should we give RhoGAM or not ? - 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 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 03-26-2014
MedicalExaminer's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 824
Threads: 66
Thanked 463 Times in 298 Posts
Reputation: 473
Default should we give RhoGAM or not ?

if mother is already sensitized to Rh antigens do we still give RhoGAM ?
i know that we should not
but here i faced a question in uw
young female Rh- at 10wks gestation develops inevitable abortion her serum antibody titer is 1:2 what should we do next ?

how do we interpret this value ?
__________________
Everything is possible for him who believes (MARK 9:23)
245/247/passed on 1st attempt/223/2mos Obsie /3 US LORS/visa not needed/2008 grad
Reply With Quote Quick reply to this message



  #2  
Old 03-26-2014
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 171
Threads: 67
Thanked 20 Times in 18 Posts
Reputation: 30
Default

Quote:
Originally Posted by MedicalExaminer View Post
if mother is already sensitized to Rh antigens do we still give RhoGAM ?
i know that we should not
but here i faced a question in uw
young female Rh- at 10wks gestation develops inevitable abortion her serum antibody titer is 1:2 what should we do next ?

how do we interpret this value ?

it means very little amount of antibody is there , titer of 1:2 means that we need to titrate it only 2 times to get rid of antibody , while if for example it was 1:9 it means we have to titrate it 9 times to get rid of antibodies ,

and weather to give anti rho if she is already has AB , what you said is true , we don't have to give it ,
Reply With Quote Quick reply to this message
The above post was thanked by:
MedicalExaminer (03-27-2014)
  #3  
Old 03-26-2014
MedicalExaminer's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 824
Threads: 66
Thanked 463 Times in 298 Posts
Reputation: 473
Default

thanks for explanation
but here i have some confusion about mtb
still on interpretation of values

http://cubeupload.com/im/t8ZsME.jpg
__________________
Everything is possible for him who believes (MARK 9:23)
245/247/passed on 1st attempt/223/2mos Obsie /3 US LORS/visa not needed/2008 grad
Reply With Quote Quick reply to this message
  #4  
Old 03-26-2014
MedicalExaminer's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 824
Threads: 66
Thanked 463 Times in 298 Posts
Reputation: 473
Default

if the patient with 1:4 is considered sensitized
any value above it would be managed without RhoGAM am i correct ?
__________________
Everything is possible for him who believes (MARK 9:23)
245/247/passed on 1st attempt/223/2mos Obsie /3 US LORS/visa not needed/2008 grad
Reply With Quote Quick reply to this message
  #5  
Old 03-26-2014
beka-CTS's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 763
Threads: 77
Thanked 1,338 Times in 347 Posts
Reputation: 1348
Default

If mother has titer more or equal to 1:6 she is considered to be sensitized and rhogamm is not given.

Uw qid:2543

I would trust uw than mtb ..uw question was updated in october 2013 .

So. If mother has titer of 1:4 administer rhogamm.

Reply With Quote Quick reply to this message
The above post was thanked by:
MedicalExaminer (03-27-2014)
  #6  
Old 03-26-2014
DrAGA's Avatar
USMLE Forums Guru
 
Steps History: Step 1 Only
Posts: 340
Threads: 46
Thanked 148 Times in 85 Posts
Reputation: 158
Default

i didnt get.. so if it less then 1:4 give rhogam ...but if its [COLOR="Red"]less then 1:16 no treatment? and when its [COLOR="Red"]more then 1:16 serial amniocentesis?

WHAT IS MEAN/ ANYBODY CAN EXPLAIN ME PLEASE
Reply With Quote Quick reply to this message
  #7  
Old 03-27-2014
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 206
Threads: 13
Thanked 177 Times in 76 Posts
Reputation: 187
Default

Quote:
Originally Posted by DrAGA View Post
i didnt get.. so if it less then 1:4 give rhogam ...but if its [COLOR="Red"]less then 1:16 no treatment? and when its [COLOR="Red"]more then 1:16 serial amniocentesis?

WHAT IS MEAN/ ANYBODY CAN EXPLAIN ME PLEASE
The 1:x way of quantifying how much antibody someone has ( 1:4 or 1:6 or 1:16 etc) just means the amount of times their sample of plasma can be diluted before the antibody is no longer detectable. For example, if your anti-Rh antibody titre was 1:4, it means your plasma can be diluted down to a solution of 1 part plasma 4 parts water before the anti-Rh is no longer detectable. If your titre was 1:16, it can be diluted down by a factor of 16 before its no longer detectable, so there is a much higher concentration of anti-Rh antibody in someone with a titre of 1:16 than 1:4.

Basically the higher the second number in the fraction, the more antibody is present.

For the problem of rhesus sensitization in Rh negative mothers, a mother is considered to be "sensitized" if her anti-Rh titre is more than 1:6. If her titre is anything less than this (1:4, 1:2 etc) then she has a small enough concentration of anti-Rh antibody to be considered unsensitized, and needs to be given RhoGAM after any time there is a risk of her being exposed to Rh antigens. If her anti-Rh titre is more than 1:6, then there is no point in giving RhoGAM as she already has developed a lot of anti-Rh antibodies.

If the titre is more than 1:16, then there is a very high concentration of anti-Rh antibodies, and the pregnancy needs to be monitored v closely if the baby is Rh positive, as there is a high risk of fetal hemolysis (which could be detected by eg serial amniocentesis looking for bilirubin etc)
Reply With Quote Quick reply to this message
The above post was thanked by:
abbas.rz (03-28-2014), DrAGA (03-27-2014), MedicalExaminer (03-27-2014), sami trailer (03-31-2014)



Reply

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
RhoGam ohbunnie USMLE Step 2 CK Forum 0 03-18-2013 01:22 AM
RhoGAM Dyke USMLE Step 2 CK Forum 4 08-02-2012 12:24 PM
Rhogam aghammoud85 USMLE Step 2 CK Forum 1 08-09-2011 01:40 PM
RHoGAM prophylaxis at 28 ? kemoo USMLE Step 2 CK Forum 2 07-21-2011 10:20 AM
When to give IV fluids and when to give blood for a bleeding pregnant patient Katharina USMLE Step 2 CK Forum 3 06-11-2010 05:35 AM

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)