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Question 1
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Which of the following will require Anti-D administration post partum?
Your Answer: Rhesus negative mother, non-sensitised, fetal cord blood Rh positive
Explanation:Rhesus positive mothers should not get anti-D. They have Rhesus antigens and the anti-D would result in maternal blood being bound and removed from her circulation. The danger is to children born to mothers who are rhesus negative. As the mother may develop antibodies against Rhesus positive fetal blood. Therefore if the baby is Rhesus negative then there is no risk of alloimmunisation (sensitisation)
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This question is part of the following fields:
- Immunology
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Question 2
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You see a patient in antenatal clinic who is concerned that she has never had chicken pox and may catch it during pregnancy. You check her Varicella status and she is non-immune. She asks you about vaccination. What type of vaccine is the varicella vaccine?
Your Answer: Attenuated
Explanation:Varicella is a live vaccine. The recent RCOG green top guidelines suggest vaccine can be considered postpartum or pre pregnancy but NOT whilst pregnant. In the non-immune pregnant woman they should be advised to avoid contact with people with chickenpox or shingles and to contact a healthcare professional promptly if exposed. If they have a significant exposure VZIG should be offered as soon as possible.
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This question is part of the following fields:
- Immunology
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Question 3
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Question 4
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Which Immunoglobulin (or antibody) is secreted in large amounts in breast milk?
Your Answer: IgA
Explanation:When considering immunoglobulins in neonates. There are only a few key points you are likely to be tested on. 1. IgA is resistant to stomach acid and found in large amounts in breast milk. 2. IgG is the only Ig that can cross the placenta so is key for passive neonatal immunity 3. When the neonate starts synthesising its own Ig it is IgM that is produced first.
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This question is part of the following fields:
- Immunology
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Question 5
Incorrect
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Fetal immunoglobulin production begins at what gestation?
Your Answer: Week 32
Correct Answer: Week 10
Explanation:Fetal production of immunoglobulin begins early on, at about 10 weeks gestation with the production of IgM antibodies. Maternal IgG, which is a key component of fetal immunity, is passed on to the foetus through the placenta from 12 weeks of gestation. Secretory IgA is not produced until after birth.
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This question is part of the following fields:
- Immunology
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Question 6
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Which immunoglobulin provides passive immunity to the neonate?
Your Answer: IgG
Explanation:Passive immunity to the neonate is provided by immunoglobulin G (IgG) since it can be transferred through the placenta from mother to the foetus.
IgA is transferred from mothers to offspring through breast milk.
IgM molecular structure is too big to be filtered through the placental vasculature to the foetus. IgM is the first Ig to be synthesised by the neonate -
This question is part of the following fields:
- Immunology
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Question 7
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Question 8
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Question 9
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Question 10
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