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Peds Labs


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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