Bloodwork Flashcards
antibody vs antigen
Antibodies, also called immunoglobulins, help fight against foreign substances calledantigens.
Antigensare any substance that stimulates the immune system to produce antibodies.
Antigens can be bacteria, viruses, or fungi that cause infection and disease.
CBC
This test gives important information about kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. Abnormal increases or decreases in cell counts may indicate an underlying medical condition that calls for further evaluation.
We choose to order a CBC with differential to measure the number of each type of white blood cell. If WBCs are elevated, this can be a sign of infection.
ABO/RH
Group and typing of expectant mothers and newborns may indicate potential for ABO hemolytic disease of the newborn (maternal antibodies cross the placental barrier to the fetal circulation system causing the destruction of fetal red blood cells).
Rh typing is used to determine Rh immune globulin candidacy for prenatal and postpartum patients. (ie. need for Rhogam to be administered)
During pregnancy, a small amount of the fetal blood can enter the maternal circulation system. If the mother is Rh negative and the fetus is Rh positive, the mother can develop an immune response against the fetal red blood cells and affect a future pregancy. This can result in another form of ABO hemolytic disease.
antibody screening
This test detects atypical antibodies (IgG) during pregnancy. The technique is designed specifically to detect IgG antibodies, though on occasion, some other antibodies (IgM) may also be detected.
An RBC (red blood cell) antibody screen is a blood test that looks for antibodies that target red blood cells.Red blood cell antibodies may cause harm to you after a transfusion or, if you are pregnant, to your baby.
Antibodies detected by the antibody screen will be subsequently identified, and further analyzed to determine if the antibody identified is clinically significant during pregnancy.
thyroid TSH, Free T4, TPO - what should the levels be?
(TSH at .45)
WHAT IS THE THYROID GLAND?
The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormones help the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.
TSH in a healthy adult is 0.45- 4.0 uIU/mL This range is ok for egg freezers at Spring
Research has shown improved pregnancy outcomes in patients with levels below 2.5 See CN 19.2 Precycle bloodwork guidelines
how does thyroid function?
The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms.
The amount of T4 produced by the thyroid gland is controlled by another hormone, TSH.
The amount of TSH that the pituitary sends into the bloodstream depends on the amount of T4 that the pituitary sees.
If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4.
Once the T4 in the bloodstream goes above a certain level, the pituitary’s production of TSH is shut off.
The thyroid and pituitary act in many ways like a heater and a thermostat. When the heater is off and it becomes cold, the thermostat reads the temperature and turns on the heater. When the heat rises to an appropriate level, the thermostat senses this and turns off the heater. Thus, the thyroid and the pituitary, like a heater and thermostat, turn on and off.
TPO antibody - over what can indicate possible thyroid problems?
(thyroid problems after 34)
Thyroid peroxidase (TPO), an enzyme normally found in the thyroid gland, plays an important role in the production of thyroid hormones.
A TPO test detects antibodies against TPO in the blood. If you’ve been diagnosed with thyroid disease, your doctor may recommend a TPO antibody test — in addition to other thyroid tests — to help determine the cause.
The presence of TPO antibodies in your blood suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto’s disease(underactive) or Graves’ disease(overactive).
In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue. Antibodies that attack the thyroid gland cause inflammation and impaired function of the thyroid.
Some people with TPO antibodies may not have thyroid disease. However, the presence of TPO antibodies may increase the risk of future thyroid disorders. If you have normal thyroid function with TPO antibodies, your doctor may recommend periodic checkups to watch for future thyroid problems.
The presences of TPO antibodies, greater than 34 IU/mL, may mean an increased risk in developing low thyroid function in the future.
vitamin D - normal range
(take vitamin D at 30)
Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement.
It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis.
Vitamin D has other roles in the body, including modulation of cell growth, neuromuscular and immune function, and reduction of inflammation
Normal range: 30-100 ng/mL
varicella - when to administer the test
(herpes 28 days later)
This test is used to determine if a woman has antibodies to the virus because it can cause birth defects of illness to a baby depending on when during the pregnancy the infection occurs.
