, water, or formula? - Answer No, because
this will interfere with the newborn's hunger drive to breastfeed and will delay and reduce
breast milk production
When does physiologic jaundice occur? - Answer 3-5 days postpartum
Why does physiologic jaundice occur? - Answer Normal breakdown of fetal hemoglobin and
immature liver metabolism = elevation of unconjugated bilirubin.
When a newborn jaundice is a concern? - Answer If there is an increase in conjugated bilirubin
or jaundice occurs in the first 24 hours of life, pathological etiologies need to be considered,
such as an ABO incompatibility,
familial Gilbert syndrome, or other anomaly.
What is Gilbert syndrome? - Answer It is a common, harmless liver condition in which the liver
doesn't properly process bilirubin. aka constitutional hepatic dysfunction and familial
nonhemolytic jaundice
What are the contraceptive options postpartum? - Answer - progestin-only pill (POP) and
- medroxyprogesterone acetate
(Depo-Provera, Depo-SubQ Provera 104).
Is progestin-only pill (POP) contraceptive safe for breastfeeding? - Answer is highly effective
and does not alter the quality or quantity of breast milk.
,How often do you give medroxyprogesterone acetate in a depot injection and how effective is
it? - Answer - q 90 days
- 99.7% effective
Frequency of feeding during months 1 and 2 - Answer - Breastfed infants: A minimum of 10
minutes at each breast every 1.5 to 3 hours
- Bottle-fed infants: 2-3 oz (60-90 mL) every 2 to 3 hours
When infant is ready for solid food? - Answer - Doubled birth weight PLUS at least 4 to 6
months of age
- Eats more than 32 oz (946 mL) formula per day or more than 8 to 10 feedings (breast or bottle)
per day
Anticipated Weight Gain and Caloric Requirements in the First 3 Years of Life? - Answer - 0-3
mo 30 g/day 120 kcal
- 3-6 mo 20 g/day 115 kca
- 6-9 mo 15 g/day 105 kcal
- 9-12 mo 9 g/day 105 kcal
- 1-3 yr 7g day 100 kcal
When progestin-only oral contraceptive can be started postpartum? - Answer - For
breastfeeding - as early as 3 wks postpartum if she is
- Not breastfeeding - immediately postpartum
What could happen to milk if you start progestin-only oral contraceptive in less than 3 weeks
postpartum? - Answer Could diminish the quantity, but not quality, of breast milk.
When combined oral contraceptives (estrogen and progesterone) can be introduced to
breastfeeding women? - Answer - 6 months or longer PLUS breastfeeding is well established.
- if started earlier than 6mo = could affect milk flow
Combined oral contraceptives (estrogen and progesterone) risks? - Answer increase
thromboembolic risk in women with other risk factors for venous thrombosis (VTE):
- aged 35 or older
, - BMI ≥30 kg/m2
- postpartum hemorrhage
- postcesarean delivery
- preeclampsia
- smoking.
When COCs can be started fro women with low VTE risk and non breastfeeding? - Answer 21
days postpartum
What % of drugs from mom (if she takes them) nursing infants get through milk? - Answer 1%
from maternal dose
Is "pump-and-dump" procedure for breastfeeding mom effective? - Answer - No, as it creates
low concentration in breast milk vs high concentration of maternal serum for the drug to diffuse
from high to low.
- If med is problematic for the infant = stop med and "pump and discard" for 3-4 T1/2 of the
drug.
Alcohol effects when brestfeeding - Answer - low molecular weight and is highly lipid soluble =
easy to pass to milk
- small amounts ingested by mom = smaller amount of milk produced by mom, reduction in the
let-down reflex, less rhythmic and frequent sucking by the infant (i.e., smaller amount of milk
ingested)
Smoking effects when breastfeeding - Answer - nicotine is highly lipid-soluble substance with a
low molecular weight (passes easily to milk)
- can reduce milk supply
- passive smoking exposure for infant
- Infant Sx when heavy maternal smoking = crankiness, diarrhea, tachycardia, and vomiting
When to screen for autism - Answer between 18 and 24 months. Look for developmental red
flags
Developmental "Red Flags" in the Young Child. - Answer Persistent presence of ≥1 of the
indicators
