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  #1  
Old 03-02-2012
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Blood The cause of this neonatal anemia!

A 2950-g (6.5-lb) black baby boy is born at home at term. On arrival at the hospital, he appears pale, but the physical examination is otherwise normal. Laboratory studies reveal the following: mother’s blood type A, Rh-positive; baby’s blood type O, Rh-positive; hematocrit 38%; and reticulocyte count 5%.
Which of the following is the most likely cause of the anemia?
a. Fetomaternal transfusion
b. ABO incompatibility
c. Physiologic anemia of the newborn
d. Sickle-cell anemia
e. Iron-deficiency anemia

please give reason along
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  #2  
Old 03-03-2012
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physiologic jaundice is the most likely diagnosis

A.) B.) are unlikely

C.) sickle cell anemia: the presentation did not give other symptoms
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Old 03-03-2012
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C.........?
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Old 03-03-2012
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c. Physiologic anemia of the newborn
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  #5  
Old 03-03-2012
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Default Physiologic

Physiologic Anemia... any other choice will cause Jaundice, but his PE is Normal apart of anemia !
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Old 03-04-2012
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What is Physiological Anemia of the newborn? And if it is physiological, why is the retic count so high? :S

I thought ABO incompatibility because sickle cell doesn't seem right... the baby is otherwise normal... I'd expect some signs of sickling - manifesting as pain > crying or fever etc.

What about his African-American race? Or is that just to confound? I was looking for G6PD deficiency before reading the options but Sickle cell anemia is also seen in African Americans.
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Old 03-04-2012
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ABO incompatibility can be slighlty severe in african americans when mommy is 'O' and baby is 'A/B'. but this is the other way round.. so am not sure if this is the right ans.. but in exam i would go with this...
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Old 03-04-2012
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is there a thing called physiological anemia of new born??? dnt thnk so....i think its abo incompatibility....
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Old 03-04-2012
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Default i think it is c

reticulocytic count isnt high in this case as it is normally between 2.5% to 6.5% in newborns and this drops after 2 weeks to the usual values in addition Infants are born with high levels of hemoglobin and RBCs in their blood. After birth, the baby's hemoglobin level normally drops to a low point at about 2 months of age, a condition known as physiologic anemia of infancy. After this occurs, the infant's body gets the signal to increase RBC production. This temporary and expected drop in the blood count (called physiological anemia of the newborn) is considered normal and no treatment is needed.
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Old 03-04-2012
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retic upto 8 in new born is okay.
physiologic anemia is not at birth, around 2 months.
sickle cell anemia at 6 months.
IDA usually at 12 months [nutrional deficits]
mother A and baby O does not contribute to ABO incompatibility
so left with fetomaternal transfusions which is in fact the answer..

here is the explanation from Kaplan Qbank

The absence of a major blood group incompatibility and the finding of a normal reticulocyte count argue strongly in favor of a recent fetomaternal transfusion, probably at the time of delivery.

what say?
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Old 03-04-2012
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Sickle cell does not give manifestation directly after birth it takes few months till the HBF decrease.
What is the physiologic anemia of the newborn.
I think this can not be ABO incompatibilty as the mother is O and the newborn is A.
From the options above I would chose Fetomaternal Hemorrhage ( explains increased Reticulocytes ).
This is the only mentioned etiology that can increase the Retics.
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  #12  
Old 03-04-2012
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Physiologic anemia is after first 24 hrs in Newborn uptil first week in fullterm n upto 2nd week in preterm...

the timing is not specified but if the child was brought within a week to the hospital it should be then ans.
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  #13  
Old 03-04-2012
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and also the retic count 5% here as it indicates .....that baby is within first two weeks ...(assuming that baby is otherwise normal due to Normal examination and lab findings)... therefore physiologic jaundice alone is the right answer....

coz neonate has it.... end of discussion folks...

please post some new questions in Biostat guys...
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Old 03-05-2012
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Quote:
Originally Posted by dr.dhruvdesai View Post
and also the retic count 5% here as it indicates .....that baby is within first two weeks ...(assuming that baby is otherwise normal due to Normal examination and lab findings)... therefore physiologic jaundice alone is the right answer....

coz neonate has it.... end of discussion folks...

please post some new questions in Biostat guys...
dude, tyagee has posted answer.. It's fetomaternal transfusion. It's not jaundice-it's anemia.
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  #15  
Old 03-05-2012
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o dude...thanks on that one...i misread the question...

NIce question...all credits to tyagee n u guys

i'm sorry
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  #16  
Old 03-05-2012
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what exactly is feto maternal transfusion ?

wat happens in it ?...i mean the pathophysio of it...
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