Ch 15 Spleen test Flashcards

1
Q

Which one of the following statements about the spleen is false?

a. The spleen lies inferior to the diaphragm.
b. The normal adult spleen measures approximately 7 cm in width.
c. The spleen is located within the retroperitoneum.
d. The spleen lies in the posterior to the hypochondrium.

A

C

The spleen is an intraperitoneal structure covered with peritoneum except at the hilum.

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2
Q

Lymph nodes emerge from the splenic hilum and course along the:

a. Renal vein
b. Splenic artery
c. Renal artery
d. Splenic vein

A

B

Lymph nodes emerge from the splenic hilum and course along the splenic artery and drain into the celiac nodes

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3
Q

Splenomegaly may result from all of the following except:

a. Trauma
b. Congestion
c. Subphrenic abscess
d. Collagen vascular disease

A

C
A left subphrenic abscess could displace the spleen but would not enlarge it. Causes for splenomegaly include collagen vascular disease, hematopoiesis, hemolytic anemia, infection, neoplasm, storage disease, and trauma.

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4
Q

An abnormal decrease in platelets may be the result of a(n):

a. Infection
b. Bone marrow disorder
c. Internal hemorrhage
d. Allergic reaction

A

C

Thrombocytopenia is an abnormal decrease in platelets, which may be the result of internal bleeding

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5
Q

The normal sonographic appearance of the splenic parenchyma is:

a. Homogeneous and similar to the liver
b. Heterogeneous
c. Hyperechoic compared with the liver
d. Hypoechoic compared with the kidney

A

A
The sonographic appearance of the splenic parenchyma should demonstrate a fine, homogeneous, low-level echo pattern similar to that of the normal liver.

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6
Q

In the early stages of sickle cell anemia, the spleen generally appears:

a. Atrophied
b. Heterogeneous
c. Enlarged
d. Hyperechoic

A

C
In the early stages of sickle cell anemia, the spleen generally appears enlarged with significant congestion of the red pulp. Later, the spleen undergoes progressive infarction and fibrosis, which causes it to decrease in size.

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7
Q

Which one of the following statements describes the correct anatomic location of structures adjacent to the spleen?

a. The diaphragm is anterior, lateral, and inferior to the spleen.
b. The fundus of the stomach and lesser sac are medial and posterior to the splenic hilum.
c. The left kidney lies inferior and medial to the spleen.
d. The right adrenal and kidney lie superior to the spleen.

A

C

The medial surface of the spleen is related to the left kidney, tail of the pancreas, stomach, and splenic flexure

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8
Q

All of the following are functions of the spleen except:

a. Production of plasma cells
b. Production of lymphocytes
c. Destruction of red blood cells
d. Destruction of white blood cells

A

C
Production of lymphocytes and plasma cells, destruction of white blood cells, and disposal of abnormal erythrocytes are functions of the spleen

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9
Q

Splenic infarction is most commonly the result of:

a. Cardiac emboli
b. Splenomegaly
c. Splenic trauma

A

A
A splenic infarction results from the occlusion of the major splenic artery or its branches. It is almost always the result of emboli that arise in the heart.

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10
Q

The spleen is variable in size and is considered to be all of the following except:

a. Tetrahedral
b. Pentagonal
c. Triangular
d. Orange segment

A

B
The spleen is of variable size and shape (e.g., orange segment, tetrahedral, triangular) but is generally considered to be ovoid with smooth, even borders and a convex superior and concave inferior surface

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11
Q

When accessory spleens are present, they are usually located:

a. At the inferior margin of the spleen
b. On the posterior aspect of the spleen
c. Near the hilum of the spleen
d. Near the kidney

A

C
The most common location of an accessory spleen is in the splenic hilum along the splenic vessels and ligaments. The location of an accessory spleen has been reported anywhere from the diaphragm and scrotum.

