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Flashcards in Finals - HDFN Deck (55):
1

____ they postulated the
immunization of a mother to paternal antigen carried on the fetus/newborn’s RBCs caused HDFN

Levine and Stetson (1939)

2

___ the antigen involved in HDFN

RhD

3

which of the ff about maternal alloimunization in HDFN is not true?
a. maternal ab are sometimes stimulated during 2nd and 3rd trimester
b. Prior pregnancy can stimulate
c. previous trauma can stimulate
d. Prior/current transfusion can stimulate

all is true :)

4

(T/F) abortion does not lead to spontaneous alloimmunization

false

it does

5

(T/F) hemorrhage of fetal RBCs can stimulate alloimmunization

true

6

___ the ab that can be involved in HDFN and causes suppression of fetal erythropoiesis as well as hemolysis

anti-K

7

which of the ff antigens is not a common cause of HDFN?
a. anti-lewis a
b. anti-e
c. anti-C
d. anti-D + E

a

lewis a never causes HDFN

8

which of the ff antigens is not a common cause of HDFN?
a. anti-E
b. anti-K
c. anti-D + C
d. anti- S

D

rarely causes HDFN

9

which of the ff is a rare cause of HDFN?
a. anti-P1
b. anti-I
c. anti-S
d. anti-lewis

C

the rest never causes HDFN

10

(T/F) Exposure to fetal RBCs and alloimmunization of mother
occur either early in the pregnancy or at delivery

false

occurs late in pregnancy and at delivery

11

(T/F) in HDFN, maternal RBCs are destroyed by fetal/newborn ab

false

fetal newborn RBC destroyed by maternal ab

12

____ are the cells that destroy antibody coated fetal RBCs

macrophages

13

____ the condition where Premature RBCs (precursors – nucleated RBCs) are released in the fetal circulation

Erythroblastosis fetalis

14

(T/F)in HDFN, fetal marrow responds to the anemia by
increasing erythropoiesis

true

15

which of the ff is not a result of anemia caused by HDFN?
a. hepatomegaly
b. hydrops fetalis
c. leukopoiesis
d. decrease in serum albumin

C

16

___ the condition where accumulation of fluid is seen such as edema or effusion in the fetus or newborn

hydrops fetalis

17

(T/F) IgG1 is associated with >severity of disease

true

18

___ the condition where unconjugated Bilirubin passes through the infant’s immature blood-brain barrier

kernicterus

bilirubin of >19mg

19

____ the enzyme that is
necessary to conjugate (bind) Bilirubin for excretion and is lacking in newborn

glucuronyl transferase

20

which of the ff is not a diagnostic procedure for HDFN during the early stages of pregnancy?
a. ABO and Rh typing
b. DAT
c. ab screen and ab panel
d. paternal antigen screening

B

21

(T/F) if father is found to be homozygous for the antigen, the genotype of fetus must be obtained

false

if father is heterpzygous

22

(T/F) when diagnosing using titers, the severity of HDFN always correlate with a higher titer

false

not always

23

____ a procedure where a sample of amnio'c fluid is taken (ultrasound guided) to ‘assess’ the
health of the fetus

amniocentesis

24

(T/F) Bilirubin concentration correlates with the degree of anemia in the fetus

true

25

___ graph used to plot OD of bilirubin concentration at 450nm

Lileys's graph

26

which of the ff is not done when directly measuring fetal anemia?
a. Hb and hct
b. DAT
c. blood typing
d. cordocentesis

all can be used to directly measure fetal anemia :)

27

___ aka percutaneous umbilical blood sampling; injectio the RBCs directly into the fetal umbilical vein

cordocentesis

used to measure fetal anemia

28

(T/F) Intrauterine transfusion (IUT) results in Hb content of >10g/dL

true

29

(T/F) in IUT, antigen positive blood is transfused to the fetus

false

ag neg blood is transfused

30

which of the ff is not a valid reason to perform IUT or cordiocentesis? pg29
a. amniotic fluid OD is in zone 2 or 3
b. amniotic fluid OD is in zone 1
c. Cordocentesis hemoglobin is

