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18 Cards in this Set
- Front
- Back
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Hydrops:
Define Adult form? |
Hydrops = overaccumulation of serous fluid in interstitial tissue or body cavities
In adults known as anasarca |
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Non-immune Hydrops Fetalis:
CV Causes (4 examples) |
CV malformations: anything causing high pressure in RV/RA
ex: tricuspic atresia, pulm valve atresia, premature closure of DA or FO Manifests as tachyarrhythmias, high output failure |
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Non-immune Hydrops Fetalis:
Chromosomal Causes |
Turner (45XO)--may also have nuchal cystic hygroma (due to abnl lymph drainage; cause of webbed neck)
Trisomy 21, 18 |
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What is a nuchal cystic hygroma?
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Abnl lymph drainage in neck; can cause webbed neck appearance in Turner's Dz
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Hydrops Fetalis:
Hemolytic Causes (Immune and Non-Immune) |
Immune:
Rh incompatibility (Erythroblastosis fetalis) ABO incompatibility Non-immune: Hg-opathies Membrane defects Enzyme Dz |
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What is eryhtroblastosis fetalis?
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Rh- mother develops IgG Ab's to D antigen on fetal cells; cross placenta and hemolyze fetal RBCs (firstborn spared)
Fetus develops hemolytic anemia |
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What is kernicterus? How does it occur?
Effects? Who is affected by this? |
Kernicterus is a rare neurological condition that occurs in some newborns with severe jaundice
Inability of newborn to conjugate bilirubin-->increase in unconj'd bilirubin (injures brain; esp BS and BG)-->CEREBRAL PALSY SEEN IN BABIES WITH ERYTHROBLASTOSIS FETALIS |
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ABO Incompatibility:
Under what circumstances would a fetus develop hyrdops? |
Type O mothers with A or B fetus in which IgG anti-A or anti-B cross placenta.
Usually produce IgM which don't cross placents, but sometimes IgG produced even without prior sensitization (CAN AFFECT NEWBORN). Type A or B moms have predominantly IgM Ab's which don't cross placenta. |
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What is Hemoglobin S and does it cause hydrops?
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Hg S = sickle Hg; not a problem for hydrops bc of protective effect of Hg F (not switched to S until near birth)
Not a problem is mother is Hg S either. |
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alpha-thalassemia:
Gene deletions and traits. |
Hb A not properly developed
1 alpha gene deleted: no anemia, nl RBCs (HbA)--silent carrier 2 genes: mild anemia, HbA (Hb B5-10%), Thal trait 4 genes deleted: DEATH in utero--severe anemia; HYDROPS |
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A hydropic fetus is born to a --/-a mother and a aa/-- father.
What are the traits of its parents and what deletions are present in the fetus? |
Mom: --/-a (3 deletions: HgH)
Father: aa/-- 2 deletions (Thal trait) Fetus ended up with 4 deletions |
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What populations are most vulnerable to hydropic alpha-thal?
Which are least vulnerable? |
Southeast asian populations most vulnerable
Does not occur in fetuses of Mediterranean or African heritage (always have at least one alpha-gene on each allele) |
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What is MCV? When should a woman be screened for alpha-thal according to MCV?
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MCV = mean cell (or corpuscular) volume; avg RBC volume
If SE ASIAN and MCV below 75, need to study mother and father of baby, to check for alpha-thal. |
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When does Hb H disease occur?
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Three alpha-thal deletions
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Infectious causes of hydrops fealits
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CMV
Parvovirus (transmitted from mother), known as Fifth Dz in children |
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Fifth Disease
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AKA Erythema infectiosum (parvovirus): rosy cheeks in children
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Rapidly dividing cell lines located in _____ are infected by this virus.
What populations are affected? |
Parvovirus infects rapidly dividing cell lines, esp ones in bone marror (esp erythroid progenitor cells).
Not important in the immunocompetent. Affects sicklers and other hemolytic disorders. |
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In fetal hydrops, where are nuclear inclusions of parvovirus likely to be seen?
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Liver, lung, heart; less so in placenta.
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