3 - Krafts Hdn

Front 1

Hydrops means accumulation of _____ fluid in the fetus during intrauterine growth.
What is hydrops fetalis?
Immune hydrops?

Back 1

edema
When the accumulation of fluid is severe and generalized
Not specific to HDN, occurs in many different conditions

Front 2

What is it called when early red cell precursors show up in the peripheral blood?

Back 2

Erythroblastosis fetalis
This can happen in any severe anemia and HDN

Front 3

Fetus inheritis blood from father that are ______ to mother. Fetal blood gets into circulation (how?). Mom makes antibodies and they cross placenta to attack baby's ___ ____

Back 3

foreign
either during last trimester of pregnancy, when cytotrophoblast is no longer present, or during childbirth
red cells = hemolytic anemia

Front 4

If the anemia is mild, ________ ________ in the liver and spleen may produce enough red cells to maintain normal numbers.

Back 4

extramedullary hematopoiesis

Front 5

If the anemia is severe, the ____ and ____ may suffer hypoxic injury, resulting in circulatory and hepatic failure

Back 5

heart
liver

Front 6

Liver failure causes decreased ______ levels and a reduction in ______ pressure in the circulation. Heart failure causes an increase in ______ pressure (blood is backing up behind the failing heart). The combo leads to generalized edema and ascites, _____ _____, which can be fatal

Back 6

protein
oncotic
venous
hydrops fetalis

Front 7

If hemolysis is severe, ______ can occur due to accumulation of unconjugated _______

Back 7

jaundice
bilirubin

Front 8

Unconjugated ______ is water insoluble; it binds to lipids in the brain (___in fetus is poorly developed), causing damage to the CNS, termed ______. The affected brain is enlarged, edematous, and _____.

Back 8

bilirubin
BBB
kernicterus
yellow

Front 9

-Only the _ Ag is involved in Rh incompatability
-Ab response depends on how much Ag mom is exposed to
-Initial exposure evokes __ (which can’t cross placenta); first baby usually safe
-Second exposure evokes ___; second baby may get ___.

Back 9

D
IgM
IgG
HDN

Front 10

Diagnosis of Rh-incompatability:
DAT will be positive in ____
IAT will be positive in _____

Back 10

baby (cells coated with mom's antibodies)
mom (though if mom had Rhogam at 28 wks IAT will be artificially positive)

Front 11

What's in Rhogam? When is it administered?

Back 11

anti-D antibody
28 weeks and within 72 hours of delivery
Mops up any circulating D+ fetal red cells by coating them with antibody before mom makes any anti-D antibodies.

Front 12

Determine dosing of Rhogam based on _____-____ test which quantifies amount of fetomaternal hemorrhage:
mom blood smear, expose to acid bath (removes ___), stain smear, baby's cells appear ___ and mom's appear ____

Back 12

Kleihauer-Betke
HbA (adult hemoglobin)
pink
ghostly

Front 13

Can use ____ ____ test for fetal cells. Use mom's blood, apply anti-___ antibody, run flow. Baby cells, if present, are intensely positive

Back 13

flow cytometry
HbF

Front 14

ABO incompatibility occurs in -__% of pregnancies but rarely severe. Most anti-A/B Ab are ___
Neonatal red cells expresss A and B ______
Many cells express A and B antigen so they sop up mom's Ab

Back 14

25
IgM (don't cross placenta)
poorly

Front 15

There's no effective protection against ____- mediated HDN

Back 15

ABO

Front 16

Some group _ women produce IgG anti-A/bB even without prior sensitization so ____ may be effected

Back 16

O
firstborn

Front 17

mild cases can be treated with ___therapy
severe cases -totaly exhange _____ through umbilical ___

Back 17

photo (unconjugated bilirubin oxidized to water-soluble dipyrroles)
transfusion
vein

Front 18

Mother can be treated with plasmapheresis to remove ___
Can also treat with high-dose IV __ but not well-defined

Back 18

Ab
Ig (immunoglobulin)