Neonatal Jaundice and Microspherocytes - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-20-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
RBC Neonatal Jaundice and Microspherocytes

An infant is born at full term. The cord blood has a hematocrit of 37% and a bilirubin of 6 mg/dL. By 10 hours after birth, the infant has developed noticeable jaundice with a bilirubin concentration of 8 mg/dL. A peripheral blood smear demonstrates a predominance of normally shaped erythrocytes admixed with many microspherocytes and reticulocytes. The direct Coombs test is weakly positive. Which of the following is the most likely cause of the infant's problems?

A. ABO incompatibility
B. Beta-thalassemia
C. Congenital spherocytosis
D. Glucose-6-phosphate-dehydrogenase deficiency
E. Sickle-cell anemia
Reply With Quote Quick reply to this message



  #2  
Old 07-20-2011
Mashee's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 147
Threads: 9
Thanked 99 Times in 61 Posts
Reputation: 109
Default

A. ABO incompatibility
Reply With Quote Quick reply to this message
  #3  
Old 07-21-2011
USMLE Forums Guru
 
Steps History: Not yet
Posts: 417
Threads: 74
Thanked 129 Times in 93 Posts
Reputation: 139
Default

Quote:
Originally Posted by Mashee View Post
A. ABO incompatibility
yes i agree, cuz most common cause of jaundice in 1st 24 hours is ABO incompatibility .. biggest clue in the stem :P
Reply With Quote Quick reply to this message
  #4  
Old 07-21-2011
USMLE Forums Master
 
Steps History: Not yet
Posts: 674
Threads: 264
Thanked 959 Times in 393 Posts
Reputation: 969
Send a message via Yahoo to ricko335
Correct Answer Answer

CORRECT ANSWER ABO INCOMPATIBLITY
The combination of rapidly rising bilirubin, jaundice, and anemia, with a positive direct Coombs test, suggests an immune hemolytic anemia, in this case due to ABO incompatibility. ABO incompatibility leading to fetal anemia is much less common than Rh incompatibility leading to fetal anemia. In almost all cases, the mother is blood group O, and the infant is A or B. Of the two variants, anti-A disease is more common and milder, whereas anti-B disease is more likely to cause severe hemolytic disease. Unlike Rh incompatibility, true hydrops fetalis and death in utero are rarely seen. Affected infants usually have a relatively mild anemia, but present with postnatal hyperbilirubinemia that may be severe enough to damage the brain (kernicterus). The direct Coombs test, which measures antibody brought in-vivo to the red cells, is usually weakly positive but can occasionally be negative. (Its negativity does not necessarily exclude the diagnosis if other features are compatible.) Microspherocytes are small red cells that have antibody-coated portions of red cell membrane clipped off by the spleen; reticulocytes are immature red cells. Infants with clinically significant ABO blood group incompatibility are managed clinically in the same way as infants with Rh compatibility. They may or may not require exchange transfusion, depending on the severity of their problems
Reply With Quote Quick reply to this message
The above post was thanked by:
curiousmind (08-11-2012), Noa2013 (07-17-2014), pass7 (07-21-2011), tomymajor (07-24-2011)
  #5  
Old 07-22-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 24
Threads: 6
Thanked 4 Times in 4 Posts
Reputation: 14
Idea! abo inompatibility

the + coombs test gives the hint
Reply With Quote Quick reply to this message
  #6  
Old 07-22-2011
USMLE Forums Scout
 
Steps History: ---
Posts: 31
Threads: 3
Thanked 6 Times in 6 Posts
Reputation: 16
Default

a- ABO Incompatibility
Reply With Quote Quick reply to this message



Reply

Tags
Hematology-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Neonatal Perinatal Medicine Fellowship without Residency DrAkash IMG/FMG Forum 4 06-19-2011 05:43 PM
Causes of neonatal meningitis Krishna USMLE Step 1 Forum 3 01-24-2011 12:07 AM
Neonatal Withdrawal Syndromes: Opiates versus Cocaine rasheed USMLE Step 2 CK Bits & Pieces 0 03-19-2010 11:18 PM
Neonatal Vomiting Sarah-cali USMLE Step 1 Forum 13 12-25-2009 03:22 PM
Neonatal conjunctivitis jessp687 USMLE Step 1 Forum 2 10-23-2009 06:47 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)