ESHPLENđź‘˝ Flashcards

1
Q

Which of the following is NOT A LOCATION where accessory spleens can be found?

A. Gastrocolic ligament
B. Gerotas fascia
C. Large bowel mesentery
D. Broad ligament

A

B Gerotas fascia
—-
Descending order

1 hilum (80%)
2 pedicle (80%)
Gastrocolic ligament
Tail
Greater omentum
Greater curvature
Splenocolic ligament
SI and LI mesentery
Left broad ligament
Left spermatic cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

WhichofthefollowingsplenicligamentsisNOTanavas­ cular plane?
A. Gastrosplenic B. Splenocolic
C. Phrenosplenic D. Splenorenal

A

Gastrosplenic has short gastric vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

All of the following are functions of the spleen EXCEPT
A. Clearance of damaged or aged red blood cells (RBCs) from the blood.
B. Extra medullary sitefor hematopoiesis and recycling iron
C. Initiation of adaptive immune response from filtration of lymph
D. Clearance of encapsulated bacteria from the bloodstream

A

C. Not lymph but BLOOD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the ff protein is not altered in Hereditary spherocytosis
A pyruvate kinase
B. Spectrin
C. Ankyrin
D. Band 3

A

D. Band 3
As well s protein 4.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Splenectomy is indicated as a treatment in which ofthe fol­lowing conditions?
A. Cold antibody autoimmune hemolytic anemia
B. Hodgkins disease
C. G6PD
D. Abscess of the spleen

A

D. Abscess of the spleen

—
AIHA- corticosteroids
Hodgkin- MIS
G6PD- drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The disproportionately high rate of overwhelming post­ splenectomy infection (OPSI) in thalassemia patients is thought to be due to an immune deficiency. Which of the following strategies has been shown to reduce mortality?
A. Partial splenectomy.
B. Prophylactic antibiotic therapy.
C.Delaying splenectomy until after 2years of age.
D. Transfusion to maintain a hemoglobin (HGB) of >9 mg/dL

A

A. Partial splenectomy

—-
B. Little evidence
C. 4 yrs old
D. Doesnt reduce complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 30-year-old woman presents to her primary care pro­vider with complaints of bleeding gums while brushing her teeth as well as menorrhagia and several episodes of epistaxis within the past month. She has been previously healthy with no prior medical problems or surgeries. Examination reveals petechiae and ecchymosis over the lower extremities. Laboratory results show white blood cell (WBC) count 7000/mm3, HGB 14 g/dL, hematocrit (HCT) 42%, and platelet count 28,000/mm3 with numer­ ous megakaryocytes on peripheral smear. First-line ther­ apy for this condition would be
A. Oral prednisone
B. IV IG
C. RITUXIMAB
D. Splenectomy

A

A. O prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The MC Physical finding in a px w hairy cell leukemia HCL

A. Massive splenomegaly
B. Shortness of breath
C. Abdominal pain
D. Joint pain

A

A. Massive splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which of the following is an indication for splenectomy in a patientwith chronic myelogenous leukemia (CML)?
A. Failure of chemotherapy to decrease splenomegaly
B. Sequestration requiring transfusion
does N I comut Hel
C. Symptomatic relief of early satiety
D. Presence of bcr gene mutation

A

C symptomatic relief of early satiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following is an indication for splenectomy in polycythemia vera (PV) ?
A. Failure of aspirin to prevent thrombotic complications
B. Frequent need for phlebotomy
C. Symptoms related to splenomegaly
D. Prevention ofprogression to myeloid metaplasia

A

C. Symptoms related to splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following is the most common etiology of splenic cysts worldwide?
A. Bacterial infection
B trauma
C parasitic infx
D congenital anomaly

A

C. Parasitic inf (like echinococcus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following is an indication for surgical tx of a splenic aneurysm
A. Pregnancy
B. >2.0 cm
C. History of thrombocytopenia
D. History of neutropenia

