Term
| locations of Embryonic Hematopoiesis |
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Definition
| in yolk sac 1st trimester, liver 2nd trimester, bone marrow 3rd trimester |
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Term
| Hemoglobin Types – Hgb F % in RBC, neonatal levels |
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Definition
@ birth, 50% of RBC have Hgb F
neonate is polycythemic (high Hgb) at birth, and decreases to trough 14 weeks
• Gower 1 & 2/Portland – earliest types of hemoglobin 1st trimester, use ζ2ε2 and α2ε2 subunits
• Fetal – another hemoglobin type, made in liver, uses α2γ2 subunits
• A1 – earlier main adult hemoglobin type, made in marrow, uses α2β2 subunits
• A2 – final supplementary adult hemoglobin type, made in marrow, uses α2δ2 subunits
• Neonate – has high (17-18) hemoglobin concentration (from both fetal & adult hemoglobin made)
• LOWEST at 2 Months – has low (10-12) hemoglobin concentration (from fetal hemoglobin stopping) physiologic anemia |
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Term
| Premature Neonate Platelets leveles |
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Definition
| count will be lower than normal, but despite this, under 150K = always bad |
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Term
| pathogenesis of Erythroblastosis Fetalis |
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Definition
hemolytic anemia of Rh+ infant caused by Rh- mother producing antibodies
left-shift of RBCs (nucleated RBCs) due to increase erythropoiesis response in neonates, from hemolytic anemia
Rh response = IgG only |
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Term
| why ABO incompatability confers protection against EF? |
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Definition
| carried on IgM not crosses placenta |
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Term
| Rigidity and stability of newborn RBCs |
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Definition
• Rigidity – neonate “eggshell” RBCs are more rigid and less permeable to cations/anions than adult RBCs, b/c more rigid – more prone to hemolysis!
• Stability – neonate RBCs are less stable, w/ more unstable methemoglobin, & more denaturation-prone |
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Term
| What's bad about giving well water to babies? |
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Definition
| • Well water – has high nitrite/nitrate concentrations, oxidizes Hgb methemoglobin; don’t give to babies |
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Term
| Clamping the babies @ birth...FX of early/late...height... |
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Definition
| • Clamping strategy – because 1/3rd of blood volume in placenta at time of birth, OB/GYN holds newborn at level of womb for 2 minutes then clamps; clamp early and child is anemic, clamp late and child is polycythemic |
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Term
Clotting factors @ birth:
Vit K dep factors, PT/aPTT, Factor VIII, IX
Anti-clotting factors: Protein C/S |
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Definition
• Clotting Factors – diminished synthesis & high clearance during birth, but…
o Vitamin K Dependent Factors – Factors 2, 7, 9, 10 all diminished at birth vitamin K supp/shots at birth. Normalize by 4-6 months of life.
o PT, aPTT – both elevated (lack of clotting) at birth
o Factor VIII – should be normal at birth, so if low Hemophilia A
o Factor IX – vit K dependent, so cannot diagnose Hemophilia B at birth
• Anti-clotting Factors (Protein C/S) – even more diminished than clotting factors, thus thrombosis risk |
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Term
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Definition
| normal @ full-term (takes iron from mother during last month, even if mom low), but low in premies (get iron late); thus if <36 wks at birth, iron supplementation is necessary |
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Term
| infections in newborns leading to hemolytic anemia/TCP |
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Definition
| rubella, CMV, toxo, syphillis, malaria |
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Term
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Definition
o Jaundice – seen quickly after birth, from hyperbilirubinemia due to hemoglobin breakdown
o Pallor – due to anemia of hemolysis
o Hepatosplenomegaly (HSM) – due to liver overdrive to produce compensatory RBCs
o Hydrops – CHF due to heart recognizing anemia & pumping way too fast |
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Term
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Definition
force an early delivery, before CHF hydrops; can also give intrauterine transfusions
o Exchange transfusion – at birth, put catheter into fetal blood line & replace with compatible
RBCs which won’t lyse from transferred maternal antibodies if Hgb < 12 or Bilirubin >20
o Maternal plasmapheresis – get rid of maternal antibodies produced… |
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Term
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Definition
can use Rhogam antibodies against Rh, given to mother so that this “fake” immune
response can prevent the development of a real immune response |
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Term
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Definition
| low hemoglobin, high retics/nucleated RBCs, hyperbilirubinemia |
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