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Test your Hemolytic Disease of the Fetus/Newborn knowledge
Questions and Answers
1.
Hemolytic Disease of the Fetus/Newborn (HDFN) is also known as?
A.
Erythroblastosis fetalis
B.
Maternal fetalis
C.
Erythroblastosis fecal
D.
None of these
Correct Answer
A. Erythroblastosis fetalis
Explanation Hemolytic Disease of the Fetus/Newborn (HDFN) is a condition in which the red blood cells of a fetus or newborn are destroyed by antibodies produced by the mother. This condition is also known as erythroblastosis fetalis. It occurs when the mother's immune system produces antibodies against the baby's blood cells, usually due to a mismatch in blood types between the mother and the baby. These antibodies can cross the placenta and attack the baby's red blood cells, leading to anemia and other complications. Maternal fetalis and erythroblastosis fecal are not correct names for this condition.
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2.
HDN is the destruction of the _____________ of the fetus/newborn by ___________ antibodies produced by the mother
A.
RBC's, IgG
B.
WBC's, IgG
C.
RBC's, IgM
D.
WBC's, IgG
Correct Answer
A. RBC's, IgG
Explanation HDN stands for Hemolytic Disease of the Newborn, which is a condition where the red blood cells (RBC's) of the fetus/newborn are destroyed. This destruction is caused by IgG antibodies produced by the mother. IgG antibodies can cross the placenta and attack the RBC's of the fetus, leading to HDN.
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3.
The HDFN process can occur in approximately _________ % of all pregnancies
A.
10
B.
20
C.
30
D.
50
Correct Answer
A. 10
Explanation The HDFN process, also known as Hemolytic Disease of the Fetus and Newborn, can occur in approximately 10% of all pregnancies. This condition arises when there is an incompatibility between the blood types of the mother and the fetus, leading to the mother's immune system attacking the fetus's red blood cells. This can result in severe complications for the baby, including anemia, jaundice, and even fetal death. Regular monitoring and medical interventions are necessary to manage HDFN and ensure the well-being of both the mother and the baby.
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4.
Such maternal antibodies can be produced by _________________?
A.
Leaking of fetal cells into the mothers circulation
B.
Previous pregnancies
C.
Alloimmunization by transfusion of foreign antigens
D.
Sometimes naturally in the second and third trimester of pregnancy
E.
All of the above
F.
None of the above
Correct Answer
E. All of the above
Explanation Maternal antibodies can be produced by various mechanisms, including the leaking of fetal cells into the mother's circulation, previous pregnancies, and alloimmunization by transfusion of foreign antigens. Additionally, maternal antibodies can sometimes be naturally produced in the second and third trimester of pregnancy. Therefore, all of the given options can lead to the production of maternal antibodies.
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5.
What can the mother be given as a preventative method?
A.
AHG immunization
B.
Rh immune globulin (RhIG)
C.
Nothing until after baby has been delivered
D.
None of the above
Correct Answer
B. Rh immune globulin (RhIG)
Explanation Rh immune globulin (RhIG) is given to the mother as a preventative method to prevent Rh sensitization. Rh sensitization occurs when a mother who is Rh-negative is exposed to Rh-positive blood, typically during pregnancy or childbirth. RhIG is given to the mother to prevent her body from producing antibodies against the Rh factor, which could harm future pregnancies. This injection is typically given around 28 weeks of pregnancy and within 72 hours after delivery to ensure the mother's immune system does not develop an immune response to the Rh antigen.
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6.
Prior to the late 1960's when post-partum injections was introduced, 95% of HDN was contributed to _____________
A.
Anti-K
B.
Anti-k
C.
Anti-D
D.
Anti-d
E.
None of the above
Correct Answer
C. Anti-D
Explanation Prior to the late 1960s, when post-partum injections were introduced, 95% of Hemolytic Disease of the Newborn (HDN) was attributed to the presence of anti-D antibodies. These antibodies are produced by Rh-negative mothers who have been sensitized to the Rh antigen during pregnancy or childbirth. When an Rh-negative mother carries an Rh-positive fetus, her immune system may produce antibodies against the Rh antigen, which can lead to HDN in subsequent pregnancies with Rh-positive fetuses. Therefore, the correct answer is anti-D.
