Question 1

Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?

Accepted Answer

A)  Phototherapy 
B)  Plasma exchange 
C)  Amniocentesis 
D)  Electrophoresis 
A)  Phototherapy 
B)  Plasma exchange 
C)  Amniocentesis 
D)  Electrophoresis A

Question 2

What is the cause of HDFN?

Accepted Answer

A)  Destruction of the mother's RBCs by autoantibody 
B)  Destruction of the fetus's RBCs by antibody produced by the mother 
C)  Destruction of the fetus's RBCs by autoantibody 
D)  Destruction of the mother's RBCs by antibody produced by the fetus 
A)  Destruction of the mother's RBCs by autoantibody 
B)  Destruction of the fetus's RBCs by antibody produced by the mother 
C)  Destruction of the fetus's RBCs by autoantibody 
D)  Destruction of the mother's RBCs by antibody produced by the fetus B

Question 3

All of the following are goals of an exchange transfusion except:

Accepted Answer

A)  to remove high levels of unconjugated bilirubin. 
B)  to correct anemia. 
C)  to remove high levels of conjugated bilirubin. 
D)  to remove high levels of maternal antibody. 
A)  to remove high levels of unconjugated bilirubin. 
B)  to correct anemia. 
C)  to remove high levels of conjugated bilirubin. 
D)  to remove high levels of maternal antibody. C

Question 4

Immunization of the mother can be caused by as little as D-positive fetal cells.

Accepted Answer

A)  10 mL 
B)  1 mL 
C)  50 mL 
D)  20 mL 
A)  10 mL 
B)  1 mL 
C)  50 mL 
D)  20 mL

Question 5

What is done to prevent HDFN caused by maternal anti-Jka antibody formation?

Accepted Answer

A)  Give Jka immune globulin. 
B)  Monitor the mother's antibody level. 
C)  Prevent formation of Jka-positive cells in the fetus. 
D)  No action is necessary; anti-Jka will not cause HDFN. 
A)  Give Jka immune globulin. 
B)  Monitor the mother's antibody level. 
C)  Prevent formation of Jka-positive cells in the fetus. 
D)  No action is necessary; anti-Jka will not cause HDFN.

Question 6

What is the physiological mechanism of Rh-immune globulin?

Accepted Answer

A)  Attachment of fetal Rh-positive red blood cells in fetal circulation, inhibiting production of anti-D 
B)  Attachment of maternal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D 
C)  Attachment of fetal Rh-positive red blood cells in maternal circulation, inhibiting production of anti-D 
D)  Attachment of fetal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D 
A)  Attachment of fetal Rh-positive red blood cells in fetal circulation, inhibiting production of anti-D 
B)  Attachment of maternal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D 
C)  Attachment of fetal Rh-positive red blood cells in maternal circulation, inhibiting production of anti-D 
D)  Attachment of fetal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D

Question 7

Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

Accepted Answer

A)  Antibody specimen 
B)  Kleihauer-Betke test 
C)  Rosette test 
D)  Solid-phase adherence test 
A)  Antibody specimen 
B)  Kleihauer-Betke test 
C)  Rosette test 
D)  Solid-phase adherence test

Question 8

What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly?

Accepted Answer

A)  Thalassemia 
B)  Sickle cell anemia 
C)  Hereditary persistence of fetal hemoglobin 
D)  Hydrops fetalis 
A)  Thalassemia 
B)  Sickle cell anemia 
C)  Hereditary persistence of fetal hemoglobin 
D)  Hydrops fetalis

Question 9

The laboratory is presented with a case of HDFN due to ABO incompatibility. The mother is Group O and the infant is Group B. The most appropriate type of blood to use for an exchange transfusion for this infant is:

Accepted Answer

A)  A 
B)  B 
C)  O 
D)  AB 
A)  A 
B)  B 
C)  O 
D)  AB

Question 10

What is the most common clinical manifestation of ABO HDFN?

Accepted Answer

A)  Severe anemia 
B)  Hyperbilirubinemia 
C)  Hyperkalemia 
D)  Hypotension 
A)  Severe anemia 
B)  Hyperbilirubinemia 
C)  Hyperkalemia 
D)  Hypotension

Question 11

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

Accepted Answer

A)  The chance of maternal sensitization to Rh antigen is increased. 
B)  The chance of maternal sensitization to Rh antigen is decreased. 
C)  It has no effect. 
D)  None of the above 
A)  The chance of maternal sensitization to Rh antigen is increased. 
B)  The chance of maternal sensitization to Rh antigen is decreased. 
C)  It has no effect. 
D)  None of the above

Question 12

The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 ml of whole blood. How many vials of Rh-immune globulin would be required?

