Krok 2 Hygiene Bases

Question: 1/30

A child is 6 years old. Within one year of observation he had URI that lasted 8 days. Physical state is satisfactory. Specify the health group:

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Assessment of health state is the most important role of a physician, who works with children and adolescents. It’s main importance lies in the fact, that the formation of physical and psychological human health, organism’s resistance to influence of unfavourable environmetnal factors and social contitions takes place in childhood.

The following criteria of complex assessment of the children and adolescents health state are used nowadays in everday practice of sanitary doctors, doctors of general education establishments, pediatricians, general practitioners and family doctors:

 Presence or absence of chronical diseases during examination;

 Functional state of main systems of organism;

 Level of organism resistance to unfavourable influence of environemntal factors;

 Current level of nervous and psychological, and physical development, its harmonicity.

According to listed above criteria, allocation scheme of children and adolescents by health groups was elaborated. There are 5 health groups:

First health group includes healthy children and adolescents with harmonious development and development level of organism functional systems corresponding to the age.

Second health group includes healthy children and adolescents who have functional and some morphological deviations, low resistance to acute and chroonic diseases, they are ill frequently during long period of time.

Third health group includes children and adolescents suffering from chronic diseases in compensation stage, with normal fucntional resources of organism.

Fourth health group includes children and adolescents suffering from chronic diseases in subcompensation stage with lowered funcional resources of organism.

Fifth health group includes children and adolescents suffering from chronic diseases in decompensation stage with significantelly lowered funcional resources of organism.

Laboratory values

Complete blood count

Laboratory value

Normal reference range

Erythrocyte count

Male: 4.3 − 5.9 · 10¹²/L

Female: 3.5 − 5.5 · 10¹²/L

Hemoglobin, blood

Male: 135-175 g/L
Female: 120-160 g/L

Color index

0.85 - 1.05

Reticulocyte count

0.5 - 1.5%

Platelet count

150 − 400 · 10⁹/L

Leukocyte count

4.0 − 9.0 · 10⁹/L

Basophils

0 − 0.065 · 109/L (0-1%)

Eosinophils

0.02 − 0.30 · 10⁹/L (0.5 - 5.0%)

Band neutrophils

0.04 − 0.30 · 10⁹/L (1 - 6%)

Segmented neutrophils

2.0 − 5.50 · 10⁹/L (47 - 72%)

Monocytes

0.09 − 0.60 · 10⁹/L (3 - 11%)

Lymphocytes

1.2 − 3.0 · 10⁹/L (19 - 37%)

Erythrocyte sedimentation rate (ESR)

Male: 0 - 15 mm/h
Female: 0 - 20 mm/h

Hematocrit

Male: 41 - 53%
Female: 36 - 46%

Biochemical blood analysis (Metabolic panel)

Laboratory value

Normal reference range

Total proteins

60-78 g/L

Albumin

35-50 g/L (52-65%)

Globulin:

23-35 g/L (35-48%)

α₁-Globulin

2-4 g/L (4.2-7.2%)

α₂-Globulin

5-9 g/L (6.8-12%)

β-Globulin

6-11 g/L (9.3-15%)

γ-Globulin

11-15 g/L (15-19%)

IgD

0 - 0.15 g/L

IgG

6.5-15 g/L

IgM

0.4-3.45 g/L

IgA

0.76-3.90 g/L

IgE

0-380 kU/L

Total Bilirubin

2-17 mcmol/L

Indirect (unconjugated) Bilirubin

2-17 mcmol/L

Direct (conjugated) Bilirubin

0-5 mcmol/L

Triglycerides

0.59-1.77 mmol/L

Total cholesterol

3.9-6.2 mmol/L

Total cholesterol

3.9-6.2 mmol/L

High-density lipoproteins (β-Lipoproteins)

<4.2 mmol/L

Low-density lipoproteins (α-Lipoproteins)

0.8-1.8 mmol/L

Low-density lipoproteins (α-Lipoproteins)

0.8-1.8 mmol/L

Glucose, blood

3.3-6.1 mmol/L (fasting)

Glycated hemoglobin

Iron, blood

9-30 mcmol/L

Potassium, plasma

3.5-5.0 mmol/L

Sodium, plasma Calcium, plasma 0.75-2.5 mmol/L

136-145 mmol/L

Calcium, plasma

0.75-2.5 mmol/L

Magnesium, plasma

0.75 - 1 mmol/L

Phosphorus (inorganic), serum

0.646-1.292 mmol/L

Chloride, blood

95-105 mmol/L

Urea, serum

3.33 - 8.32 mmol/L

Creatinine

53 - 106 mcmol/L

Uric acid

Male: 0.12-0.38 mcmol/L
Female: 0.12-0.46 mcmol/L

Lactate dehydrogenase (LDH)