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7.
What is the most prevalent cause of HDN today?
A.
ABO incompatibility
B.
Rh incompatibility
C.
ABO/Rh incompatibility
D.
All of the above
E.
None of the above
Correct Answer
A. ABO incompatibility
Explanation ABO incompatibility is the most prevalent cause of Hemolytic Disease of the Newborn (HDN) today. This occurs when the mother's blood type is incompatible with the baby's blood type, leading to the production of antibodies that attack the baby's red blood cells. Rh incompatibility, on the other hand, occurs when the mother is Rh negative and the baby is Rh positive, leading to the production of Rh antibodies. ABO/Rh incompatibility refers to the combination of both ABO and Rh incompatibilities. Therefore, the correct answer is ABO incompatibility.
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8.
Most of the time _____________ class antibodies are helpful in providing the fetus with immunity once they are born
A.
IgM
B.
IgG
C.
Both are correct
D.
Neither class has anything to do with the immunity
Correct Answer
B. IgG
Explanation IgG antibodies are helpful in providing the fetus with immunity once they are born.
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9.
The third type of HDN is caused by other blood group system antigens?
A.
True
B.
False
Correct Answer
B. False
Explanation The third type of HDN is caused by other blood group system ANTIBODIES
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10.
The other blood group systems are particularly _______
A.
Anti-K
B.
Anti-k
C.
Anti-D
D.
Anti-H
E.
None of the above
Correct Answer
A. Anti-K
Explanation The correct answer is "anti-K". The other blood group systems mentioned in the question are not specifically mentioned, but it can be inferred that they are different antigens or antibodies used in blood typing. Therefore, "anti-K" is the correct answer as it is the only option provided that fits the pattern of being an antigen or antibody in a blood group system.
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11.
The other blood group systems are alloantibodies
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because the other blood group systems, such as ABO and Rh, involve the presence of alloantibodies. Alloantibodies are antibodies that are produced in response to foreign antigens present on red blood cells. In the case of ABO and Rh systems, individuals can develop antibodies against antigens that are not present on their own red blood cells, leading to a potentially dangerous immune response if incompatible blood is transfused. Therefore, it can be concluded that the other blood group systems are indeed associated with alloantibodies.
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12.
The most serious and dangerous of the clinical symptoms is _____________
A.
Erythro fetalis
B.
Hydrops fetalis
C.
Both a & b are acceptable
D.
None of the above
Correct Answer
B. Hydrops fetalis
Explanation Hydrops fetalis is the correct answer because it refers to a condition in which there is abnormal accumulation of fluid in two or more fetal compartments. This can lead to severe complications such as heart failure, respiratory distress, and even death. It is considered the most serious and dangerous clinical symptom because it can be life-threatening to the fetus.
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13.
In HDN the ________________ are directed against the __________________ on the fetal RBC's that were inherited by the ________________________.
A.
Antigens, antibodies, mother
B.
Antigens, antibodies, father
C.
Antibodies, antigens, mother
D.
Antibodies, antigens, father
Correct Answer
D. Antibodies, antigens, father
Explanation In HDN (Hemolytic Disease of the Newborn), the antibodies produced by the mother's immune system are directed against the antigens on the fetal red blood cells that were inherited from the father. This immune response occurs when the mother is Rh negative and the father is Rh positive, leading to the production of Rh antibodies in the mother's blood. These antibodies can cross the placenta and attack the fetal red blood cells, causing hemolysis and potential harm to the baby.
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14.
_________________ and _________________ enlarge to clear all the ruptured RBC's
A.
Spleen, liver
B.
Umbilical vein, spleen
C.
Placenta, liver
D.
