Physician: Screenings for Post-Institutionalized Children, pg 2

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  • CBC: complete blood count: It gives us information on the health status of the child's blood cell, pertaining to anemia, which can be caused by a multitude of reasons. Sickle cell disease, Thalasemia, anemia of chronic illness or just iron deficiency anemia.

  • Lead screen: Lead can cause anemia and developmental delay if untreated. Lead can be found in old institution walls, water supply (pipes) and the overall environment as a pollutant.

  • G6PD deficiency: An enzyme deficiency common in Asia, Africa, and the Mediterranean region. Screening of children from these areas needs to be performed prior to prescribing medications that may cause hemolytic (blood cell breakdown) anemia in persons lacking this enzyme.

  • Hemoglobin Electrophoresis : in Asian children to look for Thalasemia Anemia

  • HIV Elisa: test for the AIDS or HIV virus

  • VDRL: test for syphilis. Frequently transmitted from the mother to child

  • Hepatitis B panel: should be performed prior to hepatitis B vaccination. It tests for acute, chronic illness as well as vaccine status.

  • Hepatitis C: for hepatitis C

  • Calcium, Phosphorous, Alkaline Phosphatase: screens for Rickets

  • Urinalysis: check the overall kidney function

  • Stool sample: for intestinal parasites. Giardia is common in institutions

  • Stool cultures : intestinal bacteria

  • Comprehensive metabolic panel SMA-20: check on overall body function, liver, kidney

  • TFT: thyroid disease

  • PPD: tuberculosis status

  • Immunization Titers: to see if the child mounted an immune response in order to continue with the current vaccine schedule or restart all vaccine from the beginning.

  • State Newborn Screen: only in children less than 12 months. To check for metabolic disorders routinely tested at birth (PKU, Biotinidase, Sickle cell)

  • Hearing and vision tests

As you can see, that there is going to be a lot of blood drawn in order to perform these test. It is a stressful time for both child and parent. I generally recommend that the parents to perform these tests on two visits spread out one week apart.

by George Rogu M.D.

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