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blood bank > HDFN > Flashcards

HDFN Flashcards

1
Q

perinatal (near birth)

A

20 weeks to 28 days after birth

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2
Q

neonate (newborn)

A

day 0 to 4 weeks

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3
Q

infant

A

4 weeks to 1 year

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4
Q

gravid

A

pregnant

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5
Q

gravida

A

number of pregnancies a single patient has had, regardless they result in a birth

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6
Q

para (parity)

A

number of pregnancies a patient has had that have reach viability

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7
Q

HDFN

A

destruction of RBC’s of the fetus or neonate by maternal antibodies

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8
Q

2 most common types of HDFN caused by

A

Rh antibodies and ABO antibodies

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9
Q

as little as ____ of fetal RBC’s are enough to stimulate formation of anti-D

A

1 mL

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10
Q

what happens to fetus

A

RBC’s lyse– release Hgb– indirect bili (does not cause a problem because will cross placenta and mother will conjugate)

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11
Q

what happens to neonate

A

RBC destruction after birth; can’t effectively conjugate bili and can’t excret = jaundice

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12
Q

how much bili is toxic

A

18-20

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13
Q

bili is brain called

A

kernicterus: seizures, poor feeding cerebral palsy

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14
Q

unconjugated bili (indirect)

A

insoluble

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15
Q

conjugated bili

A

water soluble

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16
Q

prenatal testing

A

mother type and screen

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17
Q

if screen is positive tech must do panel

A

if they have anti-D need to determine if true anti-D or had RhoGham

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18
Q

if true anti-D

A

order antibody titration and antigen typed

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19
Q

antibody titration

A

twofold serial dilution of maternal plasma

test against RBC’s that are homozygous for specific antigen

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20
Q

express titer as

A

reciprocal of highest diltuion

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21
Q

KNOW TITER SCORE

A

yeah

22
Q

if titer increases during pregnancy

A

fetus is presumed antigen positive and at risk for HDFN

23
Q

rhIG is over titer of

A

4

24
Q

if titer >8

A

a second titer needed at 18-20 weeks

25
Q

if titer >16

A

fetus will need middle cerebral artery peak systolic velocity (tells how anemic fetus is )

26
Q

if 16 or less titer

A

needs to be measured every 2-4 weeks from 2nd trimester on

27
Q

if consistently less than 16 titer

A

it is lower risk

28
Q

rho gham

A

binds positive fetal cells and removed from circulation

29
Q

1 dose of rhoghan =

A

elimnate 30 mL of fetal whole blood

30
Q

FMH

A

used to detect small amounts of rh + in maternal circulation

31
Q

if FMH +

A

specific quantity of fetal cells must be calculated and determine dosage of RhoGHAM (Kleihauer-Betke) or flow cytometrey

32
Q

if FMH -

A

still give 1 dose of rhogham

33
Q

FMH is determined by

A

how mant rossettes per field

34
Q

kleihauer-betke test

A

count 3000 cells

volume of FMH= number of fetal cells x 5,000mL/ total cells

round down answer and + 1

35
Q

principle of kleihauer-betke test

A

adult Hgb is not resistent to acid so washed out

36
Q

testing for newborns

A

cord blood

ABO/Rh - forward and DAT

37
Q

washing is important for cord blood testing to get rid of

A

wharton’s jelly

38
Q

if DAT is + for newborn perform

A

elution and ID antibody

39
Q

most common form of HDFN

A

ABO HDFN

40
Q

small pool of anti-A and anti-B can cross placenta because

A

IgG

41
Q

normal culprint of ABO HDFN is

A

anti- A,B

42
Q

who makes anti-A,B IgG

A

group. O

43
Q

what type of mothers most likely to have ABO imcompatibility

A

group O

44
Q

mothers that are imcompatible with fetal RBC’s for BOTH ABO and D are

A

protected from sensitization to D

45
Q

why are they protected

A

incompatible cells are destroyed in maternal circulation before anti-D can be formed

46
Q

treatment of HDFN

A

phototherapy, intrauterine transfusion, exchange transfusion

47
Q

phototherapy

A

utilizes light box or bili blanket

48
Q

how does phototherapy work

A

the light isomerizes unconjugated bili and makes it water soluble so it can be excreted

49
Q

intrauterine transfusion

A

inject “pedi-pak” into umbilical vein (adds irradiation)

50
Q

indications of intrauterine transfusion

A

middle cerebral artery-peak systolic velocity, cordocentesis, amniocentesis, hydrops fetalis

51
Q

what is the goal intrauterine transfusion

A

maintain Hgb >10 for rest of pregnancy

blood bank (8 decks)

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