None of the above
Correct Answer
A. Spleen, liver
Explanation The spleen and liver enlarge in order to clear all the ruptured red blood cells (RBCs). The spleen is responsible for filtering and removing damaged or old RBCs from the bloodstream, while the liver plays a role in recycling and breaking down hemoglobin from these RBCs. Therefore, the spleen and liver work together to eliminate ruptured RBCs from the body.
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15.
The most serious and dangerous of the clinical symptoms is _____________________ in which the ______________ accumulates fluid, and is capable of causing death of the fetus in utero
A.
Hydrops fetalis, mother
B.
Umbilical fetalis, fetus
C.
Hydrops fetalis, fetus
D.
Umbilical fetalis, mother
Correct Answer
C. Hydrops fetalis, fetus
Explanation Hydrops fetalis is a condition characterized by abnormal accumulation of fluid in the fetus, specifically in the body cavities such as the abdomen, chest, and skin. This condition can be life-threatening for the fetus as the excessive fluid buildup puts pressure on vital organs and can lead to their failure. If left untreated, it can cause death of the fetus in utero. Therefore, hydrops fetalis is the most serious and dangerous clinical symptom in this context, affecting the fetus.
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16.
Some clinical manifestations of the disease other than the obvious RBC lysis include anemia, jaundice, skin and subcutaneous edema
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because the question mentions that there are clinical manifestations of the disease other than RBC lysis, which include anemia, jaundice, and skin and subcutaneous edema. This implies that these symptoms are indeed associated with the disease, in addition to RBC lysis.
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17.
Fetal ascites is fluid accumulation
A.
True
B.
False
Correct Answer
A. True
Explanation Fetal ascites refers to the abnormal accumulation of fluid in the abdominal cavity of a developing fetus. This condition can be caused by various factors such as infections, genetic disorders, or structural abnormalities. The presence of fluid in the abdominal cavity can be detected through ultrasound imaging. Hence, the statement "Fetal ascites is fluid accumulation" is true, as it accurately describes the condition of fluid accumulation in the fetus's abdomen.
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18.
_______________________ is A grave condition that results from passing of unconjugated bilirubin into the lipid tissues like the brain and spinal cord, causing brain damage
A.
Amniocyte
B.
Kernicterus
C.
Hyperbilirubinemia
D.
None of the above
Correct Answer
B. Kernicterus
Explanation Kernicterus is a grave condition that occurs when unconjugated bilirubin passes into lipid tissues like the brain and spinal cord, leading to brain damage. This condition is characterized by the accumulation of bilirubin in the central nervous system, causing neurological impairments such as hearing loss, movement disorders, and intellectual disabilities. It is a serious consequence of severe hyperbilirubinemia, which is the excessive buildup of bilirubin in the blood. Amniocyte is not related to this condition and therefore not the correct answer.
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19.
Unconjugated bilirubin is when the fetal/newborn liver is not mature enough to conjugate the bilirubin
A.
True
B.
False
Correct Answer
A. True
Explanation Unconjugated bilirubin refers to bilirubin that has not been processed by the liver. In newborns, the liver may not be fully developed, leading to a condition called neonatal jaundice. This occurs when the liver is unable to effectively conjugate bilirubin, resulting in elevated levels of unconjugated bilirubin in the blood. Therefore, the statement that unconjugated bilirubin is when the fetal/newborn liver is not mature enough to conjugate the bilirubin is true.
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20.
___________ causes the most severe type of HDFN and the second most antigenic is ____________
A.
Anti-c, anti-d
B.
Anti-K, anti-d
C.
Anti-D, anti-c
D.
Anti-C, anti-k
Correct Answer
C. Anti-D, anti-c
Explanation Anti-D causes the most severe type of HDFN (hemolytic disease of the fetus and newborn) because the D antigen is the most immunogenic and commonly found on red blood cells. This means that when a person with the D antigen is exposed to anti-D antibodies, their immune system reacts strongly, leading to the most severe form of HDFN. On the other hand, anti-c is the second most antigenic, meaning it is less immunogenic compared to anti-D and causes a less severe form of HDFN.
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21.
What are the three basic types of HDN?