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12
Q

The splenic vein courses along the posterior border of the:

a. Spleen
b. Kidney
c. Pancreas
d. Adrenal gland

A

C

The splenic vein travels along the posterior border of the pancreas.

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13
Q

The spleen has two components joined at the hilum; they are the ______________ and ______________ components.

a. Anterior; posterior
b. Superomedial; inferolateral
c. Superior; inferior
d. Superolateral; inferomedial

A

B

The spleen has two components joined at the hilum: they are the superomedial and inferolateral components

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14
Q

Which one of the following may cause a splenic rupture?

a. Complicated cyst
b. Infarction
c. Metastatic tumor
d. Cavernous hemangioma

A

D

Complications of a cavernous hemangioma may include splenic rupture when the tumor increases in size.

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15
Q

. Primary tumors that may metastasize to the spleen originate from all of the following structures except:

a. Kidney
b. Ovary
c. Stomach
d. Brain

A

D
Primary tumors that may metastasize to the spleen originate from the breast, lung, ovary, stomach, colon, kidney, prostate, and melanoma.

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16
Q

. The best patient position to evaluate the spleen is:

a. Supine
b. Left lateral decubitus
c. Left posterior oblique
d. Right decubitus

A

D
To evaluate the spleen, the patient should be rotated into a steep right decubitus position to permit better transducer contact between the ribs without as much bowel interference

17
Q

Other areas that should be examined when ruling out a splenic rupture include all of the following except:

a. Liver and lesser sac
b. Pericardium
c. Pelvis
d. Renal gutter

A

B
The pericardium is located in the pleural cavity. The liver, lesser sac, pelvis, and renal gutter are potential spaces for fluid collection.

18
Q

What sonographic signs are present in the patient with histoplasmosis?

a. Atrophy
b. Cystic masses
c. Adenomas
d. Bright echoes

A

D
Histoplasmosis and tuberculosis are the most common causes of granulocytopoiesis. The sonographic appearance of granulomatosis disease includes bright echogenic lesions with or without shadowing in the splenic parenchyma.

19
Q

Which one of the following symptoms is the most symptom in patients with a splenic hamartoma?

a. Asymptomatic
b. Epigastric pain
c. Abdominal pain
d. Right upper quadrant pain.

A

A

Patients demonstrating a splenic hamartoma are generally asymptomatic.

20
Q

A spleen that has migrated from its normal location is termed:

a. Accessory spleen
b. Wandering spleen
c. Ectopic spleen
d. Splenomegaly

A

B

A “wandering” spleen has migrated from its normal position in the left upper quadrant.

21
Q

The major function of the spleen is:

a. Hematopoiesis
b. To fight infection
c. To manufacture leukocytes
d. To filter the peripheral blood

A

D

The major function of the spleen is to filter the peripheral blood.

22
Q

In the adult, splenomegaly is diagnosed when the length of the spleen exceeds _____ centimeters (cm).

a. 11
b. 12
c. 13
d. 14

A

C

In the adult, splenomegaly is diagnosed when the length of the spleen exceeds 13 cm.

23
Q

Atrophy of the spleen may be found in all of the following except:

a. Normal individuals
b. Wasting diseases
c. Sickle cell anemia
d. Cirrhosis

A

D
Atrophy of the spleen may occur in normal individuals, wasting diseases, sickle cell anemia, and chronic hemolytic anemia.

24
Q

A chronic disease of unknown causes that involves all bone marrow elements is:

a. Thalassemia
b. Polycythemia vera
c. Leukemia
d. Hodgkin disease

A

B
Polycythemia vera is a chronic disease of unknown causes that involves all bone marrow elements. It is characterized by an increase in red blood cell mass and hemoglobin concentration. Infarcts and thromboses are common.

25
Q

Massive splenomegaly is most likely the result of:

a. Infection
b. Leukemia
c. Myelofibrosis
d. Portal hypertension

A

C

Massive enlargement of the spleen is most likely a result of myelofibrosis.