Lab values / normal ranges Flashcards by mariko carding

When do you refer for anaemia

Hb < 90
not responding to treatment

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what is normal Hb range

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

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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

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

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

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

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what is normal HbA1c level

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

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what is diagnosis of GDM - GTT

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

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What is diagnosis of GDM- polycose

> 7.8

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What are normal lactates for fetal blood sampling

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how do we check for inflammation

CRP <5
Gold tube

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

AB POS

O pos

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what bilirubin level do you consult

> 250 (48hrs)
300 (anytime)

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what bishop score indicates “unfavourable uterus”

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what is tested in bishops score

position
length
consistency
dilation
station (relative to spines)

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what is tested in apgar score

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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what is normal range of neonatal BGL’s

BGL >2.6mmol

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what is blue blood tube for

Coag screen

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what is gold blood tube for

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

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What is lavender blood tube for

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

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What is haemotocrit

% of blood that is RBC’s

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kleihauer test

indication
 tube colour
 positive value

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

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What is fetal fibronectin

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What is pink blood tube for

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

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What is a coombs test
what colour tube

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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cord bloods

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

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)

marginal cord insertion- how close is placenta to internal os

<20mm

what gestation can you start using CTG

28 wks

what APGAR = "infant depression" What is referral

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

HEART RATE what is normal FHR / neonatal HR maternal

110-160 bpm 60-100 bpm

Resp rate normal neonatal + maternal

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

Normal temp neonatal

36.5-37.5

what is normal / abnormal neonatal weight loss in first week

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

What is tested in booking bloods (tube colours )

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

What is positive PCR

>30

How do you calculate artifical milk amount

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

blood cultures what are these taken for?

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

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

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

Vitamin D what is level of 'insufficiency' + 'deficiency'

<50 = insufficiency <25= deficiency

afebrile

NOT feverish

dysuria

pain when urinating

pyuria

pus in urine

diuretic

increase urination

anti diuretic what drug has this effet

reduce urination oxytocin

maternal temp- what is pyrexia?

pyrexia- >38 (with/without fetal tachycardia)

Rubella- what levels indicate 'immune'

>10 = 'detected' >5-9 = 'equivocal' <5 = not immune

hep B- what is tested

Antigen

WBC normal range Indicative of UTI

>300- Normal >>1000- UTI

order of blood

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)

when is hcg detected after fertilisation

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

which cord vessel provides best information on fetal condition

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

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

pyrexia

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

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

describe landmarks for palpation

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

Systolic vs diastolic blood pressure

After ventricular systole, When arteries fill with blood and there is max pressure Ventricular diastole, when arteries have least amount of blood

Systolic vs diastolic blood pressure

After ventricular systole, When arteries fill with blood and there is max pressure Ventricular diastole, when arteries have least amount of blood

when do you test for hyperglycaemia (no risk factors)

24-28wks

how do we calculate EDD

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

what is thrombocytopenia

low platelet count (<100)

when can a woman become pregnant postpartum?

day 21

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

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)

what iron asesssment required for woman that is vegetarian/vegan

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

what is haematocrit

% of RBC's in blood