Glossary of HDN
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- What are the 3 types of HDN?
- 1. Rh -> most severe
3. ABO -> most common
- For Rh/ABO, what type is the mother and infant?
- Rh: mom=neg, baby=pos
ABO: Mom=Otype, baby=A or Btype
- How often do Rh/ABO occur in first births?
- Rh = 5%
ABO = 40-50%
- Do Rh/ABO cause stillborn/hydrops?
- Rh = frequent
ABO = rarely
- Do Rh/ABO cause severe anemia?
- Rh = frequent
ABO = rare
- What type of DAT resuults for Rh/ABO?
- Rh = strong pos
ABO = weak or neg
- What type of RBC morphology is seen in Rh or ABO HDN?
- Rh = macrocytic, nRBCs
ABO = spherocytes.
- Do you give Rh/ABO Hdns exchange transfusions?
- Rh = frequently
ABO = infrequently
- Do you give phototherapy to Rh or ABO HDNs?
- Rh = along with exch. transf.
ABO = often it's the only treatment.
so YES to both.
- What is Erythroblastosis fetalis?
-Acceler. RBC destruction
- What 2 things result from SEVERE HDN?
- -Hydrops fetalis
-Cardio failure, tissue hypoxia.
- What is the best indicator of the clinical signif of HDN?
- Cord blood Hb/Hct.
Hb < 13 is mild
Hb < 8 is severe.
- What complication develops from HDN after birth? Why?
-Mom conjugates baby's bili before birth
-Baby liver can't do it after.
- What results from buildup of bilirubin in baby?
Why is this especially bad?
-Can cross into the brain and cause damage b/c BBB undevelopd.
- How do you knwo whether or not to do an exchange transfusion?
- If the indirect bilirubin level is over 20 mg/dL
- Only over 20 mg/dl?
- That's for a healthy 2500 g baby
For a 1250 g baby, if the level is over 9-12
- What tests are required to be done on Cord Blood evaluation?
- -ABO type
- What are 3 main categories of adverse transfusion rxns?
- 1. Immune
- What are 2 categories of immune rxns?
- 1. Recipient vs. Donor
2. Donor vs. Recipient
- what are 4 types of Recip:donor reactions?
- 1. RBC
4. Plasma protein
- What are 2 types of RBC rxtns?
- 1. Acute hemolytic
2. Delayed hemolytic
- Which is worse, acute or delayed?
- What is a distinct symptom of Acute hemolytic anemia?
- Impending doom
- what type of hemolysis is in
- Acute = intravascular
Delayed = extravascular
- what is febrile nonhemolytic transf rxn caused by?
- Recipient's antibodies to donor's WBCs.
- When do you see a febrile reaction?
- at the end of the transfusion.
- How do you treat febrile?
- with tylenol
- What is PTP?
- post transfusion purpora; rare reaction in previously immunized patients; develop an autoantibody and allogeneically destroys platelets.
- What 2 types of reactions occur with platelets?
- 1. Anaphylactic
- What causes anaphylactic reactions?
- IgA reacts with IgA-neg patients.
- What kind of blood should you transfuse to Iga-neg pateints?
- Only washed RBCs.
- What causes urticarial reactions?
- Ab in the recipient to donor's serum proteins.
- What are 2 types of Donor:Recip transf. rxtns?
- 1. GVHD - graft vs host disease
2. TRALI - transfusion related acute lung injury
- What causes GVHD?
- the donor's WBCs recognize recipient as foreign and attack.
- What causes TRALI?
- damage to the microvasculature of lungs by antibodies to the WBCs in recipient.
- What symptoms are associated with TRALI?
- Edema in the lungs, but no heart damage.
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