Deck 14: Perinatal and Neonatal Transfusion Issues

Question 1

All of the following are pregnancy-related indications for Rh-immune globulin injection except

A)Antepartum after abdominal trauma
B)Perinatal after termination of pregnancy
C)Postpartum when fetal death occurred
D)Postpartum when baby is Rh(D)negative

Answer 1

Postpartum when baby is Rh(D)negative

Question 2

Which donor red blood cells would be chosen to use in an intrauterine transfusion?

A)Group AB,Rh(D)negative that lack the offending antigen
B)Group AB,Rh(E)negative that lack the offending antigen
C)Group O,Rh(C)negative that lack the offending antigen
D)Group O,Rh(D)negative that lack the offending antigen

Answer 2

Group O,Rh(D)negative that lack the offending antigen

Question 3

The normal range for hemoglobin level in a healthy,full-term newborn is approximately

A)10.0-12.0 g/dL (100-120 g/L)
B)14.0-20.0 g/dL (140-200 g/L)
C)20.0-25.0 g/dL (200-250 g/L)
D)23.0-32.0 g/dL (230-320 g/L)

Answer 3

14.0-20.0 g/dL (140-200 g/L)

Question 4

An exchange transfusion will accomplish all of the following except

A)Reduce the amount of antibody-coated red blood cells in the newborn's circulation
B)Reduce the amount of maternal antibody in the newborn's circulation
C)Reduce the bilirubin level in the newborn's circulation
D)Reduce the hemoglobin level in the newborn's circulation

Question 5

Which of the following is the condition where bilirubin crosses the blood-brain barrier and is deposited in the cells of the basal ganglia and hippocampus?

A)Anemia
B)Hepatosplenomegaly
C)Jaundice
D)Kernicterus

Question 6

The most common cause of hemolytic disease of the newborn is incompatibility between the mother and the infant in which blood group system?

A)ABO
B)Kell
C)MNS
D)Rh

Question 7

The goal of intrauterine transfusion is increase the fetal hematocrit to

A)25-30% (0.25-0.30)
B)32-44% (0.32-0.44)
C)40-55% (0.40-0.55)
D)45-55% (0.45-0.55)

Question 8

All of the following are known to be IgM antibodies and have not been found to cause hemolytic disease of the fetus and newborn (HDFN)except

A)Anti-Leᵃ
B)Anti-Leᵇ
C)Anti-M
D)Anti-P1

Question 9

How can pregnancy cause a woman to make an antibody to a red blood cell antigen?

A)Fetal cells carrying an antigen inherited from the mother and foreign to the father cross the placenta
B)Fetal cells carrying an antigen inherited from the father and foreign to the mother cross the placenta
C)Fetal cells carrying a homozygous dose of an antigen cross the placenta
D)Fetal cells carrying a heterozygous dose of an antigen cross the placenta

Question 10

Which statement about the direct antiglobulin test (DAT)in the postpartum period is true?

A)If the DAT on a cord blood specimen is positive,an eLuᵃte should always be prepared and tested against the biological father's red blood cells.
B)If the mother has a clinically significant antibody,a DAT should be performed on a blood specimen from the newborn.
C)Laboratory standards mandate that a DAT be performed on cord blood collected from every live birth.
D)The strength of the DAT in cases of ABO compatibility is indicative of the severity of the hemolytic process.

Question 11

Prior to giving Rh-immune globulin (RhIG),when should a second antibody screen be tested on an Rh(D)-negative woman whose initial antibody screen was negative?

A)8 weeks gestation
B)12 weeks gestation
C)24 weeks gestation
D)28 weeks gestation

Question 12

How does phototherapy reduce the blood bilirubin level?

A)Conjugates bilirubin in the liver to a form that can be excreted in the urine
B)Conjugates bilirubin in the skin to a form that can be excreted in the bile
C)Converts unconjugated bilirubin in the skin to a form that can be excreted by the lungs
D)Converts unconjugated bilirubin in the skin to a form that can be excreted in the urine

Question 13

Which method is the most accurate means of determining the severity of fetal hemolytic anemia and the need for treatment of the fetus?

A)Amniotic fluid analysis
B)Doppler flow studies
C)Fetal blood sampling
D)Maternal antibody titer

Question 14

Which term refers to delivery of a live infant?

A)Gravid
B)Gravida
C)Para
D)Peri

Question 15

Infants at risk for severe cytomegalovirus (CMV)infection include all of the following except

A)Infants born prematurely
B)Infants born to CMV-seropositive mothers
C)Infants with low birth weight who are undergoing ECMO
D)Infants with congenital immunodeficiency disorders

Question 16

A minimum of at least one ______ dose of Rh-immune globulin (RhIG)must be administered to all Rh(D)-negative women who deliver an Rh(D)-positive infant,provided the woman has not already made anti-D.

A)100 µg
B)200 µg
C)300 µg
D)400 µg

Question 17

Complications of amniocentesis include

A)Infection
B)Pyruvate kinase deficiency
C)Rh sensitization
D)Thalassemia

Question 18

Amniocentesis can be performed as early as

A)10 weeks gestation
B)15 weeks gestation
C)20 weeks gestation
D)25 weeks gestation

Question 19

The model or classic case of hemolytic disease of the fetus and newborn (HDFN)involves an

A)Rh(D)-negative mother who makes anti-A directed against the Rh(D)-negative red blood cells of her fetus
B)Rh(D)-negative mother who makes anti-D directed against the Rh(D)-positive red blood cells of her fetus
C)Rh(D)-positive mother who makes anti-A,B directed against the Rh(D)-negative red blood cells of her fetus
D)Rh(D)-positive mother who makes anti-D directed against the Rh(D)-negative red blood cells of her fetus

Question 20

In general,for the neonatal population,a platelet count of ___________ is considered the minimum to maintain hemostasis.

A)50 × 10³/µL (50 × 10⁹/L)
B)75 × 10³/µL (75 × 10⁹/L)
C)100 × 10³/µL (100 × 10⁹/L)
D)150 × 10³/µL (150 × 10⁹/L)