Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Which test estimates how much fetal blood has entered the mother's circulation, to guide the dose of anti-D?
A breastfeeding mother has a hard, tender lump in one breast without fever. She feels well. What is the most likely cause and the best advice?
A patient weighs 80 kg and is prescribed 10 mg/kg as a single dose. Find the dose D in mg.
A child weighing 10 kg is prescribed 10 mg/kg per dose of an oral suspension that contains 125 mg in 5 mL. What volume V do you give?
500 mL was ordered over 12 hours. After 4 hours you find that 410 mL is still in the bag, and the order must still finish on time. To what rate R in mL/h must the pump be reset?
A bag contains 250 mg of a drug in 250 mL and runs at 15 mL/h. How many milligrams per hour D does the patient receive?
Answer: A · Kleihauer–Betke test
The Kleihauer–Betke test (or flow cytometry) measures fetal red cells in maternal blood after a sensitising event such as trauma or birth. The result guides whether extra anti-D is needed.
Answer: D · A blocked duct; keep feeding and vary positions
A tender lump without fever usually means a blocked duct. Frequent feeding, varied positions and gentle care help clear it. Fever, redness and flu-like symptoms suggest mastitis, which also usually allows continued feeding.
Answer: D = 800 mg
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: V = 4 mL
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: R = 51.25 mL/h
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
Many hospitals allow such an adjustment up to 25% without a new order; check local policy.
Answer: D = 15 mg/h
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
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