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Final exam > Lab values / normal ranges > Flashcards

Lab values / normal ranges Flashcards

1
Q

When do you refer for anaemia

A

Hb < 90
not responding to treatment

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2
Q

what is normal Hb range

A

110 1st trimester/ 105 in 2nd and 3rd
140

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3
Q

what are normal ferritin levels
what levels indicate “absent iron stores”
what should be considered if ferritin very high (>100)

what is requirement to confirm ferritin levles

A

normal= >30
‘absent iron stores’ = <15
>100- check inflammation, organ disease
>
check absence of inflammation ( CRP>5 )

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4
Q

what is normal platelets level
what is level indicating possible PE / HELLP/ thrombocytopenia

A

normal >150
<100 could be PE/ HELLP/ thrombocytopenia

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5
Q

what is normal HbA1c level

A

normal = <40
41-50 = “prediabetic” - 1 week prick testing / do OGTT @24wks
>50 likely diabetic

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6
Q

what is diagnosis of GDM - GTT

A

OGTT-
Fasting BGL >5.5
2HR POST prantil> 9.0

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7
Q

What is diagnosis of GDM- polycose

A

> 7.8

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8
Q

What are normal lactates for fetal blood sampling

A

<4

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9
Q

how do we check for inflammation

A

CRP <5
Gold tube

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10
Q

Blood types
- which blood group can accept blood from anyone (universal recipient)
- which group can give blood to anyone (universal donor)

A

AB POS

O pos

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11
Q

what bilirubin level do you consult

A

> 250 (48hrs)
300 (anytime)

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12
Q

what bishop score indicates “unfavourable uterus”

A

<6

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13
Q

what is tested in bishops score

A

position
length
consistency
dilation
station (relative to spines)

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14
Q

what is tested in apgar score

A

appearance (colour) - blue + pale / body pink, limbs blue / all PInk
pulse- absent / <100 / >100
grimace (response to stimuli)- none / grimace / cry
activity (tone)- limp / some flexion/ active
respiratory effort -none / slow irregular / good, cry

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15
Q

what is normal range of neonatal BGL’s

A

BGL >2.6mmol

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16
Q

what is blue blood tube for

A

Coag screen

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17
Q

what is gold blood tube for

A

LFT + Rnl
CRP
Ferritin
B2
Viral studies (hepatitis syphylis, HIV)

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18
Q

What is lavender blood tube for

A

CBC (Hb, platelets, haemotocrit, HbA1c, kleihauer, ACTH)

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19
Q

What is haemotocrit

A

% of blood that is RBC’s

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20
Q

kleihauer test

indication
 tube colour
 positive value
A

indication- tests for presence of fetal cells in maternal serum
tube - CBC
positive = >6

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21
Q

What is fetal fibronectin

A
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22
Q

What is pink blood tube for

A

Group and Hold, cross match, Blood group, Antibody screen, Coombs

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23
Q

What is a coombs test
what colour tube

A

what is it - taken from cord bloods to test for presence of “foreign” antibodies
indication- maternal neg blood group / jaundice
Pink tube

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24
Q

cord bloods

A

NORMAL
cord lactates ≤ 4.1 mmol/ L (Rising lactates = fetal acidosis)
ph > 7.1 (note - LOW pH = acidity caused by excess CO2)

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25
Q

fetal fibronectin
indication
when
How to take test
how to interpret results

A

indication- screening test for women with suspected preterm labour (24-36wks)

How-
Vaginal swab-
take before any digital exam/ other swabs- this can artificially stimulate more fibronectin to be released.
Don’t use lubricant
Results influenced by bleeding, recent intercouse

Negative test- high neg predictive value (likely to be accurate)
positive test- low predictive value (<30% of women that have positive result, actually birth within 7days)

26
Q

marginal cord insertion- how close is placenta to internal os

A

<20mm

27
Q

what gestation can you start using CTG

A

28 wks

28
Q

what APGAR = “infant depression”
What is referral

A

< 6 @ 10mins = TRANSFER “moderate”
<6 @ 1min + not improving @10mins= EMERGENCY “severe”

29
Q

HEART RATE
what is normal FHR / neonatal HR
maternal

A

110-160 bpm
60-100 bpm

30
Q

Resp rate
normal neonatal + maternal

A

neonatal = 40-60 rpm
maternal = 12-20rpm

31
Q

Normal temp
neonatal

A

36.5-37.5

32
Q

what is normal / abnormal neonatal weight loss in first week

A

normal = <10% weight loss (make a plan if 7-10%)
abnormal = >10% weight loss

33
Q

What is tested in booking bloods (tube colours )

