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Pediatrics

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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)  


   


 
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Created by: Abarnard