ABD Board-Spleen

Question 1

location of spleen

Answer 1

peritoneal organ

lt upper quandrant

between stomach and diaphragm

Question 2

spleen delivers

Answer 2

antigens to the immune system

Question 3

measurment of spleen

Answer 3

12cm long

8cm tran

4cm thick

Question 4

splenomegaly indicated with long measurement > than

Answer 4

12cm

Question 5

organs located on visceral surface of the spleen

Answer 5

stomach

left kidney

pancreas

splenic flexure of the colon

Question 6

what is located medial to the splenic hilum

Answer 6

fundus of stomach

lesser sac

pancreatic tail

Question 7

the left kidney lies ____ and ____ to the spleen

Answer 7

inferior and medial

Question 8

the pancreatic tail is located _____ to the upper pole of the left kidney in the splenic hilum

Answer 8

anterior (ventral)

Question 9

normal varient that is commonly found with spleen

Answer 9

accessory spleen

may be confused with enlarged lymph node or mass in tail of pancreas

Question 10

accessory spleens are usually ____ in diameter and located ____

Answer 10

5cm

splenic hilum

Question 11

focal lesions resulting from previous infections

Answer 11

splenic cacifications

bright with or without shadowing

Question 12

other splenic cacification can be associated with

Answer 12

splenic artery wall cacifications (diabetic)

splenic artery aneurysms cacifications

pneumocystis carinii infection

splenic infarcts

Question 13

splenic cysts

Answer 13

autosomal dominant polycystic disease

hydatid cysts

liquified infarcts or hematomas

pancreatic psuedocysts

Question 14

true cysts lined by squamous epithelium. appear as solitary cysts averaging 10 cm in size. The wall may be calcified and the internal contents may appear echogenic

Answer 14

epidermoid cysts

Question 15

can erode into the spleen due to their proximity. May weaken vessels causing psuedoaneurysms and bleeding into the pseudocyst

Answer 15

pancreatic pseudocysts

Question 16

primary neoplasms of the spleen are

Answer 16

rare

Question 17

most common benign primary neoplasm of the spleen

Answer 17

hemangiomas

Question 18

______ ______ more frequently metastasizes to the spleen followed by breast and lung cancer

Answer 18

malignant melanoma

Question 19

appearance of metastatic lesions of the spleen

Answer 19

may vary but are commonly hypoechoic

Question 20

common in patients with bacterial endocarditis and splenic artery aneurysms

Answer 20

splenic infatct

peripheral wedge shaped hypoechoic lesion

with necrosis and liquification the area will appear anechoic and ultimately will calcify

Question 21

may result in sepsis due to endocarditis, dental infections or urosepsis

Answer 21

splenic abscess

Question 22

appearance of splenic abscess

Answer 22

complex cystic lesions

gas may produce echogenic foci with reverberation (comet tail)

Question 23

due to mutant hemoglobin S resulting in sickling of the red blood cells

Answer 23

sickle cell disease

Question 24

complications of sickle cell

Answer 24

anemai (decreased RBC’s/hemoglobin)

infection (decreased immunity)

acute chest syndrome (decreased O2 sat)

pain (vascular occlusion and inchemia)

stroke (TCD monitoring)

cholecystitis (due to chronic hemolysis)

pulmonary hypertension

Question 25

with sickle cell the spleen begins to enlarge at the end of the first year of life. The spleen remains enlarged although due to splenic sequestration (pooling of sickled cells) and repeated infarction, over time, the spleen becomes fibrotic and shrinks (autosplenectomy) typically before the end of childhood

Answer 25

that sucks!!!!

Question 26

most common reason leading to splenomegaly

Answer 26

congestive (portal hypertension andn splenic vein thrombosis)

Question 27

other reasons for splenomegaly

Answer 27

immune response (bacteroa; emdpcardotos and omfectious mononucleosis)hypertrophy

RBC destruction hypertrophy (hereditary spherocytosis and thalassemia major)

myeloproliferative (chronic myeloid metaplasia)

infiltrative (sarcoidosis)

neoplastic (chronic lymphocytic leukemia and lymphoma)

Question 28

when spleen enlarges is does not extend in the ___ and ___ directions

Answer 28

posterior

lateral

Question 29

blood disorder resulting in uncontrolled RBC production causing hyperviscosity and hypercoagulation*.

Answer 29

polycythemia vera

Question 30

polycythemia vera may be the cause of

Answer 30

splenomegaly

budd chiari syndrome

portal vein thrombosis

splenic infarcts

Question 31

typically a calcified circle is seen in the left upper quadrant on x ray and this is suspected

Answer 31

splenic artery aneurysm

Question 32

appearance of splenic artery aneurysm

Answer 32

may appear as a cystic mass or if calcified a hyperechoic shadowing foci usually in the area of the hilum

Question 33

two classifications of heterotaxia (situs ambiguous/inversus)

Answer 33

polyspenia

asplenia

Question 34

left dided predominance associated with:

multiple LUQ spleens

biliary atreasia(absent GB)

intestinal malrotation

azygous continuation of unterrupted IVC (70%)

cardiac depects

Answer 34

polysplenia

Question 35

right sided predominance, associated with:

absent spleen

midline liver and GB

intestinal malrotation

reversed positions of aorta and IVC

cardiac defects

Answer 35

asplenia

Question 36

with splenic trauma the subcapsular or intraparenchymal hematomas results when the splenic casule

Answer 36

remains intact

Question 37

perisplenic or intraperitoneal hematomas results with the capsule

Answer 37

ruptures

Question 38

focused assessment with sonography for trauma (fast)

Answer 38

done in ER checks for free fluid in peritoneal cavity

looking for trauma damage and blood/fluid

Question 39

blood spillage outside the circulatory system will result in a _____ hematocrit

Answer 39

decreased

hematocrit is the volume of red blood cells found in 100ml of blood

Question 40

history of splenic rupture or surgery on spleen, cells may implant throughout the peritoneal cavity (autotransplantation) resulting in an ectopic spleen

Answer 40

posttraumatic splenosis