A

A. Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A 45-year-old man presents to the emergency depart­ ment with emesis of bright red blood. Laboratory results include HGB 10 g/dL, HCT 30%, platelets 300,000/mm3, international normalized ratio (INR) 1 .0, aspartate trans­ aminase (AST) 30 U/L, alanine transaminase (ALT) 45 U/L, and albumin 4.0 g/dL. After appropriate resusci­ tation he undergoes esophagogastroduodenoscopy (EGD) which is notable for gastric varices. What is the appropriatetreatmentforhiscondition?
A. Transjugular intrahepatic portosystemic shunt B. Variceal band ligation
C. Splenorenal shunt.
D. Splenectomy

A

D. Splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which ofthe following is NOT part ofthe triad seen with FELTY SYNDROME
A. RA
B. SPLENOMEGALY
C. NEUTROPENIa
D. Thrombocytopenia

A

D. Thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common complication following open
splenectomy?
A. Pancreatitis
B. Left lower lobe atelactasis
C. Pleuraleffusion
D. Wound infection

A

B. LLL atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which of the following patients is at highest risk for OPSI?

A. A30-year old who underwent splenectomy for ITP.

B. A25-year old who underwent splenectomy for iatrogenic­ bleeding after a total colectomy.
C. A3-yearold who underwent splenectomy for heredi­Tary spherocytosis.
D. A 4-year old who underwent splenectomy due to Bleeding aftera motor vehicle crash

A

C. 3 yr old splenectomy for HS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which of the following asplenic patients should receive prophylactic antibiotic therapy to protect against 0PSI?
A. A35-year-old man undergoing a tooth extraction.
B. A4-year old child who recently underwent plenectomy.
C. A 15-year-old boy who underwent splenectomy at age 13.
D. There is little evidence supporting efficacy ofprophy­lactic antibiotics.

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

More than 80% of accessory spleens are found in the splenic hilum. What is the
common location for an accessory spleen?

A. The greater omentum
B. The gastrocolic ligament
C. The tail of the pancreas
D. The splenocolic ligament

A

B. Gastrocolic ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which of the following is the primary function of the spleen in humans?
A. Production of red cells
B. Production of white cells
C. Storage of blood
D.Hostdefense

A

D. Host defense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Approximately what volume of aged red blood cells are removed by the spleen every day?
A. 2 mL
B. 20 ml
C. 100 ml
D. 250 ml

A

B. 20 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In a normal patient what percentage of platelets are sequestered in the spleen?

A. 2%
B. 16%
C. 33%
D.50%

A

C. 33% or 1/3 of platelet pool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

,

Which of the following proteins is abnormal in patients with hereditary spherocytosis?
A. Tuftsin
B. Ankyrin ,
C.Opsonin
D. Properdin

A

B. Ankyrin

Also band 3, protein 4.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Transposition between the bcr gene on chromosome 9 and the abl gene on chromosome 22 is the hallmark of which of the following conditions?
A. Chronic myeloid leukemia
B Chronic myelomonocytic leukemia
C. Acute myeloid leukemia
D. Polycythemia vera

A

A. CML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

. Abnormal storage of sphingomyelin is found in
A. Gaucher’s disease
B. Niemann pick disease
C. Amyloidosis
D. Feltys syndrome

A

B. Neimann pick dse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which of the following is the most common cause of congenital hemolytic anemia?
A. Glucose-6-phosphate dehydrogenase deficiency
B. Pyruvate kinase deficiency
C. Hereditary spherocytosis
D. Hereditary elliptocytosis

A

B pyruvate kinase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

An 18-year-old otherwise healthy woman is incidentally found to have a 2-cm splenic aneurysm of the mid portion of the splenic artery. Which of the following is the treatment of choice for this patient?
A. Observation only
B. Embolization
C. Ligation or resection of the aneurysm
D splenectomy