Most pregnant women have already been exposed to the virus and therefore are immune.
For those women who do not have antibodies, they can be immunized. This vaccine is a 2-dose series, taken 28 days apart. Conception should not be attempted until 30 days after the second dose.
Rubella - german measles - how long to wait after vaccine before trying to get preg?
This test is used to confirm the presence of adequate protection against the rubella virus and to detect a recent or past infection.
It can also be used to identify those who have never been exposed to the virus or have not been vaccinated.
This test is ordered on all pregnant women and those planning to become pregnant to verify that they have a sufficient amount (titer) of rubella antibodies to protect them from infection.
If contracted during pregnancy, this disease may have severe effects on the developing fetus, including blindness, heart defects, hearing defects, musculoskeletal defects, and mental retardation.
The vaccine is a single dose, however the patient will need to wait 30 days after administration to attempt pregnancy.
CMV
CMV is a blood test ordered to detect the presence or absence of antibodies to CMV. It is a herpes virus.
The blood test is useful in determining whether a patient is currently infected or has antibodies form a previous infection. It is a herpes virus.
In the United States, nearly one in three children are already infected with CMV by age five. Over half of adults have been infected with CMV by age 40. Once CMV is in a person’s body, it stays there for life and can reactivate. A person can also be re-infected with a different strain (variety) of the virus. Most people with CMV infection have no symptoms and aren’t aware that they have been infected.
Infants infected before birth are usually asymptomatic after they are born, however some can develop hearing, vision, neurological, and developmental problems over time.
Sperm donors are tested for CMV as there are white blood cells in sperm and results are compared to the patient’s since there is a theoretical risk of transmission via insemination. However, there has been no reported cases of CMV transmission using donor sperm.
infectious disease
This testing—while not directly related to yourfertilityor ability to conceive—helps to ensure a safepregnancyand healthy baby. These pathogens can be transmitted through insemination procedures and from infected mothers to the fetus or newborn.
Hep B surface antigen
A viral disease primarily involving the liver, which may be transmitted by contact with virally infected blood or bodily fluids.
HBV is one of the most common infectious diseases in the world; it has been estimated that 350 million people worldwide are HBV carriers. HBV can be transmitted parenterally, sexually, vertically, and via other routes of mucosal exposure
Once infected with the virus, individuals may carry the virus and infect others, through exposure to blood, bodily fluids, or at childbirth.
If a woman is known to be Hepatitis B antigen positive, her child should receive special medication at the time of childbirth to prevent infection with the Hepatitis virus.
Vaccine available
Hep C surface antibody - can women breastfeed?
Hep C is a disease caused by a virus that infects the liver. A hep C infection can lead to inflammation of the liver and cause the immune system to attack healthy liver cells.
HCV is a blood-borne RNA virus that is transmitted primarily through parenteral exposure (blood products, shared needles, needle stick injuries). HCV also has been detected in saliva, urine, semen, vaginal secretions, and breast milk, and sexual and vertical transmission are probable secondary modes of transmission. HCV infects over 1% of the world’s population.
Groups at highest risk are intravenous drug users, hemophiliacs, homosexual men, sexual partners of HCV-infected individuals, and sex workers.
HCV is a highly pathogenic virus: 80% of patients infected with HCV will develop chronic liver disease
Unlike HBV, there is no vaccine for HCV. There is no vaccine available to treat infants born to HCV-infected women; breastfeeding is allowed.
HIV 1/2
The virus responsible for Acquired Immunodeficiency Syndrome (AIDS); it compromises the bodies immune system and its ability to protect against infection.
This test screens for the presence of antibodies to HIV. Women who are antibody positive to HIV have a significant chance of transmitting this virus to their newborns.
HIV-1 is the most common type of HIV and occurs all over the world. ~95% of people living with HIV have HIV-1.
HIV-2 is mainly present in West Africa, but it is slowly starting to appear in other regions, including the United States, Europe, and India.
