2 Peds Lab Studies
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| All states have what in the newborn screening? | pku and congenital hypothyroidism
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| pku causes | mental retardation
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| Hearing screen | AAP recommends universal hearing screening for all newborns by 1 month of age, with appropriate intervention before 6 months of age
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| Hearing risk assessment | do at all health maintenance visits, and periodic hearing screening between ages 4 and 10 years of age.
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| When should vision be assessed? | recommended screening to detect amblyopia, strabismus and defects in visual acuity in children younger than 5 years of age. AAP/bright futures suggests at 3-4 years of age. >5 at all health maintenance visits
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| Autism screening | at 18 and 24 months of age
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| Developmental screening | 9, 18 and 30 months of age
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| Iron deficiency screening | once between 9-12 months and 15-18 months. Annually thereafter until age 5.
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| Neonates testing | newborn screen, blood type and screen/DAT (from cord blood usually), bilirubin, glucose, TORCH, HgB
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| Ideal timing of newborn screen | between 24-72 hours post birth. Ideally after baby is 1 day old. PKU will be false negative if done <24 hours and must be repeated in 7 days
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| Information to include on heel stick filter paper | date, time, feeding source on requisition. In NC, you need to mail this to State Laboratory of Public Health w/in 24 hours
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| Which part of the heel do you stick for blood collection in a newborn? | lateral to avoid bone
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| Newborn screening in NC | 35 disorders
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| If mother is type O or Rh-negative then what test is performed in addition to blood type? | Direct Antiglobulin test
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| Cord blood and DAT are used to diagnose | Hemolytic dz of the newborn. Infants <4 months old rarely make red cell alloantibodies
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| what assesses for kernicterus in neonates? | bilirubin levels. Kernicterus is aka bilirubin encephalopathy. Bilirubin reference ranges vary depending on preterm vs term, but M=F
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| Infants at risk for hypoglycemia | diabetic mom, preterm, SGA/LGA, stressed (difficult labor or some other condition)
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| Level of glucose to confirm and treat | <45mg/dl
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| TORCH | Toxoplasmosis. Other (syphilis, varicella zoster, parvovirus, HIV, Hep B, Borrelia burgdorferi). Rubella. CMV. Herpes Simplex
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| Hemoglobin | Screen neonates with risk or symptoms of anemia or polycythemia vera at 3-6 hours
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| Children screens | hemoglobin, hemoglobin electrophoresis, blood lead level, TST, cholesterol/lipids
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| Lead poisoning level in children | venous blood lead level>/= 10mcg/dL. Guidelines: screen at least once before age 6. Ideal: test at 12-24 months and repeat in 12 months for high risk kids
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| Which site is used to collect a blood specimen for lead levels? | fingertip capillary specimen. MUST BE A VENOUS SPECIMEN. PUT IN TUBE WITH ROYAL BLUE TOP: EDTA TUBE. If capillary screen is +, must be f/u with venous confirmation
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| Lead level 10-19ug/dL | venous diagnostic test within 3 months. retest Q 2-3 months until 3 consecutive levels<10
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| Lead level 20-44ug/dL | venous diagnostic test w/in 1 week. If +, refer for medical evaluation and environmental investigation
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| Lead level >/=45ug/dL | venous diagnostic test ASAP. If +, chelation
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| TB testing is appropriate in | all children at HIGH RISK for TB. TST is the only recommended screening test. Can begin TST>/= 3 months. Repeat annually if TB risk persists
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| When is it appropriate to screen a child's lipids? | child >2 if: parent with total chol>240 then child should get a total cholesterol. If fm hx of CVD before age 55, get a lipid panel
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| when should female adolescent's hgb be measured? | heavy menses, chronic weight loss, poor nutrition or vegetarian diet, athletes
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| Cervical cancer screening | Begin screening via annual Pap smear 3 years after sexual debut or with history of child sexual abuse
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