13: Splenic Disorders

Question 1

Red vs White pulp in spleen

Answer 1

Red: sinusoids filled with blood, filters abnormal RBCs and platelets
White: consists of marginal zone, PALS, and primary follicle

Question 2

Describe the three zones of the white pulp

Answer 2

1. Marginal zone: macrophages clear debris
2. PALS: T cells
3. Primary follicle: B cells + Ab production

Question 3

Most common cause of splenomegaly in America

Answer 3

Congestive state related to portal hypertension (from cirrhosis, vein thrombosis, or cardiac failure)

Question 4

Splenomegaly vs hypersplenism

Answer 4

1. Splenomegaly: enlarged spleen, can be active or passive

2. Hypersplenism: RBCs removed by spleen, causing splenomegaly

Question 5

Point where you could feel an enlarged spleen on the abdomen

Answer 5

Castell’s point

Question 6

When can a child with mono return to non contact and contact sports?

Answer 6

Non-contact: 3 weeks from sx onset

Contact: 4 weeks from sx onset

Question 7

Three things to do during a splenectomy

Answer 7

1. Take down attached ligaments (gastrosplenic s, etc.)
2. Ligate splenic A then splenic V
3. Avoid the pancreatic tail

Question 8

Three bacteria to get immunized against as a patient without a spleen

Answer 8

1. Streptococcus pneumoniae
2. Neisseria meningitis
3. Haemophilus influenzae B

Question 9

What are Howell Jolly Bodies?

Answer 9

Retained DNA in RBCs that were not removed by the spleen in hyposplenia/post-splenectomy