45-90 U/L

α-Amylase (diastase), blood

25-125 U/L

Aspartate aminotransferase (AST)

15-40 U/L

Alanine aminotransferase (ALT)

10-40 U/L

Phosphatase (alkaline)

30-115 U/L

Coagulogram

Laboratory value

Normal reference range

Prothrombin time 80-100%

(< 12 seconds)

Fibrinogen

2-4 g/L

Partial thromboplastin time (activated)

< 28 seconds

Lee-White coagulation time

5-10 minutes

Bleeding time (Duke method)

< 4 minutes

Acid-base balance

Laboratory value

Normal reference range

pH arterial blood

7.35-7.45

Pco2 arterial blood

33-45 mm Hg

Po2 arterial blood

75 - 105 mm Hg

Bicarbonate, blood (HCO₃)

22-28 mmol/L

Other blood values

Laboratory value

Normal reference range

Cortisol, serum

230 -750 nmol/L

Osmolality, serum

275 - 295 mOsmol/kg H2O

Thyroid-stimulating hormone, serum or plasma

0.5-5 mIU/L

Thyroxine (T4), serum

65-155 nmol/L

Thyroid-stimulating hormone, serum or plasma

0.5-5 mIU/L

Triiodothyronine (T3), serum

1.77 - 2.43 nmol/L

Ferritin, serum

Male:15-200 mcg/L
Female: 12-150 mcg/L

Thymol turbidity test

<5 U

C-reactive protein (CRP)

<6 mg/dL

Antistreptolysin 0 (ASL0)

250 U

Antistreptohyaluronidase (ASH)

250 U

Urine

Laboratory value

Normal reference range

Urine specific gravity

1.016-1.022

Nechiporenko’s test: leukocytes

< 2 · 10⁶/л

Nechiporenko’s test: erythrocytes

< 1 · 10⁶/л

Proteins, total

<45.0 - 75.0 mg/24 h (<0.033 g/L)

Calcium

2.5 - 7.5 mmol/24 h

Creatinine clearance

Male: 97 - 137 mL/min
Female: 88 - 128 mL/min

Oxalate

90 - 445 mcmol/L

17-Ketosteroids (17-KS)

Male: 27.7 - 79.7 mcmol/24 h
Female: 17.4 - 55.4 mcmol/24 h

17-Hydroxycorticosteroids

(17-OCS) 5.5 - 27.6 mcmol/24 h

α-Amylase (diastase), urine

28-160 U/L

List of abbreviations

ACTH => Adrenocorticotrophic hormone
ADP => Adenosine diphosphate
ALT, ALAT => Alanin aminotranspherase
ALV => Artificial lung ventilation
AP => Arterial (blood) pressure
AST, AspAT => Aspartat aminotranspherase
ATP => Adenosine triphosphate
ВСG => Bacillus Calmette-Guérin
BP => Blood (arterial) pressure
CK => Creatine kinase
CNS => Central nervous system
СоА => Coenzyme A
CRP => C-reactive protein
CT => Computed tomography
COX => Cyclooxygenase
DIC => Disseminated intravascular coagulation
DTP (DPT) => Diphtheria-tetanus-pertussis vaccine
EDTA => Ethylenediamine tetra-acetic acid
ELISA => Enzyme-linked immunosorbent assay
ENT => Ear, nose, and throat (as a department in a hospital)
EPR (ER) => Endoplasmic reticulum
ESR => Erythrocyte sedimentation rate
EV => Enterovirus
FC => Functional class
GABA => Gamma aminobutyric acid
Hct Ht => Hematocrit
HDL => High-density lipoproteins
HR => Heart rate
IDL => Intermediate-density lipoproteins
IU => International unit
IUPAC => International Union of Pure and Applied Chemistry
LDH => Lactate dehydrogenase
LDL => Low-density lipoproteins
LOX => Lipoxygenase
MAO => Monoamine oxidase
MRI => Magnetic resonance imaging
NSAID => Nonsteroidal anti-inflammatory drug
PE (PATE) => Pulmonary embolism (Pulmonary artery thromboembolism)
PSA => Prostate-specific antigen
RBC => Red blood count
RR => Respiratory rate
SES => Sanitary-and-epidemiologic station
STD => Sexually transmitted disease
STI => Sexually transmitted infection
T/l => Trillion/liter
TABT => Typhoid-paratyphoid A and B plus tetanus toxoid vaccine
TMJ => Temporomandibular joint
TSH => Thyroid-stimulating hormone
TU => Tuberculin unit
URTI => Upper respiratory tract infection
V/f => Vision field
VLDL => Very-low-density lipoproteins
WBC => White blood count
WPW => Wolff-Parkinson-White syndrome