4.9 Hemolytic Disease of the Fetus and Newborn Flashcards
All of the following are reasons for a positive DAT on cord blood cells of a newborn except:
A. High concentrations of Wharton jelly on cord blood cells
B. Immune anti-A from an O mother on the cells of an A baby
C. Immune anti-D from an Rh negative mother on the cells of an Rh-positive baby
D. Immune anti-K from a K-negative mother on the cells of a K-negative baby
Immune anti-K from a K-negative mother on the cells of a K-negative baby
A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken?
A. Perform a Kleihauer-Betke test
B. Issue one full dose of RhIg
C. Perform a DAT on the infant
D. Perform an antibody screen on the mother
Issue one full dose of RhIg
What should be done when a woman who is 24 weeks pregnant has a positive antibody screen?
A. Perform an antibody identification panel; titer, if necessary
B. No need to do anything until 30 weeks’ gestation
C. Administer RhIg
D. Adsorb the antibody onto antigen-positive cells
Perform an antibody identification panel; titer, if necessary
All of the following are interventions for fetal distress caused by maternal antibodies attacking fetal cells except:
A. Intrauterine transfusion
B. Plasmapheresis on the mother
C. Transfusion of antigen-positive cells to the mother
D. Middle cerebral artery peak systolic velocity (MCA-PSV)
Transfusion of antigen-positive cells to the mother
Cord blood cells are washed six times with saline, and the DAT result and negative control are still positive. What should be done next?
A. Obtain a heelstick sample
B. Record the DAT result as positive
C. Obtain another cord blood sample
D. Perform elution on the cord blood cells
Obtain a heelstick sample
What can be done if HDFN is caused by maternal anti-K?
A. Give Kell immune globulin
B. Monitor the mother’s antibody level
C. Prevent formation of K-positive cells in the fetus
D. Not a problem; anti-K is not known to cause HDFN
Monitor the mother’s antibody level
Should an O-negative mother receive RhIg if a positive DAT on the newborn is caused by immune anti-A?
A. No, the mother is not a candidate for RhIg because of the positive DAT result
B. Yes, if the baby’s type is Rh negative
C. Yes, if the baby’s type is Rh positive
D. No, the baby’s problem is unrelated to Rh blood group antibodies
Yes, if the baby’s type is Rh positive
Should an A-negative woman who has just had a miscarriage receive RhIg?
A. Yes, but only if she does not have evidence of active anti-D
B. No, the type of the baby is unknown
C. Yes, but only a minidose regardless of trimester
D. No, RhIg is given to women at full-term pregnancies only
Yes, but only if she does not have evidence of active anti-D
SITUATION:. The automated blood bank analyzer reports a type of O negative on a woman who is 6 weeks pregnant with vaginal bleeding. The woman tells the emergency department physician she is O positive and presents a blood donor card. The MLS performs a test for weak D and observes a 1+ reaction in the AHG phase. The Kleihauer-Betke test result is negative. Is this woman a candidate for RhIg?
A. Molecular testing is indicated to ascertain the type of weak D
B. Yes, she is Rh positive
C. No, there is no evidence of a fetal bleed
D. Yes, based on the automated typing results
Molecular testing is indicated to ascertain the type of weak D
Which of the following patients would be a candidate for RhIg?
A. B-positive mother; B-negative baby; first pregnancy; no anti-D in mother
B. O-negative mother; A-positive baby; second pregnancy; no anti-D in mother
C. A-negative mother; O-negative baby; fourth pregnancy; anti-D in mother
D. AB-negative mother; B-positive baby; second pregnancy; anti-D in mother
O-negative mother; A-positive baby; second pregnancy; no anti-D in mother
The Kleihauer-Betke acid elution test identifies 40 fetal cells in 2,000 maternal RBCs. How many full doses of RhIg are indicated?
A. 1
B. 2
C. 3
D. 4
4
Kernicterus is caused by the effects of:
A. Anemia
B. Unconjugated bilirubin
C. Antibody specificity
D. Antibody titer
Unconjugated bilirubin
Anti-E is detected in the serum of a woman in the first trimester of pregnancy. The first titer for anti-E is 32. Two weeks later, the antibody titer is 64 and then 128 after another 2 weeks. Clinically, there are beginning signs of fetal distress. What may be done?
A. Induce labor for early delivery
B. Perform plasmapheresis to remove anti-E from the mother
C. Administer RhIg to the mother
D. Perform an intrauterine transfusion using E-negative cells
Perform plasmapheresis to remove anti-E from the mother
What testing is done for exchange transfusion when the mother’s serum contains an alloantibody?
A. Crossmatching and antibody screen
B. ABO, Rh, antibody screen, and crossmatching
C. ABO, Rh, antibody screen
D. ABO and Rh only
ABO, Rh, antibody screen, and crossmatching
Which blood type may be transfused to an AB-positive baby who has HDFN caused by anti-D?
A. AB negative, CMV negative, Hgb S negative; irradiated or O negative, CMV negative, Hgb S negative
B. AB positive, CMV negative; irradiated or O positive, CMV negative
C. AB negative only
D. O negative only
AB negative, CMV negative, Hgb S negative; irradiated or O negative, CMV negative, Hgb S negative
