Term
| What is the typical blood draw for an adult versus a pediatric versus a neonatal patient? |
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Definition
| adult= 10 mL; pediatric 5-7 mL; neonatal <1 mL |
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Term
| What is the total blood volume in a neonate? |
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Definition
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Term
| Why are there more identification errors when dealing with newborn blood test results? |
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Definition
| barcode labels don't fit or cannot be read by barcode readers |
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Term
| Common pediatrictests are often performed as ______ tests. |
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Definition
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Term
| Esoteric pediatric tests are performed by... |
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Definition
| outsourcing to a send-out-lab |
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Term
| Why is there a lot of variation between labs for pediatric values? |
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Definition
| analytes and their normal ranges may change over life due to physiologic processes and developmental changes; little data regarding normal ranges, esp in kinds <3 yoa |
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Term
| T/F Electrolytes are different for pediatric patients than for adults. |
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Definition
| true; esp ionized calcium is increased |
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Term
| What common lab markers are decreased in the pediatric patient? |
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Definition
| albumin and total protein; pretty muchn all other lab values are increased |
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Term
| What is the average Hb/Hct of a newborn? |
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Definition
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Term
| What is the average WBC in a term newborn? |
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Definition
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Term
| What is the definition of neonatal anemia? |
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Definition
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Term
| What is a normal RR for an infant? |
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Definition
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Term
| What is a normal pulse rate for an infant? |
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Definition
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Term
| What is a noraml systolic BP for an infant? |
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Definition
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Term
| What measurements are taken on a baby as soon as they are born? |
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Definition
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Term
| What type of prophylactic and diagnostic care is given to a newborn before they leave the hospital? |
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Definition
| opthalmic antibiotic ointment (prophylaxis for gonorrhea and chlamydia), vitamin K, hepatitis B vaccine, CBC, type and screen, newborn screen, hearing screen |
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Term
| What are 2 common causes of neonatal anemia? |
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Definition
| physiologic anemia and immune mediated (HDN) |
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Term
| What lab should you definately get to work up neonatal anemia? |
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Definition
| DAT (direct coomb's test) |
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Term
| How do you manage neonatal anemia? |
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Definition
| limit blood draws, EPO, PRBC transfusion |
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Term
| What causes physiologic neonatal anemia? |
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Definition
| excessive blood draw, prematurity with inadequate EPO production, blood loss at delivery |
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Term
| Why does it matter if your DAT is strongly positive or weakly positive? |
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Definition
| strong positive indicates HDN with Rh incompatibility (Duffy or Kell), weakly positive indicates ABO HBD which is common but mild) |
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Term
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Definition
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Term
| How common is neonatal jaundice? |
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Definition
| 60% of term neonates; 80% of preterm neonates |
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Term
| In HDN, at what day does the baby present with jaundice? |
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Definition
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Term
| In physiologic jaundice, what day does the baby present with HDN? |
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Definition
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Term
| How can you measure serum bilirubin in a newborn? |
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Definition
| SBR quantitation as a blood test or SBR estimation with either Kramer's rule or transcutaneous bilirubinometry |
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Term
| How should you measure bilirubin levels in premature infants? |
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Definition
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Term
| What is the gold standard for measuring bilirubin in infants? |
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Definition
| SBR quantitation with blood draw |
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Term
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Definition
| jaundice progresses caudally: face= 10; trunk= 15; pelvis/thighs=20; arms/fore-arms/legs= 25; hands and feet= > 25 |
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Term
| What are the symptoms of kernicterus? |
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Definition
| lethargy, fever, seizures, permanent neurologic disability |
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Term
| At what level are bilirubin levels unsafe in the neonate? |
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Definition
| ther are no safe or unsafe levels that have been established but generally around 30 -45 is when kernicterus happens |
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Term
| Of the four million US babies who are screened annually, how many test positive for the newborn screening test? |
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Definition
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Term
| All states test their newborns for what diseases? |
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Definition
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Term
| Almost all (47) states test for what on the newborn screening test? |
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Definition
|
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Term
| When should the heel stick be drawn for newborn screening tests? |
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Definition
| 48-96 hrs of life (if less than 36 hours need a re-screen by day 14) |
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Term
| What is the cost of newborn screening? |
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Definition
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Term
| The vast majority of diseases tested for on the LA Newborn screen are what types of diseases? |
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Definition
| inborn errors of metabolism |
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Term
| Most visitis with the pediatrician are during what time period for a child? |
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Definition
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Term
| After 2, when do children need to come back for immunizations? |
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Definition
| 4-6 years and 11-12 years |
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Term
| What kinds of lab testing is performed on healthy kids? |
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Definition
| CBC maybe after 12 yoa, lead screening and cholesterol at least once |
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Term
| What percent of hospital admissions are pediatric? |
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Definition
|
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Term
| What percent of peds admission are neonates? |
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Definition
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Term
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Definition
| child less than 30 days old |
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Term
| Pediatric patients are most often admitted to the hospital through the... |
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Definition
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Term
| How do you test for respiratory viruses in pediatric patients? |
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Definition
| nasopharyngeal aspirate against a respiratory viral panel |
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Term
| What viruses are tested for on a respiratory viral panel? |
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Definition
| adenovirus, flu A and B, parainfluenza, RSV, metapneumovirus |
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Term
| What is the methodology behind a respiratory viral panel? |
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Definition
| antigen testing by EIA, IF, or RT-PCR |
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Term
| When is sensitivity highest for a respiratory viral panel? |
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Definition
| within 1st two days of symptoms |
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Term
| What is the advantage of using a respiratory viral panel over say a culture or serology? |
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Definition
| the panel is faster (takes 30 minutes versus 10 days) and requires only 1 specimen (serology requires at least 2) |
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Term
| Why might you order cultures if you have already have a respiratory viral panel? |
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Definition
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Term
| Name the acute phase reactants? |
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Definition
| increased platelet count, increased erythrocyte sedimentation rate, and increased C-reative protein |
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Term
| At what platelet count is an acute phase reaction? |
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Definition
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Term
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Definition
| 2mL of blood set in a vertical tube and analyzed for cellular and plasma separation rate at 1 hr |
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Term
| Whatis the most sensitive acute phase reactanat? |
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Definition
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Term
| What acute phase reactant will rise and fall to parallel course of disease? |
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Definition
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Term
| What are the features of Kawasaki's disease? |
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Definition
| fever x > 5 days; erythema on extremities; buccal erythema, rash, injection sclerae, LAD aneurysm, ESR |
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