Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Alloimmunization > Flashcards

Alloimmunization Flashcards

1
Q

immune response to foreign antigen after exposure to different cells or tissues

A

alloimmunization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can alloimmunization affect the fetus?

A

transplacental passage → hemolytic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most common 3 red blood cell alloimmunization that account for majority of fetuses with severe disease that require intrauterine transfusion for fetal anemia or cause hydropic still birth

A

anti D
anti c
anti Kell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are two common factors of alloimmunization?

A

ABO compatibility and status of father

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rh D alloimmunization can be caused by a fetus with _____ and a mother with _____

A

Rh + erythrocytes

Rh - erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in order for Rh D alloimmunization to occur a significant number of fetal erythrocytes must gain access to maternal circulation, how can this occur?

A 
ectopic pregnancy
surgery
miscarriage
D&C
C-section
delivery 
fetal maternal hemorrhage (placenta previa or abruption placentae)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What procedure increases the risk of maternal fetal hemorrhage? What should Rh-D negative mom get prior to procedure?

A

chorionic villus sampling

RhoGAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what 3 conditions can result in Rh D alloimmunization?

A
  1. Rh (+) fetus in Rh (-) mom
  2. mom must have immunogenic capacity to produce antibodies against Rh D antigen
  3. significant number of fetal erythrocytes must gain access to maternal circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If breach of choriodecidual space is suspected, how soon should you administer RhoGAM?

A

within 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

in subsequent pregnancies if a mother carries Rh (+) fetus, what affect can the anti Rh antibodies have on the fetus?

A 
hemolytic anemia
jaundice 
kernicterus 
hepatosplenomegally 
fetal hydrops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

condition characterized by abnormal collection of fluid in the fetus

A

hydrops fetalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

at least 2 of the following are places were fluid abnormally collects and results in hydrops fetalis

A

edema (>5 mm)
ascites
pleural effusion
pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

two classifications of hydrops fetalis

A

immune and nonimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what two things are hydrops fetalis frequently associated with?

A

polyhydramnios and thickened placenta (>6 cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

common complaints of hydrops fetalis

A 
polyhydramnios in thick placenta 
size is greater than dates 
fetal tachycardia (>160)
decreased fetal movement
abnormal serum screening 
antenatal hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

maternal antibodies against RBC of fetus cross the placenta and coat fetal RBC and destroy them

A

immune hydrops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

severe anemia as a result of immune hydrops leads to….

A

high output CHF
liver and spleen increases RBC production → hepatic circulatory obstruction (Portal HTN)
hemolytic disease of newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

any cause of hydrops fetalis that is not immune related → failure of interstitial fluid to return to the venous system

A

nonimmune hydrops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some causes of nonimmune hydrops?

A

cardiac failure
impaired venous retun
obstruction of normal lymphatic flow
increased capillary permeability

20
Q

method used to screen for antibodies for anti D and other atypicals

A

indirect Coombs test

21
Q

Indirect Coombs test indicates Rh (-) woman is alloimmunized to Rh D, what is the next step?

A

order anti-D titer → roughly correlates with disease severity
Doppler flow studies

22
Q

Anti-D titer of ___ requires further assessment

A

1:16

23
Q

If a titer is less than 1:16, how often should you follow them with titer?

A

monthly

24
Q

preferred method and standard of care for monitoring fetal anemia

A

Doppler velocimetry of middle cerebral artery

25
Q

As a fetus becomes more anemic, how will Doppler velocimetry change?

A

more anemic → decrease blood viscocity → increase velocity of flow through MCA

26
Q

Prevention of alloimmunization of Rh

A

RhoGAM

27
Q

How does RhoGAM work?

A

binds to fetal RBC and prevents maternal mixing

28
Q

3 instances/indications where you would give Rh (-) and negative antibody screen RhoGAM?

A
  1. @ 28 weeks gestations
  2. with 72 hours of delivery
  3. potential mixing of blood
29
Q

method to scree for fetal-maternal hemorrhage in routine situations begins with _____

A

rosette fetal red blood cell assay

30
Q

inubate maternal sample with rh immunoglobulin that will bind fetal Rh-D (+) RBC → add enzyme treated reagent indicator RBC

A

rosette fetal RBC assay

31
Q

Positve rosette test indicates Rh D (+) fetal RBC, what does positive test look like?

A

form aggregates (rosettes) visualized by light microscopy

32
Q

Positive rosette tests should be followed by a method to determine percentage of fetal RBC in maternal ciruclation

A

Kleihauer Betke test

33
Q

test to quantify amount of fetomaternal hemorrhage

A

Kleihauer Betke test

34
Q

all pregnant women should be tested at time of first prenatal visit for ____ and ____ and screened for erythrocyte antibodies

A

ABO blood group and Rh D type

35
Q

when should you repeat RhD antibody testing for all unsensitived Rh D (-) women?

A

24-28 weeks

36
Q

ideal time to administer anti-D immune globulin

A

within 72 hours of potentially sensitizing event

37
Q

ABO hemolytic disease due to incompatibilty is most pronounced in mother with blood type ___ and the father is ____

A

Mother → O

Father → A, B, or AB

38
Q

predominant antibodies in mother with type O blood

A

IgG

39
Q

what race is ABO hemolytic disease MC in?

A

African Americans

40
Q

How is ABO disease unlike Rh?

A

ABO can occur in first pregnancy since anti A or B antibodies are found early in life

41
Q

what will the fetus develop in ABO hemolytic disease within 24 hours?

A

jaundice

42
Q

treatment for ABO hemolytic disease

A

usually none

43
Q

how is ABO hemolytic disease less severe than anti-D sensitization?

A

less antibodies cross placenta
ABO antigens are in low numbers
fetal RBC are less developed at birth
presence of ABO antigens in tissues and secretions

44
Q

these alloantibodies in pregnancy are known to suppress erythropoeisis → can result in serious disease despite low amniotic bilirubin levels and low antibody titers

A

Kell alloimmunization

45
Q

how does anti-Kell autoantibodies impact fetal RBC?

A

fetal RBC destruction → erythroid precursor cells express Kell antigen → rapid and earlier development of fetal anemia

46
Q

when severe Kell immunization occurs what is essential to prevent fetal death?

A

intrauterine blood transfusion

Obstetrics (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions