Brainscape's Knowledge GenomeTM

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


See full index

Blood Banking > (P) Hemolytic Disease of the newborn part 1 > Flashcards

(P) Hemolytic Disease of the newborn part 1 Flashcards

1
Q

Most important red cell antigen after A and B antigens in blood banking

A

D antigen

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

What is the other name for the hemolytic disease of the newborn

A

erythroblastosis fetalis

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

It is termed as erythroblastosis fetalis due to the
presence of ______

A

erythrolasts

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

T or F

A person with Rh negative blood can develop Rh antigens if he / she receives blood from a person with Rh positive blood

A

F (develop Rh ANTIBODIES)

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

T or F

A person with Rh positive blood can receive blood from a person with Rh negative blood without any problems

A

T

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

A condition in which the fetus or neonate’s red blood cell
are destroyed by IgG antibodies produced by the
mother.

A

HEMOLYTIC DISEASE OF THE NEWBORN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Definition of terms

breaking down of RBC

A

hemolytic

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

Definition of terms

The making of immature red blood cells resulting to the preence of erythroblasts in the blood

A

erythroblastosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition of terms

refers to the fetus

A

fetalis

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

True for the causes of HDFN except:

a. Rh incompatibility
b. ABO
c. other system antibodies incompatibility
d. Rh positive mother, Rh negative baby
e. none of the above

A

d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A. Rh-HDN
B. ABO-HDN

  1. rare, declining, severe, clinically significant
  2. more common, mild, subclinical
A
  1. A
  2. B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

other causes of HDN except

a. Anti-c (hr’)
b. Anti-E (rh’’)
c. IgM
d. Anti-Lea, Anti-Leb
e. Anti-P1, Anti-M, and Anti-N

A

c

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

familiarize the factors of HDN

A
  1. pregnancy
  2. factors affecting immunization
  3. immune response
  4. antigenic exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Factors of HDN

required for HDN to occur, as it is vital for antigenic exposure leading to HDN

A

Pregnancy

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

types of immune response

a. Non-responders
b. hyper-responders

  1. increases the titer of Anti-D or IgM
  2. Indifferent to antigenic stimulation
A
  1. B
  2. A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In hyper-responders, what is the product of the increase in titer of anti-D?

A

multiple antibody formation

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

Rh negative individual exposed to one unit of Rh-positive blood are ______% immunized

A

50%

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

Rh negative women with Rh positive fetus are ___%
immunized

A

10

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

____mL is needed in immunization to stimulate a response and create
antibodies in the process of stimulation

A

0.5mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
  • Occurs when the volume of fetal red cells is insufficient.
  • This occurs in primary immunization, and within the
    secondary immunization is the rapid production of
    antibody.
A

ANAMNESTIC RESPONSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which pregnancy is of higher risk for Rh-HDN?

a. first
b. second
c. third
d. fourth

A

b

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rh incompatibility greatly affects a person’s quality of life and give rise to problems during pregnancy

a. first statement is true, second is false
b. second statement is true, first is false
c. both statements are true
d. neither statements are true

A

b

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

a. first pregnancy
b. second pregnancy

  1. antibodies are produced due
    to the exposure of the maternal blood to the neonate’s blood
  2. In the ___________ antibodies produced from
    the x pregnancy attacks the fetus with Rh positive
    blood
  3. It is still considered safe but the mother who is RhD-
A
  1. a
  2. b
  3. a
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the symptoms in mild cases of HDN

A

mild anemia and jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the presenations in severe HDN

A

*death
* increased bilirubin
* CNS damage (kernictus)

DIK / DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Explain the progression of Rh factor sensitization

A
  1. Rh- Mother’s and Rh+ Baby’s blood mix
  2. Mother forms antibodies agains Rh positive antigens
  3. Mother’s antibodies enter baby’s blood and attack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

familiarize the effects of red cell distribution

A

a. anemia
b. marked erythrophagocytosis
c. organ enlargement
d. hyperbilirubinemia
e. hydrops fetalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what type of anemia is in HDN

A

Hemolytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
  • Due to the immature liver of the newborn and inability to
    conjugate the unconjugated _________ result in the
    unconjugated __________increasing and crossing the blood
    brain barrier causing _______________.
A
  1. bilirubin
  2. bilirubin
  3. kernictus / CNS damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

matching type

a. 18 mg/dL
b. 20 mg/dL
c. >30 mg/dL

  1. Already considered increased
  2. Kernicterus, death
  3. Mental Retardation
A
  1. a
  2. c
  3. b
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

