Quiz 2 - OB and Neonatal

Routine testing on a prenatal patient should include—

a. ABO/Rh, Antibody Screen, Antibody Identification, and Titer

b. Direct Coombs

c. ABO/Rh and Antibody Screen

ABO/Rh, Fetal Bleed Screen, and KB Stain

a. ABO/Rh, Antibody Screen, Antibody Identification, and Titer

Conditions in which OB patients are considered a candidate for RhIg are—

a. Mom is D negative and not sensitized to D antigen, Baby D or weak D positive

b. Mom is D negative and sensitized, Baby D or weak D positive

c. Mom is D negative and not sensitized to D antigen, Baby D or weak D negative

d. Mom is D positive, Baby D negative

a. Mom is D negative and not sensitized to D antigen, Baby D or weak D positive

Testing on a cord blood reveals a mixed field reaction with Anti-A typing sera. A heelstick is obtained and the same reaction is noted. The most likely explanation is—

a. Maternal contamination

b. Contamination due to Wharton’s jelly

c. ABO subgroup

d. HDFN

c. ABO subgroup

Fetal Bleed Screen—

a. calculate RhIg dose

b. quantitate a fetomaternal bleed

c. detect Rh positive red cells in an Rh negative person

d. detect fetal hemoglobin

c. detect Rh positive red cells in an Rh negative person

The largest fetomaternal bleed usually occurs—

a. in the first trimester

b. in the second trimester

c. in the third trimester

d. at delivery

d. at delivery

The diagnosis of ABO-HDN is made—

a. during delivery

b. after delivery

c. at 28 weeks

d. during prenatal testing

b. after delivery

The ABO and Rh of a pregnant woman should be established—

a. early in the pregnancy

b. late in the pregnancy

c. after delivery

d. timing is irrelevant

a. early in the pregnancy

The main differences between the fetus and the newborn when HDFN is present—

a. bilirubin metabolism

b. size of the RBC

c. presence of anemia

d. maternal antibody level

a. bilirubin metabolism

When severe HDFN due to unidentified incompatibility is evident, which of the following should be used for the exchange transfusion?

a. paternal RBCs

b. any fresh unit of RBCs

c. maternal RBCs

d. RBCs from maternal siblings

b. any fresh unit of RBCs

If an A positive mother who has an anti-K delivers an O negative infant with a 2+ positive DAT, what type of blood would be the best choice for use in an exchange transfusion?

a. Group O negative, K negative, CMV negative, sickle cell negative, washed, irradiated, leukoreduced red cells

b. Group A positive, K negative, CMV negative, sickle cell negative, washed, irradiated, leukoreduced red cells pooled with AB plasma

c. Group O negative, K negative, CMV negative, irradiated whole blood

d. Group O negative, K negative, CMV negative, sickle cell negative, irradiated, leukoreduced red cells pooled with AB plasma

d. Group O negative, K negative, CMV negative, sickle cell negative, irradiated, leukoreduced red cells pooled with AB plasma

The source of the antigen that stimulates the production of antibody in HDFN—

a. is paternal antigen

b. is a paternal antigen not found in the mother

c. must be inherited from both parents

d. is a maternal antigen not found in the father

b. is a paternal antigen not found in the mother

The blood product of choice for an exchange transfusion to remove the infant’s antibody sensitized RBCs and control hyperbilirubinemia is—

a. fresh whole blood

b. O RBCs suspended in AB FFP

c. RBCs washed

d. heparinized RBCs

b. O RBCs suspended in AB FFP

The sample of choice to determine compatibility for an intrauterine transfusion would be—

a. paternal plasma

b. infant or maternal plasma

c. infant’s eluate

d. maternal plasma

d. maternal plasma

The typical laboratory profile of HDFN caused by ABO incompatibility is—

a. Mother group A, baby group O, antibody elution =, cord hemoglobin 10.0 g/dL

b. Mother group A, baby group O, antibody elution +, cord hemoglobin 1.0 g/dL

c. Mother group O, baby group A, DAT +s, cord hemoglobin 10.0 g/dL

d. Mother group O, baby group B, DAT +s, cord hemoglobin 10.0 g/dL

e. Mother group O, baby group A, DAT=, cord hemoglobin 3.0 g/dL

e. Mother group O, baby group A, DAT=, cord hemoglobin 3.0 g/dL

Production of maternal antibodies depends on all of the following EXCEPT—

a. presence of a specific antibody in the fetus

b. lack of a specific antigen in the mother

c. presence of a specific antigen in the fetus

d. immunologic strength of an antigen

a. presence of a specific antibody in the fetus

All of the following characteristics are typical of HDFN caused by the D antigen EXCEPT—

a. depends on the mother’s ability to respond to foreign D antigens

b. may require an exchange transfusion

c. usually occurs in the first pregnancy

d. lab profile includes a positive DAT, decreased cord hemoglobin, and increased total cord bilirubin

c. usually occurs in the first pregnancy

The most severe form of hemolytic disease of the newborn is associated with—

a. anti-A

b. anti-D

c. anti-K

d. anti-A,B

b. anti-D

How many doses of RhIg are indicated for a Kleihauer-Betke determination of 2.0% fetal Hgb?

a. 3

b. 2

c. 1

d. 4

d. 4

Kleihauer-Betke stains are used for all of the following EXCEPT—

a. detect the presence of any fetal hemoglobin regardless of Mom’s Rh status

b. calculate RhIg dose

c. indicate an exchange transfusion

d. detect hematological disorders

c. indicate an exchange transfusion

A group A positive infant <4 months of age has been receiving transfusion therapy with group O blood products. Bilirubin is 3.0 mg/dL and hemoglobin is 7.0 g/dL. Which of the following is true?

a. if the infant is discharged and readmitted, mom’s plasma must be used for the antibody screen

b. if the infant is to receive a type specific unit, the infant’s plasma must be tested against A1 cells at AHG

c. if the infant is discharged and readmitted within 10 days, infant must only receive group O products

d. the infant can receive a type specific unit without any further testing as long as the current antibody screen is negative

b. if the infant is to receive a type specific unit, the infant’s plasma must be tested against A1 cells at AHG

The most important serological test for the diagnosis of hemolytic disease of the newborn is—

a. the indirect antiglobulin test

b. cord bilirubin

c. the direct antiglobulin test

d. the antibody titer

c. the direct antiglobulin test

One dose of RhIg is sufficient to protect against ___ mL of RBCs or ___ mL of whole blood

a. 10, 15

b. 15, 30

c. 12, 28

d. 30, 15

b. 15, 30

An Rh negative mom could be protected from Rh sensitization if the infant is ABOP incompatible because—

a. fetal ABO antigens are not fully developed

b. fetal isoagglutinins are not yet present

c. fetal ABO incompatible cells are destroyed before sensitization can occur

d. fetal Rh positive cells are destroyed by RhIG

c. fetal ABO incompatible cells are destroyed before sensitization can occur

True or false? An AB negative OB patient should receive RhIg after amniocentesis or miscarriage.

True

True or false? Antenatal RhIg is administered at 4 weeks gestation.

False