Correct Answer ABO,Rh,other blood groups ABO, Rh, Other blood groups ABO
Rh
Other Blood Groups ABO
Rh
other blood groups ABO
Rh
Other blood groups
Explanation The answer is ABO, Rh, and Other Blood Groups. There were too many possible ways to input the answers so if this is what you got then the answer is correct
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22.
The risk for HDN due to Rh or other system antibodies can be diagnosed during pregnancy
A.
True
B.
False
Correct Answer
A. True
Explanation During pregnancy, the risk for hemolytic disease of the newborn (HDN) caused by Rh or other system antibodies can be diagnosed. This is because the mother's blood is tested for the presence of these antibodies, which can cross the placenta and attack the baby's red blood cells. If the mother is found to have these antibodies, appropriate measures can be taken to monitor and manage the condition, such as administering Rh immune globulin or performing intrauterine blood transfusions if necessary. Therefore, the statement is true.
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23.
ABO-HDN is usually diagnosed pre-delivery
A.
True
B.
False
Correct Answer
B. False
Explanation ABO-HDN cannot be diagnosed until after delivery
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24.
In order for _____________________ to occur there has to be exposure of the _________ born(s) RBC to the mother
A.
Sensitization, first
B.
Sensitization, second
C.
Susceptibility, first
D.
Susceptibility, second
Correct Answer
A. Sensitization, first
Explanation In order for sensitization to occur, there has to be exposure of the newborn's RBC to the mother. Sensitization refers to the process in which the mother's immune system is exposed to the antigens present on the surface of the baby's red blood cells (RBC). This exposure triggers the production of antibodies by the mother's immune system against these antigens. This sensitization usually occurs during pregnancy or childbirth, when the mother's blood comes into contact with the baby's blood. Therefore, sensitization must happen first before any further immune responses or reactions can take place.
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25.
The influence of the Rh groups of the mother and fetus/newborn also play a role in the incidence of D-immunization
A.
True
B.
False
Correct Answer
B. False
Explanation The influence of the ABO goups
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26.
When the mother and fetus are __________ -incompatible, _____________ is less likely to be formed than when the mother-fetus blood types are compatible.
A.
Rh, anti-k
B.
Rh, anti-D
C.
ABO, anti-k
D.
ABO, anti-D
Correct Answer
D. ABO, anti-D
Explanation When the mother and fetus have incompatible ABO blood types, it is less likely for the formation of antibodies against the Rh factor (anti-D) to occur compared to when the blood types are compatible. This is because ABO incompatibility does not directly affect the Rh factor, which is a separate antigen present on the surface of red blood cells. Therefore, the presence of ABO incompatibility does not stimulate the production of anti-D antibodies as much as when the mother and fetus have compatible blood types.
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27.
If mom and baby are both "O" she will be ____________ likely to form anti-D than an "O" mom with an "A" fetus
A.
More
B.
Less
C.
About the same
Correct Answer
A. More
Explanation If both the mother and baby have blood type "O," the mother will be more likely to form anti-D antibodies compared to an "O" mother with an "A" fetus. This is because the "A" fetus would have antigens on its red blood cells that are different from the mother's blood type, triggering the mother's immune system to produce anti-D antibodies. In the case of both mother and baby being "O," there would be no antigenic difference, resulting in a higher likelihood of the mother forming anti-D antibodies.
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28.
What is the most immunogenic Rh antigen?
A.
D
B.
K
C.
Anti-D
D.
Anti-K
Correct Answer
A. D
Explanation The most immunogenic Rh antigen is D. This means that the D antigen is the most likely to stimulate an immune response in individuals who do not have the D antigen on their red blood cells. This can lead to the production of antibodies against the D antigen, which can cause complications in blood transfusions and pregnancies.
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29.
Outside the Rh group system, the most clinically significant antibody capable of causing HDN is ________
A.
Anti-D
B.
Anti-K
C.
D
D.