_________ results from high
levels of unconjugated bilirubin in the fetus blood which is
more than 20 mg/dL

A

kernictus / bilirubin encelopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Because unconjugated bilirubin are lipid soluble and toxic, it
can cross the blood brain barrier and it will penetrate
__________ and ________________causing neurotoxicity

A

neuronal and glial membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

familiarize the severe permanent neurologic symptoms secondary to kernicterus

A

*choreoathetosis
* spaticity
* muscular rigidity
* ataxia
* deafness
* mental retardation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

hydrops fetalis

these are the organs that increase in size due to the increased production of red cells as the fetus’s anemia worsen

A

liver and spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

is an abnormal accumulation of fluid beneath the
skin. This condition in the detus is known as hydrops fetalis

A

edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

process of the removal of
amniotic fluid which is
used in bilirubin testing

A

amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

who performs amniocentesis?

a. RMT
b. RN
c. MD
d. all of the above

A

c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

aminotic fluid is measured using??

A

spectrophotometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

for infants with HDN amniocentesis is done during the _______ week of gestation

A

28th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

for infants with severe HDN amniocentesis is done during the _______ week of gestation

A

22nd week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

enumerate the tests for neonatal studies

A
  1. ABO typing
  2. Rh typing
  3. Direct antiglobulin test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Direct coombs test

employed using

A

anti-human globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Direct coombs test

reagent:

A

coomb’s reagent

44
Q

Direct coombs test

detect:

A

antibody that coats the RBC in vivo, producing agglutniation

45
Q

The baby’s sample is positive for the presence of
the mother’s antibody on the surface of RBCs in condition called
erythroblastosis fetalis

What is the best blood that can be given if this is blood
transfusion?

A

Rh -, ABO type specific

46
Q

Maternal _____ antibodies with specificity for the ABO blood
group system pass through the placenta to the fetal
circulation where they can cause hemolysis of fetal red
blood cells which can lead to fetal anemia and HDN

A

IgG

47
Q

ABO HDN occurs commonly in the

a. first born
b. second born
c. equally in all offsprings

A

a

48
Q

which is more common in ABO HDN

a. symptomatic
b. asymptomatic

A

symptomatic

49
Q

ABO HDN commonly occurs in mothers that are of what blood type?

a. A
b. B
c. O

A

c

50
Q

familiarize the complications of ABO HDN

A
  • High at birth or rapidly rising bilirubin
  • Prolonged hyperbilirubinemia
  • Bilirubin induced Neurological Dysfunction
  • Cerebral Palsy
  • Kernicterus
  • Neutropenia
  • Thrombocytopenia
  • Hemolytic Anemia: MUST NOT be treated with iron
  • Late onset anemia: MUST NOT be treated with iron. This can
    persist up to 12 weeks after birth.
51
Q

Causes of ABO HDN (3)

A
  1. exposure
  2. fetal-maternal transfusion
  3. blood transfusion
52
Q

What type of antibody are anti-a and anti-b usually?

A

IgM

53
Q

what type of antibody are anti-a and anti-b that can cross the placenta?

A

IgG

54
Q

Exposure to A-antigens and B-antigens, which are both
widespread in nature, usually leads to the production of
(IgM/IgG) anti-A and IgM anti-B antibodies but occasionally IgG
antibodies are produced

A

IgM

55
Q
  • In about a third of all ABO incompatible pregnancies
    maternal IgG anti-A or IgG anti-B antibodies pass through the
    placenta to the fetal circulation leading to a _______
    direct Coombs test for the neonate’s blood
A

weakly positive

56
Q

ABO HDN is generally mild and short-lived and only
occasionally severe because

A
  1. IgG anti-A and anti-B enter fetal circulation
  2. fetal RBC surface A and B antigens are not fully developed
57
Q

ABO serology

If mother has IgM, she is treated with ___ and ___, neutralizing A and B substances

A

2-mercaptoethanol and dithiothreidol

58
Q

T or F

Routine antenatal antibody screening blood tests or indirect
Coombs test does notscreen for ABO HDN

A

T

59
Q

T or F

If IgM anti-A or IgM anti-B antibodies are found in the
pregnant woman’s blood, they are not reported with the
test results, because they do not correlate well with ABO
HDN

A

F (IgG)

60
Q

HDN diagnosis is usually made by investigation of a newborn
baby who has developed jaundice during the ________of
life.

