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Peds Labs
Pediatrics
| Question | Answer |
|---|---|
| most common reason for transfusion in NICU | Removal of blood for lab testing |
| Neonatal tests | Newborn screen, blood type & screen / DAT, Bili, Glucose, TORCH, Hemoglobin |
| TORCH = | Toxoplasmosis. Other (syphilis, GC, VZV, parvovirus, TB, HIV, Hep B/C/G, Borrelia, malaria, coxsackie). Rubella. CMV. HSV. |
| Newborn screen includes (in all states): | PKU, congenital hypothyroidism |
| Newborn screen: most states also test for: | galactosemia, MSUD |
| Info on newborn screen State Lab slip: | Date, time, feeding source; dry paper 3 hrs flat surface, mail to lab within 24 hrs |
| False negative PKU if: | if tested prior to 24 hours of age; if so (or untested at d/c from hosp), retest within 7 days |
| NC newborn screen: | Amino acid disorders (7); Organic acid disorders (10); Fatty acid oxidation disorders (8); Other (10) |
| blood type & DAT if: | mom is type O or Rh neg |
| Pos Ab screen vs pos DAT | AB screen = passive mom Ab; DAT = mom Ab attached to infant RBCs (HDN) |
| confirm & tx infant if glucose is: | <45 |
| TORCH: consider cx for: | rubella, CMV, HSV, GC, TB |
| TORCH: consider Ag testing for: | Hep B, Chlamydia |
| TORCH: consider Ab testing: | IgM or increasing IgG for Toxoplasmosis, syphilis, parvovirus, HIV, Borrelia |
| Hgb: screen at-risk neonates within: | 3-6 hrs |
| Tests: children | Hgb; Hgb electro; Pb; TST; Chol/ lipids; (UA if FH kidney dz) |
| Hgb: test at-risk kids when: | 9-12 mos; 15-18 mos; q yr thru 5 yo |
| Lead testing guidelines | screen at least once <age 6 w/o RF determination, or use lead risk exposure questionnaire; ideal: at 12-24 mos, repeat in 12 mos for high-risk |
| Pb venous dx test | 10-19: do within 3 mos; 20-44 within 1 wk; retest q2-3 mos until 3 consec <10 |
| When to begin TST? | >3 mos for high risk (repeat annually) |
| When to do lipid testing? | >2 yo; parent total Chol >240, FH CVD <55 yo |
| Tests: adolescents | Hgb, UA, STI, cervical ca screening |
| When to get a UA in pediatric patient? | annually if sexually active; FH kidney dz |
| STI testing: | If early onset,multi partner, sx, h/o CSA; GC/CT, syphilis, HIV |
| When to order annual Pap test? | Within 3 yrs of sexual debut or h/o CSA |
| Labs for neonatal hyperbilirubinemia | Total bili high. High direct (conj) +/- indirect (unconjugated) bili (depending on cause). CBC, retic. ABO/Rh and direct Coombs. |
| Elevated immunoreactive trypsin (IRT) levels at birth are seen in: | Phenylketonuria (PKU) |
| Positive osmotic fragility test indicates: | G6PD deficiency (hemolytic anemia w/ oxidative drugs – sulfa, nitrofurantoin, quinidine) |
Created by:
Abarnard
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