A

Gold- Ferritin, viral (hepatitis B, Syphilis, HIV, Rubella immunity)
Lavender- CBC, Hb, haematocrit, HbA1c
Pink- blood group, antibody

Chlamydia - women <25yrs
Vit D- not recommended to routinely test

34
Q

What is positive PCR

A

> 30

35
Q

How do you calculate artifical milk amount

A

total vol in 24hrs =[ weight (kg) x 60ml ]/ 8 (assume 3hourly feeds)

36
Q

blood cultures
what are these taken for?

A

what it does- blood test to check for presence of bacteria- can indicate risk of sepsis
indication- suspected sepsis

37
Q

BMI
What is healthy BMI range, and recommended weight gain
What is overweight BMI + recommended gain
what is obese BMI + recommended gain

A

BMI 18-25 / 11.5-16KG gain
BMI 25-30 / 7-11.5
BMI >30 / 5-9KG

38
Q

Vitamin D
what is level of ‘insufficiency’ + ‘deficiency’

A

<50 = insufficiency
<25= deficiency

39
Q

afebrile

A

NOT feverish

40
Q

dysuria

A

pain when urinating

41
Q

pyuria

A

pus in urine

42
Q

diuretic

A

increase urination

43
Q

anti diuretic
what drug has this effet

A

reduce urination
oxytocin

44
Q

maternal temp- what is pyrexia?

A

pyrexia- >38 (with/without fetal tachycardia)

45
Q

Rubella- what levels indicate ‘immune’

A

> 10 = ‘detected’
5-9 = ‘equivocal’
<5 = not immune

46
Q

hep B- what is tested

A

Antigen

47
Q

WBC
normal range
Indicative of UTI

A

> 300- Normal
>1000- UTI

48
Q

order of blood

A

bBrgPPG

blood culture bottles
pale blue (coag studies)
dark blue
red (virology / immunology)
green (renal / liver )
purple (CBC)
Pink (G&S, Cross match)
Grey (Glucose)

49
Q

when is hcg detected after fertilisation

A

blood- 9 days after fertilisation
urine- 10-12 days

50
Q

which cord vessel provides best information on fetal condition

A

arterial (blue)- this is blood that has just left fetus
venous blood (REd) provides additioanl info

large difference betwee A/V ph can indicate RECENT problem (eg. cord compression)
small difference: longstanding problem

51
Q

what may Dryness in vagina (i.e. during VE) indicate?

A

pyrexia

52
Q

human milk vol requirements
day 1
day 2
day 3
day 4

A

1) 2-10ml
2) 5-15ml
3) 15-30ml
4) 60ml

53
Q

describe landmarks for palpation

A

40 - slightly below xiphisternum
36 wks- xiphisternum
30 wks- half way between umbilicus and xiphisternum
24 weeks- just above umbilicus
16 wks- below umbilicus
12 weeks- just above pubic symphysis

54
Q

Systolic vs diastolic blood pressure

A

After ventricular systole, When arteries fill with blood and there is max pressure

Ventricular diastole, when arteries have least amount of blood

55
Q

Systolic vs diastolic blood pressure

A

After ventricular systole, When arteries fill with blood and there is max pressure

Ventricular diastole, when arteries have least amount of blood

56
Q

when do you test for hyperglycaemia (no risk factors)

A

24-28wks

57
Q

how do we calculate EDD

A

LMP + [7 days +9mths] / + [7 days - 3mths] / 280 days

58
Q

what is thrombocytopenia

A

low platelet count (<100)

59
Q

when can a woman become pregnant postpartum?

A

day 21

60
Q

what is mean cell vol (MCV) + mean cell haemaglobin (MCH)

A

MCV-average size of RBCs (low MCV = microcytic cells)
MCV increases slighly in pregnancy so unreliable until IDA established

MCH= amount of hb in cells.
Low MCH = “hypochromic” cells- pale

if MCV + MCH both low- urgent iron supplements required
(could be IDA, thalassaemia)

61
Q

what iron asesssment required for woman that is vegetarian/vegan

A

check b12 + folate levels
for potential megaloblastic anaemia
(low Hb, normal ferritin) = high MCV, low Mhb

62
Q

what is haematocrit

A

% of RBC’s in blood

Final exam (14 decks)

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