Accepted Answer

A)  1 
B)  2 
C)  3 
D)  4 
A)  1 
B)  2 
C)  3 
D)  4

Question 13

Which red blood cell morphology is most characteristic in ABO HDFN and absent in Rh HDFN?

Accepted Answer

A)  Target cells 
B)  Teardrop cells 
C)  Microspherocytes 
D)  Burr cells 
A)  Target cells 
B)  Teardrop cells 
C)  Microspherocytes 
D)  Burr cells

Question 14

Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D.

Accepted Answer

A) True 
 B)False

Question 15

Anti-D in the serum of a third trimester pregnant woman with a titer of 16 is indicative of:

Accepted Answer

A)  Rh-immune globulin. 
B)  active immunization. 
C)  passive immunization. 
D)  none of the above. 
A)  Rh-immune globulin. 
B)  active immunization. 
C)  passive immunization. 
D)  none of the above.

Question 16

Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

Accepted Answer

A)  Hydrops fetalis 
B)  Kernicterus 
C)  Bilirubinemia 
D)  Bilirubinuria 
A)  Hydrops fetalis 
B)  Kernicterus 
C)  Bilirubinemia 
D)  Bilirubinuria

Question 17

Which of the following antibodies have not been known to cause HDFN?

Accepted Answer

A)  Anti-C 
B)  Anti-S 
C)  Anti-D 
D)  Anti-Lea 
A)  Anti-C 
B)  Anti-S 
C)  Anti-D 
D)  Anti-Lea

Question 18

In which type of HDFN is the firstborn affected?

Accepted Answer

A)  ABO 
B)  Rh 
C)  Lewis 
D)  P 
A)  ABO 
B)  Rh 
C)  Lewis 
D)  P

Question 19

In HDFN, the IgG antibodies are directed against which antigen on the fetal red blood cells?

Accepted Answer

A)  Maternal 
B)  Paternal 
C)  Bacterial 
D)  Viral 
A)  Maternal 
B)  Paternal 
C)  Bacterial 
D)  Viral

Question 20

Besides the Rh antibodies, what other red blood cell antibody is common to cause severe HDFN?

Accepted Answer

A)  Anti-M 
B)  Anti-Lea 
C)  Anti-K 
D)  Anti-Fyb 
A)  Anti-M 
B)  Anti-Lea 
C)  Anti-K 
D)  Anti-Fyb

Exam 20: Hemolytic Disease of the Fetus and Newborn

Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?

What is the cause of HDFN?

All of the following are goals of an exchange transfusion except:

Immunization of the mother can be caused by as little as D-positive fetal cells.

What is done to prevent HDFN caused by maternal anti-Jka antibody formation?

What is the physiological mechanism of Rh-immune globulin?

Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly?

The laboratory is presented with a case of HDFN due to ABO incompatibility. The mother is Group O and the infant is Group B. The most appropriate type of blood to use for an exchange transfusion for this infant is:

What is the most common clinical manifestation of ABO HDFN?

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 ml of whole blood. How many vials of Rh-immune globulin would be required?

Which red blood cell morphology is most characteristic in ABO HDFN and absent in Rh HDFN?

Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D.

Anti-D in the serum of a third trimester pregnant woman with a titer of 16 is indicative of:

Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

Which of the following antibodies have not been known to cause HDFN?

In which type of HDFN is the firstborn affected?

In HDFN, the IgG antibodies are directed against which antigen on the fetal red blood cells?

Besides the Rh antibodies, what other red blood cell antibody is common to cause severe HDFN?

Red Blood Cells and Platelet Preservation: Historical Perspectives and Current Trends

Basic Genetics

Fundamentals of Immunology

Concepts in Molecular Biology

The Antiglobulin Test

The Abo Blood Group System

The Rh Blood Group System

Blood Group Terminology and Common Blood Groups

Uncommon Blood Groups

Detection and Identification of Antibodies

Pre-Transfusion Testing

Blood Bank Technologies and Automation

Donor Selection

Transfusion-Transmitted Diseases

Component Preparation

Transfusion Therapy

Adverse Effects of Blood Transfusion

Apheresis

Cellular Therapy in the Transplant Setting

Autoimmune Hemolytic Anemias

Tissue Banking As Part of the Transfusion Service

The Hla System

Relationship Testing

Quality Management

Patient Blood Management

Transfusion Safety and Federal Regulatory Requirements

Laboratory Information Systems in the Blood Bank

Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

Filters

What is done to prevent HDFN caused by maternal anti-Jk^a antibody formation?