B

31

which off the ff is false about blood for IUT?
a. Hematocrit should be >70%
b. fresh RBC ≤ 7 day-old is preferred
c. must be Group O, antigen negative
d. non-irratiated

D

must be irradiated to prevent GVHD

32

____ treatment for mild HDFN where unconjugated bilirubin is converted to biliverdin

phototherapy with UV light (430-490 nm)

33

___ a treatment for HDFN where unconjugated bilirubin is removed, preventing kernicterus

Exchange transfusion

34

___ treatment for HDFN used to to correct anemia when the
Bilirubin level is not too high

small aliquot of transfusions

35

which of the ff is false about exchange transfusion?
a. replaces incompatible RBCs
b. supresses erythropoiesis
c. removes bilirubin
d. blood is cleansed and given back to newborn

D

false! blood becomes waste

36

___ a preventative measure for maternal alloimmunization to Rh D

high-dose Rh Immune Globulin (RhIG)

37

which of the ff is false about Rh immunoglobulin?
a. are IgMs
b. are IgGs
c. derived from pools of human plasma
d. supresses D pos packed or whole blood

A

they are IgGs

38

which of the ff is false about Rh immunoglobulin?
a. reduces immunization of D positive mother
d. given at 28 weeks gestation
c. given after abortions or ectopic pregnancy
d. administered within 72 hours
afer delivery

A

given to D neg mothers

choice D: done if mother delivers D pos/ D weak baby but is not immunized yet

39

*(T/F) Prophylactic anti-D
(passive immunization) should not be interpreted as active immunization

true

40

___ the screening test for postartum administration of RhIg

Rosette technique

41

____ an acid elution test used to quantitate the amount of fetal bleed in mother's cirvulation

Kleihauer-Betke (K-B)

42

___ describe the a positive KB test result

Maternal RBCs appears as ‘ghosts’ while fetal cells will remain pink (see lec 11 pg 50)

43

(T/F) the RhIg dose given to mother can be determined by quantitation of fetal cells from the KB technique

true

see page 51

44

___ the most common cause of HDN

ABO incompatibility between mother and fetus/newborn

45

(T/F) the destruction of the fetal RBCs in ABO HDN ALWAYS results in severe anemia

false

rarely coz:
ABO ag are not fully developed on fetal RBCs
– Ab is neutralized by tissue and soluble ags

46

which off the ff is not a symptom of ABO HDN?
a. hyperbilirubinemia and jaundice between 12 – 48 hours of birth
b. DAT positive
c. titers can predict disease
d. spherocytosis can occure

C

titers cant predict (titer for Rh, yes)

47

which ethnicity has a higher incidence of ABO HDN ?
a. Europeans
b. Africans
c. Asians
d. Eurasians

B

48

within the African ethnicity, which blood type is ABO HDN most likely seen?
a. A
b. B
c. O
d AB

B

mothers are group O

49

within the Europeans, which blood type is ABO HDN most likely seen?
a. A
b. B
c. O
d AB

a

mothers are group O

50

_____ a cause of mother-fetal blood incompatibility due to maternal IgG platelet antibodies crossing the placenta and causing severe thrombocytopenia

Immune Thrombocytopenia

51

___ FNAIT; a type of Immune Thrombocytopenia that is a result of specific maternal
alloantibodies directed at (baby's) platelet antigens which is inherited from the father

Fetal/neonatal allo-immune thrombocytopenia

52

(T/F) FNAIT can be responsible for the majority of intracranial hemorrhage cases due low platelets

true

53

____ Platelet antigen most commonly involved in FNAIT

HPA-1a

54

which of the ff is false about FNAIT?
a. not evident until symptoms show at birth
b. Platelet ab may develop early in the first
c. maternal IgMs crossing the placenta are involved
d. affected platelet ag are inherited from father

C

55

___ a type of immune thrombocytopenia where Autoantibody against platelets react with patient’s own platelets, donor or fetal
platelets

Immune Thrombocytopenic Purpura