TB lead-in trial (copy of pulm-tb – delete after review)

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Tuberculosis in Children

Question 1 of 12

Reference values

Typical paediatric values. A real laboratory quotes its own ranges, and several of these move with age.

Age	Heart rate	Respiratory rate	Systolic BP — hypotension below
Term newborn	110–160	30–40	60 mmHg
1–12 months	110–160	30–40	70 mmHg
1–2 years	100–150	25–35	70 + (2 × age) mmHg
2–5 years	95–140	25–30	70 + (2 × age) mmHg
5–12 years	80–120	20–25	70 + (2 × age) mmHg
Over 12 years	60–100	15–20	90 mmHg

Measure	Reference	Note
Temperature	36.5–37.5 °C	38.0 or above is fever
Oxygen saturation	94–100 percent in air	under 92 in air needs oxygen and admission
Capillary refill	under 2 seconds	3 seconds or more suggests shock
Heart rate	see the table above	age dependent
Respiratory rate	see the table above	age dependent
Blood pressure	see the table above	age dependent

Measure	Reference	Note
pH	7.35–7.45
PaCO₂	35–45 mmHg (4.7–6.0 kPa)	the respiratory term
PaO₂	80–100 mmHg (10.6–13.3 kPa)	breathing room air
Bicarbonate	22–26 mmol/L	the metabolic term
Base excess	−2 to +2 mmol/L
Lactate	under 2 mmol/L	over 4 marks shock
A–a gradient	under 10–15 mmHg in air	a normal gradient means the lungs are not the problem

Measure	Reference	Age note
Haemoglobin	see age note	newborn 14–22 g/dL; physiological nadir 9.5–13.5 at 6–9 weeks; 6 months to 6 years 10.5–14; 6–12 years 11.5–15.5
White cells	see age note	newborn 9–30 ×10⁹/L; 1 year 6–18; 4–10 years 4–13.5; adolescent 4.5–11
Neutrophils	neutropenia under 1.5 ×10⁹/L, severe under 0.5
Platelets	150–450 ×10⁹/L
MCV	lower limit roughly 70 + age in years (fL)	to about 12 years
ESR	under 10–20 mm/h
CRP	under 5–10 mg/L	laboratory dependent

Measure	Reference	Note
Sodium	135–145 mmol/L
Potassium	3.5–5.0 mmol/L	up to 6.0 in the newborn
Chloride	98–107 mmol/L
Bicarbonate	22–26 mmol/L	same value as on the gas
Urea	2.5–6.5 mmol/L (7–18 mg/dL)
Creatinine	infant 15–35, child 25–60, adolescent 50–90 µmol/L	rises with muscle mass, so an adult range over-reads a child
Glucose	3.5–5.5 mmol/L (63–99 mg/dL)	newborn above 2.6 mmol/L
Urine sodium / chloride	under 20 mmol/L means the loss is not renal	a high urine chloride points to the kidney or a diuretic

Measure	Reference	Note
ALT / AST	10–40 / 10–45 U/L
GGT	5–35 U/L	up to 200 in the first months of life
Alkaline phosphatase	child 100–400 U/L, higher in the growth spurt	an adult range makes normal childhood bone turnover look like disease
Bilirubin (total)	under 17 µmol/L (1 mg/dL) beyond the newborn period
Conjugated bilirubin	under 17 µmol/L, or under 20 percent of total	above this is always pathological
Albumin	35–50 g/L
Ammonia	newborn under 110, child under 50 µmol/L
Calcium / magnesium / phosphate	2.2–2.7 / 0.7–1.0 / 1.2–2.0 mmol/L	phosphate runs higher in infancy, to about 2.6
Lipase or amylase	three times the upper limit defines pancreatitis
Sweat chloride	under 30 normal, 30–59 intermediate, 60 or more diagnostic

Measure	Newborn	Child
White cells	0–20 /mm³	0–5 /mm³
Protein	0.4–1.2 g/L	0.15–0.45 g/L
Glucose	at least 60 percent of the blood glucose	at least 60 percent of the blood glucose
Bacterial pattern	hundreds to thousands of neutrophils, high protein, low glucose	same

Why the other options are wrong

Score: 0 / 0

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