A

Answer:C. Ligation or resection of aneurysm for mid splenic

B: painful splenic infarction and absces
D: distal lesions that are close to the hilum

Mid=LIGATE
Distal= SPLENECTOMY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A 48-year-old patient presents with isolated bleeding gastric varices, splenic vein thrombosis, and normal liver function. Which of the following is likely to be the treatment of choice?
A. Beta blockers and banding
B. Splenorenal bypass
C. Splenic vein ligation
D. Splenectomy

A

D. Splenectomy

Thrombosis= resect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Splenectomy is indicated in a child with sickle cell following
A. 1 episode of sequestration
B. 2 episodes of sequestration
C. 3 episodes of sequestration
D. None of the above

A

A. 1 ep of sequestration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which of the following is associated with an increased risk for pulmonary hypertension following splenectomy?
A. Sickle cell disease
B. Warm antibody auto-immune hemolytic anemia
C.Thalassemia
D. Idiopathic thrombocytopenic purpura

A

C. Thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What percentage of patients referred for surgery for idiopathic thrombocytopenic purpura will have a permanent response (i.e., not need further steroids)?
A. 15% B. 35% C. 55% D. 75%

A

D. 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A px who presents with altered mental status thrombocytopenia and lower ex petechia will most likely benefit from
A.Steroids
B. Methotrexate
C. Plasma exchange
D. Splenectomy

A

C. Plasma exchange

THIS IS TTP, w petechia as the MC presenting sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which of the following is a common indication for splenectomy in a patient with AGNOGENIC myeloid metaplasia?
A. Early satiety
B. Thrombocytopenia
C. Neutropenia
D. Splenic rupture

A

A. Early satiety

Others
Poor gastric emptying
LUQ heaviness or pain
Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The treatment of choice in an otherwise healthy 22-year-old patient with a large, sepatated splenic abscess is

A. Antibiotic therapy only
B. Antibiotics + percutaneous drainage
C. Antibiotics + partial splenectomy
D. Antibiotics + splenectomy

A

D. 14 days antibiotics w splenectomy (TOC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Patients undergoing elective splenectomy should receive vaccinations against Streptococcus pneumoniae, H. influenzae type B, and meningococcus
A. 2-4 wks before surgery
B. The day of surgery
C. 1 week after surgery
D. 1 month after surgery

A

A. 2-4 weeks before surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The most common early complication after open splenectomy is
A. Atelectasis
B. Hemorrhage
C. Subphrenic abscess
D. Wound infection

A

A. Atelactasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Regarding risk factors for developing OPSI, a female patient has
A NO RISK
B high risk
C Low risk

A

No risk

Low risk : Trauma
Intermediated risk: SIP
SPHEROCYTOSIS
ITP
PORTAL HTN

High risk: MA THAHO
MALIGNANCY
THALASSEMIA
HODGKINDS DISEASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

This is the term for a group of inherited disorders of hemoglobin synthesis prevalent among people of Mediterranean extraction and classified according to the hemoglobin chain affected.

Idiopathic Thrombocytopenic Purpura ( ITP)
Felty’s Syndrome
Thalassemia
Lymphoma Amyloidosis

A

Thalasemmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is true about the blood supply of the
spleen?
A.NOTA

B. The spleen derives most of its blood
from the internal epigastric artery.

C. The splenic vein joins the superior mesenteric vein to form the portal vein.

D. The most common type of its arterial terminal branches has the long main trunk dividing near the hilum into short terminal branches.

E.The spleen receives some of its blood supply from the short adrenal vessels.

A

C.SV joins SMV to form PV

39
Q

What is the basic vaccination requirement for patients for splenectomy?