A

first week

61
Q

ABO SEROLOGY

test is run using cord blood

a. Direct Coombs
b. Hemoglobin
c. both
d. neither

A

c (+ bilirubin also)

62
Q

ABO SEROLOGY

Tested in vitro
a. Direct Coombs
b. Indirect Coombs
c. both
d. neither

A

b

63
Q

Why is Direct Coombs test done after the birth of the baby?

A

to confirm the antibodies attached to the infant’s RBC

64
Q

high reticulocyte count:

a. infant needs transfusions
b. infant does not need additional transfusion

A

b

65
Q

low reticulocyte count

a. HDN from anti-kell
b. ABO-HDN

A

A (and in infants that have been treated with intrauterine transfusion)

66
Q

why is ferritin checked in infants?

A

most infants with HN are have iron overload syndrome

67
Q

What type of cells is predominant in Rh?

A

macrocytes

68
Q

CONSEQUENCES OF HDN

Jaundice in ABO: ___
Jaundice in Rh : ____

A

o Jaundice in ABO: Icterus praecox
o Jaundice in Rh: Icterus gravis

69
Q

T or F

hydrops fetalis and kernicterus are common in ABO HDN

A

F (uncommon)

70
Q

INDICATIONS OF HDN

bilirubin at birth: ___ mg/dl
Cord bilirubin: ____ mg/dl

A
  • Bilirubin at birth: 5 mg/dL
  • Cord Bilirubin is more than 4
71
Q

INDICATIONS OF HDN

  • 12 hours: ____mg/dL
  • 24 hours: ____mg/dL
  • Hgb: ___g/dl
A
  • 12 hours: 11.5mg/dL
  • 24 hours: 16 mg/dL
  • Hgb: 8 g/dL
72
Q

Intrauterine Fetal Blood Transfusion for Rh Disease:

___________ is done to determine the position of the fetus
and placenta

A

fetoscopy

73
Q

The risk of Intrauterine Blood Transfusion (IUT) depends on (2)

A

prior condition of fetus and gestational age

74
Q

What are the three conditions that signals the need for the analysis of amniotic fluid

A
  1. titer >32 for anti-D
  2. titer > 8 for anti-kell
  3. fourfold increase of the titer
75
Q

INDICATIONS FOR AMNIOCENTESIS

To perform amniocentesis at ___ weeks of gestation in the
previous child

A

26

76
Q

INDICATIONS FOR AMNIOCENTESIS

To perform amniocentesis at __ weeks of gestation if the
previous child is severely affected

A

22

77
Q

INDICATIONS FOR AMNIOCENTESIS

Perform if the maternal antibody of the mother increases
before the __ week. The mother’s antibody is being
monitored.

A

34th

78
Q

INDICATIONS FOR AMNIOCENTESIS

High values of bilirubin shown by ____ method or
hemoglobin concentration of cord blood below ____

A

Liley method
10

79
Q

LILEY’S GRAPH

a. bottom zone
b. middle zone
c. upper zone

  1. minimally affected
  2. affected or very mildly affected
  3. moderate to marked hemolysis in the fetus
A
  1. b
  2. a
  3. c
80
Q

BLOOD TO BE USED
1. if anti-D is present
2. if anti-D is absent
3. for intrauterine transfusion

A
  1. Rh positive
  2. Rh negative
  3. O negative
81
Q

at what bilirubin levels is phototherapy not effective?

A

0.5 to 2 mg/dL

82
Q

familiarize the treatments available

A
  1. intravenous immunoglobulin therapy
  2. exchange transfusion
  3. plasma exchange
  4. intravenous immune globulin
83
Q

TREATMENT

  • used to successfully treat many cases of HDN
  • used on anti-D and anti-E
  • reduces the need for exchange transfusion and shortens length of phototherapy
  • recommended for treatment in isoimmune hemolytic disease by the American Association of Pathologist
  • reduce the need
    for exchange transfusions in Rh and ABO hemolytic
    disease.
A

Intravenous Immunoglobulin therapy (IVIG)

84
Q

IVIG is recommended for what total serum bilirubin levels?

