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BB Exam 4 - Rh Immune Globulin (Rhogam, RhIG)
Lecture 28
55
Biology
Undergraduate 3
03/14/2015

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Term
What is RhIG?
Definition
D ABY injected IM to unsensitized Rh = Moms who deliver a Rh + baby
Term
Where does RhIG come from?
Definition
Hyperimmunized human donor (Gamma globulin solution)
Term
What is RhIG processed to prevent?
Definition
Disease transmission
Term
What does RhIG prevent?
Definition
Mom from building an anti-D after exposure to baby's D + blood during pregnancy or at birth
Term
If proper dosage is given at 28 weeks of pregnancy and within 72 hours of birth, ____% of moms will be protected from building an anti-D
Definition
>99%
Term
If proper dosage is given at 28 weeks of pregnancy and within ____ hours of birth, >99%% of moms will be protected from building an anti-D
Definition
72
Term
If proper dosage is given at ___ weeks of pregnancy and within 72 hours of birth, >99%% of moms will be protected from building an anti-D
Definition
28
Term
RhIG has reduced HDN from 13% to ____% in Rh = moms having D + babies
Definition
0.2
Term
How thick is the membrane that separates fetal circulation from maternal circulation?
Definition
2 cell thick
Term
Anemia causes ___ ___ which increases cardiac output and fluid and salt retention by the kidneys
Definition
Tissue Hypoxia
Term
As mom's ABY titer _____ it crosses placenta and coats AGN + cells of baby and cells are cleared by the baby's spleen
Definition
Rises/Increases/Goes Up
Term
Anemia causes Extramedullary hematopoiesis, ___ ___ ___ ___
Definition
enlarging spleen and liver
Term
True or False:
Hepatic involvement leads to portal hypertension with ascites and hypoalbuminemia and subsequently edema
Definition
True
Term
When hemoglobin dimmers exceed the quantity of _____, the now free Indirect Bilirubin can deposit in the brain and cause permanent damage
Definition
Albumin
Term
When you perform what will you help relieve baby's BM and stop extramedullary production?
Definition
Intrauterine transfusion
Term
True or False:
At birth the baby is anemic, but bilirubin is NOT a problem because mom's liver took care of it
Definition
True
Term
True or False:
Most Significant bleeds occur at delivery
Definition
True
Term
True or False:
In Postnatal use for RhIG, Baby's RH + cells may appear as MFA in mom's Rh = blood
Definition
True
Term
Will there be adverse effects for the Mother if she is Rh = and is given RhIG when the Baby is Rh +, baby died, or if the baby's blood type is unknown.
Definition
No
Term
Postnatal - If detect Anti-D one must determine if it is from what or what?
Definition
RhIG @ 28 weeks
Mom has acquired Anti-D
Term
What will the ABY level be if the mom is truly immunized?
Definition
High
Term
What will the ABY level be if mom Anti-D is passive?
Definition
Low
Term
Fetal Screen - 1 in 300 deliveries result in bleed >____
Definition
15 mL
Term
What are you looking for with the Fetal Screen?
Definition
Rosettes
Term
More than 7 rosettes per 5 fields indicates what?
Definition
>15 mL bleed
Term
What are the rosettes potentially seen in the Fetal Screen?
Definition
Baby's RH+ cells coated with Anti-D with Rh + cells clustered around them
Term
If the Fetal Screen is +, perform _________ to quantitate
Definition
Kleihauer-Betke stain
Term
True or False:
Fetal Screen test is NOT reliable when the infant or mother is weak D positive
Definition
True
Term
What stain makes the fetal cells stain pink and the adult cells appear ghostlike?
Definition
Kleihauer-Betke stain
Term
What causes the adult cells to appear as ghosts in the Kleihauer-Betke stain?
Definition
Acid elutes the Adult cells
Term
Give the formula to find the % of Fetal Cells
Definition
(# of fetal cells/500)x100
Term
Give the formula to find the mL of fetal whole bleed
Definition
% of fetal cells x 50
Term
Give the formula to find the # of vials to give
Definition
(mL of fetal-maternal bleed / 30) + 1
Term
What is the following considered:
Transfusion of Rh + components to Rh = recipient
Definition
Other uses for RhIG
Term
What is the Most Common type of HDN?
Definition
ABO
Term
What is the Most Severe type of HDN?
Definition
Rh
Term
What are the Most Common Other RBC AGNs?
Definition
K & c
Term
True or False:
Platelet ABYs - Both AlloABYs & AutoABYs
Definition
True
Term
Identify the following:
Mom O=, Weak D =, IAT =
Baby A+ DAT w+
Definition
ABO HDN
Term
Identify the following:
Mom O=, Weak D =, IAT +, Anti-D 1:256
Baby A+, DAT 4+
Definition
D-HDN
Term
Identify the following:
Mom O=, weak D MFA, IAT =, Fetal Screen +
Baby A+, DAT =
Definition
Increased Fetal Maternal Bleed
Term
Identify the following:
Mom O=, weak D =, IAT +, Anti-D 1:256
Baby A=, Weak D invalid, DAT +2
Definition
D-HDN
Term
Identify the following:
Mom @ 28 weeks gestation
O=, Weak D=, IAT+, Anti D 1:8
Baby O=, D =, IAT +, Anti D 1:2
Definition
Received RhIG
Term
Would you give Rhogam to the following:
Mom O=, Weak D =, IAT =
Baby A+ DAT w+
Definition
Yes
Term
Would you give Rhogam to the following:
Mom O=, Weak D =, IAT +, Anti-D 1:256
Baby A+, DAT 4+
Definition
No, already has ABY
Term
Would you give Rhogam to the following:
Mom O=, weak D MFA, IAT =, Fetal Screen +
Baby A+, DAT =
Definition
Yes, more than one dose
Term
Would you give Rhogam to the following:
Mom O=, weak D =, IAT +, Anti-D 1:256
Baby A=, Weak D invalid, DAT +2
Definition
No, already has ABY
Term
Would you give Rhogam to the following:
Mom @ 28 weeks gestation
O=, Weak D=, IAT+, Anti D 1:8
Baby O=, D =, IAT +, Anti D 1:2
Definition
Depends on Baby's Type
Term
Intrauterine, Exchange, or Neonatal Transfusion -
Blood 5-7 days old to Maximize ______
Definition
2,3-DPG
Term
Intrauterine, Exchange, or Neonatal Transfusion -
Blood 5-7 days old to Lesson ______
Definition
Potassium
Term
Intrauterine, Exchange, or Neonatal Transfusion -
Resuspended to HCT of ______
Definition
75-90%
Term
Intrauterine, Exchange, or Neonatal Transfusion -
Resuspended to HCT of 75-90%, then O cells mixed with ABY FFP to make final HCT of ______
Definition
50-55%
Term
Intrauterine, Exchange, or Neonatal Transfusion -
Crossmatch compatible with ______ serum
Definition
Mom's
Term
Intrauterine, Exchange, or Neonatal Transfusion -
If Maternal ABY is present, what type of units are used?
Definition
AGN = units
Term
Intrauterine, Exchange, or Neonatal Transfusion -
If 1st IAT is =, Crossmatch need not be required for how long?
Definition
First 4 months of age
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