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BLOODBANK LAB > RH LAB TEST, TREATMENT, PREVENTION > Flashcards

RH LAB TEST, TREATMENT, PREVENTION Flashcards

1
Q

Type the mother for ABO and Rh early in pregnancy.

A
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2
Q

Mother’s serum is usually screened by means of the ______ to see if an antibody exists; if an antibody is found, it is identified and the titer determined. This titer
is rechecked throughout pregnancy as a monitor of the ________

A

indirect AHG test

possible severity of the disease.

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3
Q

An increasing titer indicates an ________.

A

active immune response

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4
Q

After _____,several tests can be performed on the child’s red cells, in addition to further
tests on the maternal serum.

A

birth,

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5
Q

a sample of ______ is tested for ABO group and Rh type, and a ______ is performed.

A

umbilical cord RBCs

direct AHG test

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6
Q

Other laboratory tests that may be performed on the child’s RBCs include:

A 
hemoglobin determinations
blood smear examination 
differential
reticulocyte count
serum bilirubin determination
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7
Q

The decision to perform _____ will depend on a combination of laboratory results and on the clinical condition of the child.

A

exchange transfusion

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8
Q

Preparation can and should be made ______ birth so that the exchange can be done as
soon as possible if necessary.

A

before

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9
Q

Acid elution technique (modified Kleihauer-Betke test)

A

Detection of Fetal Hemoglobin or Hemoglobin F (Hb F)

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10
Q

this stain is based on the fact

that fetal hemoglobin is resistant to acid elution

A

Acid elution technique (modified Kleihauer-Betke test)

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11
Q

this stain is based on the fact
that fetal hemoglobin is _____ to acid elution (separation of a substance by extraction), whereas adult hemoglobin is not; when a thin blood smear is exposed to an acid buffer, the adult RBC _______into the buffer, leaving only the RBC
stroma, but the _____is unaffected and retains its hemoglobin. The smears are
examined under the microscope after staining, and the _______ in the maternal RBCs is used to calculate the approximate volume of fetal hemorrhage into the maternal circulation

A

resistant
loses its hemoglobin
fetal RBC
percentage of fetal cells

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12
Q

Chromatography:

_________for hemoglobins,

and _________ for globin chains

A

Ion-exchange HPLC

Reverse-phase HPLC

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13
Q

______ based on antibodies against Hb F; it permits the distinction of true fetal cells, which contain Hb F as the _______, from maternal circulating F cells, which have lower cellular Hb F content.

A

Flow cytometry

major form of hemoglobin

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14
Q

Treatment for infants with severe HDN includes _______.

A

RBC exchange transfusion

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15
Q

a significant proportion of the child’s RBCs is replaced with transfused red cells.

A

exchange transfusion

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16
Q

The exchange transfusion corrects the ______and removes the _______, at least temporarily, and can prevent brain damage. The procedure may need to be ________, depending on the level of bilirubin accumulation.

A

anemia
abnormal levels of serum bilirubin
repeated several times

17
Q

The type of RBCs used for transfusion depends on the _______.

A

antibody responsible for the

disease

18
Q

Use of ______ is the most common selection in exchange transfusion.

A

O-negative red cells

19
Q

The RBCs must be ______ for the antigen against which the antibody has been formed.

A

negative

20
Q

The child is given blood that is comparable with the ______.

A

mother

21
Q

In HDN caused by the formation of anti-D antibody in the mother’s serum, the child is
transfused with RBCs that are specific for the child’s own ABO type but _______ This is because not all the child’s blood is replaced at the time of exchange, and some maternal antibody is left. RBCs are given that will not react with the remaining antibody and will not harm the child.

A

negative for the D antigen.

22
Q

In an ______, packed RBCs are infused through the fetal abdominal wall into the peritoneum.

A

intrauterine transfusion

23
Q

Differentiate exchange transfusion and intrauterine transfusion.

A

Exchange transfusion is used as treatment for infants with severe HDN. While in an intrauterine transfusion, packed RBCs are infused through fetal abdominal wall into peritonuem

24
Q

Direct transfusion into the umbilical vein may also be attempted.

A

T

25
Q

Prevention of Rh Immunization

A

(Use of Rh Immune Globulin)

26
Q

If ____ is injected into Rh-negative women who deliver Rh-positive babies within ____
hours of delivery, they are well protected against Rh problems in subsequent pregnancies.

A

RhIg

72

27
Q

The use of RhIg is based on interference with the recognition of the Rh antigen on the fetal cells by the mother’s immune system. This blocking interference prevents
immunization (sensitization) by the fetus _____ RBCs. The mother is passively immunized by the administration of RhIg when recognition of _______(sensitization) by fetal RBCs is most likely.

A

Rh-positive

foreign antigen on the maternal RBCs

27
Q

The use of RhIg is based on interference with the recognition of the Rh antigen on the fetal cells by the mother’s immune system. This blocking interference prevents immunization (sensitization) by the fetus _____ RBCs. The mother is passively immunized by the administration of RhIg when recognition of _______(sensitization) by fetal RBCs is most likely.

A

Rh-positive

foreign antigen on the maternal RBCs

28
Q

Most exposure to fetal blood occurs at _____.

A

delivery

29
Q

RhIg is injected _____ within _____ hours of delivery in mothers: (1) _____
negative, (2) ________, and (3) _________

A 
intramuscularly
72
(1) who are D
(2) who have no detectable anti-D antibody
(3) where newborns are D
positive.
30
Q

_______ at __weeks’ gestation has also been advocated by the American College of Obstetricians and Gynecologists. If done, a sample of RBCs obtained immediately before treatment should be tested for _____, ______, ______ and identification of antibody, if present.

A

Antepartum treatment
28
ABO group, Rh type, antibody screen

31
Q

RhIg is supplied as a _____, _____, approximately _____ solution to be injected intramuscularly.

A

sterile, clear

1ml solution

32
Q

RhIg is a concentrated solution (____ μg/mL) of _____ that may be derived from human _____.

A

300
IgG anti-D
plasma

33
Q

It does not transmit hepatitis, HIV, or other detectable infectious diseases.

A

RhIg

34
Q

The anti-D antibody can be detected ______ after the administration of RhIg and
is sometimes found for as long as ______ thereafter. If it is detected ______ after
delivery, active immunization and failure of the RhIg can be assumed. Such failures are
infrequent, but they can occur if RhIg is given _________or if Rh immunization has _____ during the pregnancy.

A 
12 to 60 hours
5 months
6 months
 too late or in too small a dose,
RH immunization has already occurred
35
Q

If the amount of Rh-positive fetal RBCs entering the mother’s circulation is ___________, the standard dose of RhIg is not enough to prevent anti-D antibody formation. Thus, it is important to determine the presence and amount of ________. This may be done by ____ or enzyme-linked antiglobulin testing.

A

greater than 30 mL of whole blood

fetomaternal hemorrhage

acid elution

BLOODBANK LAB (4 decks)

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