Blood Bank BOC (3 Physiology and Pathophysiology)

Based upon Kleihauer-Betke test results, which of the following formulas is used to determine the volume of fetomaternal hemorrhage expressed in mL of whole blood?

% of fetal cells present X 50

The results of a Kleihauer-Betke stain indicate a fetomaternal hemorrhage of 35ml of whole blood. How many vials of Rh immune globulin should be given?

3

An obstetrical patient has had 3 previous pregnancies. Her first baby was healthy, the 2nd was jaundiced at birth and required an exchange transfusion, while the 3rd was stillborn. Which of the following is most likely the cause?

Rh incompatibility

These laboratory results were obtained on maternal and cord blood samples: Mother: A- Baby: AB+, DAT: 3+ cord hemoglobin: 10 g/dl (100 g/l) Does the baby have HDN?

Yes, the DAT and cord hemoglobin level both support HDN

Rh immune globulin administration would NOT be indicated in an Rh-negative women who has a (n):

anti-D titer of 1:4,096

HLA antigen typing is important in screening for:

A kidney donor

Which unit should be selected for exchange transfusion if the newborn is group A, Rh-positive and the mother is group A, Rh-positive with anit-c?

A, CDe/CDe

A blood component used in the treatment of hemophilia A is:

Factor VIII (8) concentrate

Rh-Immune Globulin is requested for an Rh-negative mother who has the following results: Mothers postpartum sample: D: 0 D control: 0 Weak D: 1+(mixed field) Weak D control: 0 What is the most likely explanation?

Mother had a fetomaternal hemorrhage of D+ cells

Criteria determining Rh immune globulin eligibility include:

Mother has not been previously immunized to the D antigen

What is the most appropriate interpretation for the laboratory data given below when an Rh-negative women has an Rh-positive child? Rosette fetal screen using enzyme treated D+ cells Mothers sample: 1 rosette/ 3 fields Positive control: 5 rosettes/ 3 fields Negative control: No rosettes observed

Mother needs 1 vial of RhIg

A 40 year old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL (108 g/L). This patient will most likely be treated with:

No transfusion

A blood specimen from a pregnant woman is found to be group B, Rh-negative and the serum contains anti-D with a titer of 512. What would be the most appropriate type of blood to have available for a possible exchange transfusion for her infant?

O, Rh-negative

Anti-E is identified in a panel at the antiglobulin phase. When check cells are added to the tubes, no agglutination is seen. the most appropriate course of action would be to:

Quality check the AHG reagent and check cells and repeat the panel

When the main objective of an exchange transfusion is to remove the infants antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:

RBC suspended in fresh frozen plasma

ABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that:

Rh HDFN is clinically more severe than ABO HDFN

The rosette test will detect a fetomaternal hemorrhage (FMH) as small as:

10 mL

A Kleihauer-Betke stain of a postpartum blood film revealed 0.3% fetal cells. What is the estimated volume (ml) of the fetomaternal hemorrhage expressed as whole blood?

15

An acid elution stain was made using a 1-hour post-delivery maternal blood sample. Out of 2,000 cells that were counted, 30 of them appeared to contain fetal hemoglobin. It is the policy of the medical center to add 1 vial of Rh immune globulin to the calculated dose when the estimated volume of hemorrhage exceeds 20 mL of whole blood. Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances.

4 (fetal cells counted/cells counted) X (maternal blood volume)

A group A, Rh positive infant of a group O, Rh-positive mother has a weakly positive direct antiglobulin test and a moderately elevated bilirubin 12 hours after birth. The most likely cause is:

ABO incompatibility

The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid:

Change in optical density measured at 450 nm

The following results are seen on a maternal postpartum sample: Mothers postpartum sample: D: 0 D control: 0 Weak D: 1+ (mixed field) Weak D control: 0 The most appropriate course of action is to:

Investigate for a fetomaternal hemorrhage

To prevent graft-vs-host disease, RBCs prepared for infants who have received intrauterine transfusions should be;

Irradiated

A patient in the immediate post bone marrow transplant period has a hematocrit of 21%, The red cell product of choice for this patient would be:

Irradiated (Bone marrow transplant patients are at risk for transfusion-associated graft-vs-host disease and therefore should receive irradiated blood products)

ABO-hemolytic disease of the newborn:

Is usually seen only in the newborn of group O mothers

Which of the following antigens is MOST likely to be involved in hemolytic disease of the newborn?

Kell

Blood selected for exchange transfusion must:

Lack red blood cell antigens corresponding to maternal antibodies.