K
Correct Answer
B. Anti-K
Explanation The correct answer is anti-K. Outside of the Rh group system, the antibody anti-K is the most clinically significant in causing Hemolytic Disease of the Newborn (HDN). HDN occurs when the mother's antibodies cross the placenta and attack the red blood cells of the fetus. The anti-K antibody can cause severe hemolytic anemia in the newborn, leading to complications such as jaundice, organ damage, and even death. It is important to identify and monitor this antibody during pregnancy to prevent and manage HDN.
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30.
What is the usual treatment for ABO-HDN?
Correct Answer phototherapy Phototherapy
Explanation the correct answer is phototherapy
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31.
___________________ is the most important initial factor in being able to determine the risk of HDN
A.
Prenatal care
B.
Obstetrician care
C.
Patient history
D.
None of the above
E.
All of the above
Correct Answer
A. Prenatal care
Explanation Prenatal care is the most INITIAL factor
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32.
The first round of blood bank testing is to determine the mothers ________________________
A.
Blood type, ABO, and Rh
B.
Weak D and Type an Screen
C.
All of the above
D.
None of the above
Correct Answer
C. All of the above
Explanation The first round of blood bank testing is crucial in determining various aspects related to the mother's blood. This includes determining her blood type (ABO) and Rh factor. Additionally, this round of testing also involves checking for Weak D and conducting a Type and Screen test. Therefore, the correct answer is "all of the above" as all these factors are assessed in the initial round of blood bank testing.
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33.
Clinically significant antibodies require further testing, such as a(n) __________________
A.
Antibody titer
B.
Type and screen
C.
All of the above
D.
None of the above
Correct Answer
A. Antibody titer
Explanation Clinically significant antibodies require further testing, such as an antibody titer. An antibody titer is a laboratory test that measures the concentration of antibodies in a person's blood. This test is used to determine the level of antibodies produced in response to a specific antigen. By measuring the antibody titer, healthcare professionals can assess the strength of the immune response and determine if the antibodies present are clinically significant. Therefore, an antibody titer is necessary to evaluate the significance of antibodies in a clinical setting.
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34.
Blood banks determine their own critical levels of the titer results, but generally speaking a titer of ______ or ______ is considered significant with the possibility of increasing titers meaning potentially INCREASED severity of HDN
A.
16, 32
B.
32, 64
C.
16, 64
D.
None of the above
Correct Answer
A. 16, 32
Explanation Blood banks determine their own critical levels of titer results, but generally speaking, a titer of 16 or 32 is considered significant with the possibility of increasing titers meaning potentially increased severity of HDN. This means that if the titer results for a specific antibody in the blood sample are 16 or 32, it indicates a higher risk of hemolytic disease of the newborn (HDN) and the severity of the condition may increase if the titers continue to rise.
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35.
Other prenatal testing may include which of the following
(MARK ALL THAT APPLY)
A.
Paternal phenotyping
B.
Ultrasound
C.
Amniocentesis
D.
Cordocentesis
E.
Fetal repositioning
F.
Fetal ABO
G.
Fetal Rh
H.
Weak D testing
I.
Cord blood samples
Correct Answer(s)
A. Paternal pHenotyping B. Ultrasound C. Amniocentesis D. Cordocentesis
Explanation Other prenatal testing may include paternal phenotyping, ultrasound, amniocentesis, and cordocentesis. Paternal phenotyping involves analyzing the blood type and Rh factor of the father to determine the risk of certain genetic conditions in the fetus. Ultrasound is a common prenatal test that uses sound waves to create images of the fetus and monitor its development. Amniocentesis is a procedure where a small sample of amniotic fluid is taken to test for genetic abnormalities. Cordocentesis, also known as fetal blood sampling, involves taking a sample of blood from the umbilical cord to test for genetic disorders or other conditions.
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36.
Introduction of RhIG or Rhogam, an injection of immune ____________, has decreased the incidence of HDN due to _______________
A.
IgM anti-K, anti-K
B.
IgG anti-D, anti-D
C.
IgM anti-D, anti-D
D.