A

TSB level is within 2
to 3 mg/dL (34-51 μmol/L) of the exchange level

85
Q

Can IVIG be repeated within 12 hours (yes / no)

A

yes if necessary

86
Q

T or F

infants always needs both exchange transfusion and phototherapy

A

F ( rarely needs exchange transfusion)

87
Q

At what total bilirubin level is exchange transfusion done?

A

as high as 20 mg/dL and continues to rise

88
Q

what blood type is used for exchange transfusion

A

fresh, O negative
packed RBCs and type specific fresh frozen plasma

89
Q

T or F

the O negative packed RBCs for exchange transfusion is crossmatched against the baby

A

F (against the mother)

90
Q

TREATMENT

*widely used treatment of immune-mediated disease

*applied to the pregnant women with high
antibody titer, or that has past history of stillbirth due to HDN

  • effective in decreasing the antibody titer
    and quantity of antibody.
  • a way to delay the need for fetal intervention
    that has been hydrops fetalis (edema) in which before 22
    week gestation in a previous pregnancy.
A

Plasma exchange

91
Q

TREATMENT

plasma exchange can reduce the antibody titer up to how many percent?

A

75%

92
Q

TREATMENT

  • use strengthened body immune system beside
    to treat immune deficiency
  • found to decrease
    hemolysis leading to reduction in serum bilirubin level.
  • The immunoglobulin could act by occupying the FC receptors
    of reticulo-endothelial cells preventing them from taking up
    and lysing antibody coated RBCs. This subsequently leads
    to decrease in the need for exchange transfusion.
A

Intravenous Immune Globulin

93
Q

What is the prevention done against HDFN?

A

Rh immune globulin (RhIG or Rhogam)

94
Q

PREVENTION

Antenatal (during pregnancy): The first injection of RHIG
is recommended to be administered during the ________ week of pregnancy.

A

28th week of
pregnancy

95
Q

PREVENTION

Postnatal (after birth): Another injection is advised within
____hours after delivery. The injection contains 1 vial, and
each vial is composed of 300 μg/15 mL of Rh-positive fetal
red blood cells (RBCs).

A

72 HOURS

96
Q

PREVENTION

What is prevented by the administration of Rh immune globulin in pregnant women

A

alloimmunization

97
Q

RhIG is a concentrate of __________ prepared from pooled
human plasma of D-negative people who have been
exposed to the D antigen and who have made antibodies
to it.

A

IgG anti-D

98
Q

SIGNIFICANCE OF RhIG

  • RhIG prevents alloimmunization in D-negative mother
    exposed to D-positive fetal red cells. In the meantime, it
    protects mother from being __________ to D antigen of fetal
    during pregnancy and after delivery of infant.
A

sensitized

99
Q

SIGNIFICANCE OF ADMINISTRATION OF RhIG

The following are true except:
a. RhIG suppress the mother’s immune response following exposure to D-positive fetal red cells
b. RhIG encourages the mother to produce anti-D
c. RhIG protects subsequent D-positive pregnancies.
d. none of the above

A

b

100
Q

USE OF RhIG

RhIG is administered to (Rh-negative / Rh-positive) patients who
have received Rh-positive (Rh+) cells, such as Whole
Blood Concentrate or Platelet Concentrate

A

Rh-negative

101
Q

In Hemolytic Disease of the Newborn (HDN), RhIG is administered except for when:
a. Mother is Rh (-) and Du (-)
b. Mother is not immunized yet to D antigen
c. infant is Rh (-) Du (-)
d. in abortion: the infant is assumed to be Rh+

A

c

102
Q

GUIDELINES FOR RhIG ADMINISTRATION IN D-NEGATIVE
PREGNANT WOMAN:
1. All doses should be given within ___ hours of delivery or
procedure. If she is not given RhIG within ___ hours after the
birth of an Rh-positive baby, she will begin to make
antibodies to the fetal blood cells

A

72

103
Q

GUIDELINES FOR RhIG ADMINISTRATION IN D-NEGATIVE
PREGNANT WOMAN:

Woman (should / should not) be sensitized to D antigen

A

should not be

104
Q

Provide the dose needed:

Up to 12 weeks of gestation for abortion,
miscarriage and end period of ectopic
pregnancy.

A

50ug

105
Q

Provide the dose needed

✓ End period of pregnancy which is after 12th
week of gestation.
✓ After amniocentesis.
✓ After delivery of D-positive infant.

A

120ug

106
Q
A

Blood Banking (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions