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