Question 1

What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?

Accepted Answer

A)  Indirect bilirubin is transported across the placenta and excreted via maternal kidneys. 
B)  Indirect bilirubin is conjugated in the fetal liver to direct bilirubin. 
C)  Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin. 
D)  None of the above 
A)  Indirect bilirubin is transported across the placenta and excreted via maternal kidneys. 
B)  Indirect bilirubin is conjugated in the fetal liver to direct bilirubin. 
C)  Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin. 
D)  None of the above

Question 2

Why are premature newborns more likely to require exchange transfusions than full-term infants?

Accepted Answer

A)  Premature newborns are deficient in carrier protein (albumin) for bilirubin transport. 
B)  Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin. 
C)  Premature newborn livers are too underdeveloped to conjugate bilirubin. 
D)  None of the above 
A)  Premature newborns are deficient in carrier protein (albumin) for bilirubin transport. 
B)  Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin. 
C)  Premature newborn livers are too underdeveloped to conjugate bilirubin. 
D)  None of the above

Question 3

Blood transfusions to the fetus and premature infants should be to prevent graft-versus-host disease.

Accepted Answer

A)  gamma irradiated 
B)  negative for hemoglobin S 
C)  less than 7 days old 
D)  beta irradiated 
A)  gamma irradiated 
B)  negative for hemoglobin S 
C)  less than 7 days old 
D)  beta irradiated

Question 4

What immunoglobulin is capable of crossing the placenta?

Accepted Answer

A)  IgG 
B)  IgM 
C)  IgA 
D)  All of the above 
A)  IgG 
B)  IgM 
C)  IgA 
D)  All of the above

Question 5

Which of the following best describes the principle of the Kleihauer-Betke test?

Accepted Answer

A)  D-positive indicator cells form rosettes around maternal Rh-positive RBCs. 
B)  D-positive indicator cells form rosettes around fetal Rh-positive red blood cells. 
C)  Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells. 
D)  Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells. 
A)  D-positive indicator cells form rosettes around maternal Rh-positive RBCs. 
B)  D-positive indicator cells form rosettes around fetal Rh-positive red blood cells. 
C)  Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells. 
D)  Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells.

Question 6

What is the role of the technologist in the diagnosis and clinical management of HDFN?

Accepted Answer

A)  Perform exchange transfusions 
B)  Serological diagnosis of maternal alloimunization 
C)  Ultrasonography, Doppler assessment 
D)  All of these 
A)  Perform exchange transfusions 
B)  Serological diagnosis of maternal alloimunization 
C)  Ultrasonography, Doppler assessment 
D)  All of these

Question 7

When is the antenatal dose of Rh-immune globulin given?

Accepted Answer

A)  20 weeks 
B)  13 weeks 
C)  28 weeks 
D)  36 weeks 
A)  20 weeks 
B)  13 weeks 
C)  28 weeks 
D)  36 weeks

Question 8

What physiological phenomenon associates erythroblastosis fetalis with HDFN?

Accepted Answer

A)  Release of nucleated red blood cells (RB
C)  into circulation of mother inflicted with HDFN 
B)  Release of mature RBCs into circulation of neonate inflicted with HDFN 
C)  Release of nucleated RBCs into circulation of neonate inflicted with HDFN 
D)  None of the above 
A)  Release of nucleated red blood cells (RB
C)  into circulation of mother inflicted with HDFN 
B)  Release of mature RBCs into circulation of neonate inflicted with HDFN 
C)  Release of nucleated RBCs into circulation of neonate inflicted with HDFN 
D)  None of the above

Question 9

Which IgG subclass carries more potency in red blood cell hemolysis?

Accepted Answer

A)  IgG2 
B)  IgG3 
C)  IgG4 
D)  None of the above 
A)  IgG2 
B)  IgG3 
C)  IgG4 
D)  None of the above

Question 10

The antibody titer of maternal antibody is directly proportional to severity of HDFN.

Accepted Answer

A) True 
 B)False

Question 11

Why does the rate of RBC destruction after birth decrease in an infant diagnosed with HDFN?

Accepted Answer

A)  Maternal antibody is no longer entering infant circulation via the placenta. 
B)  Reticuloendothelial system of the neonate reaches an equilibrium with the rate of RBC destruction. 
C)  The bone marrow of the neonate compensates for sequestered RBCs. 
D)  None of the above 
A)  Maternal antibody is no longer entering infant circulation via the placenta. 
B)  Reticuloendothelial system of the neonate reaches an equilibrium with the rate of RBC destruction. 
C)  The bone marrow of the neonate compensates for sequestered RBCs. 
D)  None of the above

Question 12

Cannulation of the umbilical vein under ultrasound guidance is known as:

Accepted Answer

A)  cordocentesis. 
B)  amniocentesis. 
C)  apheresis. 
D)  pericardiocentesis. 
A)  cordocentesis. 
B)  amniocentesis. 
C)  apheresis. 
D)  pericardiocentesis.

Question 13

Which prenatal serologic tests are recommended during the first trimester?

Accepted Answer

A)  ABO 
B)  Rh 
C)  Antibody screen 
D)  All of the above 
A)  ABO 
B)  Rh 
C)  Antibody screen 
D)  All of the above

Question 14

Why is suppression of erythropoiesis an advantage of exchange transfusions?

Accepted Answer

A)  Reduces the production of compatible RBCs 
B)  Reduces the production of incompatible RBCs 
C)  Decreases the risk of iron overload 
D)  Clears nucleated RBCs from circulation 
A)  Reduces the production of compatible RBCs 
B)  Reduces the production of incompatible RBCs 
C)  Decreases the risk of iron overload 
D)  Clears nucleated RBCs from circulation

Question 15

Due to a short supply of O-negative packed cells, an Rh-negative patient was transfused with 1 unit of Rh-positive red blood cells. Calculate the number of Rh-immune globulin vials needed to protect against 250 mL of Rh-positive packed cells.

Accepted Answer

A)  5 
B)  17 
C)  10 
D)  23 
A)  5 
B)  17 
C)  10 
D)  23

Exam 20: Hemolytic Disease of the Fetus and Newborn

What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?

Why are premature newborns more likely to require exchange transfusions than full-term infants?

Blood transfusions to the fetus and premature infants should be to prevent graft-versus-host disease.

What immunoglobulin is capable of crossing the placenta?

Which of the following best describes the principle of the Kleihauer-Betke test?

What is the role of the technologist in the diagnosis and clinical management of HDFN?

When is the antenatal dose of Rh-immune globulin given?

What physiological phenomenon associates erythroblastosis fetalis with HDFN?

Which IgG subclass carries more potency in red blood cell hemolysis?

The antibody titer of maternal antibody is directly proportional to severity of HDFN.

Why does the rate of RBC destruction after birth decrease in an infant diagnosed with HDFN?

Cannulation of the umbilical vein under ultrasound guidance is known as:

Which prenatal serologic tests are recommended during the first trimester?

Why is suppression of erythropoiesis an advantage of exchange transfusions?

Due to a short supply of O-negative packed cells, an Rh-negative patient was transfused with 1 unit of Rh-positive red blood cells. Calculate the number of Rh-immune globulin vials needed to protect against 250 mL of Rh-positive packed cells.

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

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