IgG anti-K, anti-K
Correct Answer
B. IgG anti-D, anti-D
Explanation The correct answer is IgG anti-D, anti-D. The introduction of RhIG or Rhogam, an injection of immune globulin, has decreased the incidence of HDN (hemolytic disease of the newborn) due to IgG anti-D antibodies. RhIG is given to Rh-negative mothers during pregnancy to prevent the development of antibodies against the Rh antigen. These antibodies can cross the placenta and cause HDN in subsequent pregnancies if the baby is Rh-positive. Rhogam works by binding to any Rh-positive fetal red blood cells that may have entered the mother's bloodstream, preventing her from developing an immune response and producing anti-D antibodies.
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37.
The purpose of the injection of RhIG is to reduce pregnancy-associated _____________________ formation
A.
Anti-D
B.
Anti-K
C.
Either A or B
D.
None of the above
Correct Answer
A. Anti-D
Explanation The purpose of the injection of RhIG is to reduce pregnancy-associated anti-D formation. This means that the injection is given to prevent the formation of antibodies against the Rh(D) antigen. RhIG is typically administered to Rh-negative individuals who are at risk of developing antibodies against the Rh(D) antigen, such as during pregnancy or after a blood transfusion. By preventing the formation of anti-D antibodies, the injection helps to protect future pregnancies and prevent complications related to Rh incompatibility.
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38.
This RhIG injection is designed to be administered to ___________ mothers who deliver _____________ babies or babies that are still-born whose blood type is not known.
A.
Rh-positive, Rh-negative
B.
Rh-positive, Rh-positive
C.
Rh-negative, Rh-positive
D.
Rh-negative, Rh-negative
Correct Answer
C. Rh-negative, Rh-positive
Explanation This RhIG injection is designed to be administered to Rh-negative mothers who deliver Rh-positive babies or babies that are still-born whose blood type is not known. RhIG is a medication given to Rh-negative mothers to prevent the development of antibodies against the Rh factor. If an Rh-negative mother gives birth to an Rh-positive baby, there is a risk that the mother's immune system will produce antibodies that can harm future Rh-positive pregnancies. Therefore, RhIG is given to Rh-negative mothers in these situations to prevent the development of antibodies.
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39.
One "dose" or vial of RhIG is able to protect the mother from stimulating ______________ in response to 15 mL Rh-positive cells of 30 mL positive whole blood
A.
Anti-D
B.
Anti-K
C.
Anti-k
D.
Anti-H
E.
None of the above
Correct Answer
A. Anti-D
Explanation RhIG, also known as Rh immune globulin, is a medication given to Rh-negative mothers during pregnancy to prevent the formation of antibodies against Rh-positive blood cells. In this case, the correct answer is "anti-D" because RhIG protects the mother from producing antibodies against the Rh(D) antigen, which is found on Rh-positive blood cells.
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40.
In order for the mother to receive the RhIG shot she must be Rh negative, Du negative, must not already have immune anti-D, and baby must be Rh negative
A.
True
B.
False
Correct Answer
B. False
Explanation The mother must be Rh-negative and baby must be Rh-positive. The RhIG is of NO BENEFIT once the mother has already formed anti-D. Need to make sure if anti-D is found that it is a TRUE anti-D and not just in circulation from prior RhIG injection.
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41.
The number of vials to be administered is determined ___________ delivery, by first performing a ______________ screen
A.
Before, fetal
B.
Before, antibody
C.
After, fetal
D.
After, antibody
Correct Answer
C. After, fetal
Explanation The correct answer is "after, fetal". The number of vials to be administered is determined after fetal delivery, by first performing a fetal screen. This means that the decision on the number of vials to be administered is made after the delivery of the fetus, and it is based on the results of a fetal screen.
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42.
(Refer to previous question) If that screen is negative, administer ONE injection, but if it is positive, a _______________________________ must be performed in order to quantitate the amount of vials to be injected.
A.
Kernicterus
B.
Kleihauer-Betke
C.
Rosette Technique
D.
None of the above
Correct Answer
B. Kleihauer-Betke
Explanation If the screen is positive, a Kleihauer-Betke test must be performed in order to quantitate the amount of vials to be injected.
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