A Vaccinate against malignancy
B Vaccinate against encapsulated pathogens
C Vaccinate against fungal infection.
D Vaccinate against viral infection
E All of the choices are correct

A

B. Against encapsulated pathogens

40
Q

Regarding the function of the spleen, properdin is usually associated with:

A. Cytopoiesis B. Storage c. Defense
Filtration

A

Defense

The spleen also appears to be a major source of properdin, important in the initiation of the alternate pathway of complement activation

41
Q

Regarding risk factors for developing OPSI, a patient with Hodgkin’s lymphoma has:

No risk
Low risk
A high risk

A

High risk

Other high risk
Sickle cell anemia
Thalassemia
HL

42
Q

Which of the following is the most common pathogen causing Overwhelming Post- splenectomy Infection (OPSI)?
A. Strep pneumoniae
B. H. Influenzae type B
C. E. Coli
D. N. Meningitides
E. Bacterioides

A

A strep pneumo

43
Q

The possibility of anaphylaxis happens when splenectomy is done for _____.
A. Trauma
B. Both Trauma & Infection
C. Infection
D. Neither Trauma nor infection

A

C. Infection

44
Q

A 30 year old female with thalassemia was recommended for a splenectomy by her hematologist. The possible reasons for this surgical referral include the following , EXCEPT

A. Splenic infarct
B.Symptomatic splenomegaly
C. Hypersplenism
D. Excessive transfusion requirements
E. NOTA

A

E. NOTA

SHIE

45
Q

What is the most common anatomic variant of the spleen ?
A. Ectopic
B. Horshoe
C. Splenic
D. Accessory
E. Wandering

A

D. In 80%

  1. Gastrocolic
  2. Pancreatic tail
46
Q

Regarding the function of the spleen, cytopenia usually associated with:
A. Filtration B. Cytopoiesis C. Defense
D. Storage

A

Filtration

“CyFi”

47
Q

What is true about vaccination in patients for splenectomy?

A. All of the choices are correct
B. In emergency splenectomy, patients
should be vaccinated immediately after surgery.
C. In elective splenectomy, patients should be vaccinated 2 weeks prior to surgery.
D. Vaccination should be given intra operatively to optimize antigen processing
E. None of the choices is correct

A

C. In elective splenectomy, px should be vaxx 2 weeks PRIOR to surgery

48
Q

Splenectomy is done for a pseudocyst. When asked, patients would always relate to a previous history of _____.
A. Neither Trauma nor infection
B. Both Trauma & Infection
C. Infection
D. Trauma

A

D. Trauma

Pseudocyst is dt trauma

49
Q

Splenectomy is expected to improve symptoms in sickle cell anemia because the _____ function of the spleen is eliminated.
A. Filtration B. Cytopoiesis C. Storage
D. Immune

A

A. Filtration

“Sick Filter”

50
Q

What is the most common pulmonary
complication encountered after open splenectomy?

A.Pulmonary hypertension
B.Pneumonia
C. Left sided pneumothorax
D. Pleural effusion
E. Left lower lobe atelectasis

A

E. Left lower lobe atelactasis
Closest to the surgical site

51
Q

Splenectomy for portal hypertension is for _____ purposes
A. Staging B. Palliative C. Curative

A

B. Pallative

52
Q

Regarding risk factors for developing OPSI, a trauma patient has

No risk
A high risk
Low risk

A

Low risk

53
Q

Regarding risk factors for developing OPSI, sickle-cell anemia has:

No risk
A high risk
Low risk

A

High risk

Other high risk

HL
Age
Malignancy

54
Q

Regarding risk factors for developing OPSI, an 8-year old patient has

No risk
A high risk
Low risk

A

High risk

Ithers
Sickle cell
Malignancy
HL

55
Q

The following are potential complications of splenectomy, EXCEPT

Stroke
bleeding
None of the choices is correct
All of the choices are correct Myocardial infarction

A

NOTA

BC ALL ARE PITENTIALCOMPLICATIONS

56
Q

32 year old male presented with left sided abdominal pain with fever and myalgia. On PE, there was tenderness on the left upper quadrant. An ultrasound of the abdomen noted splenomegaly and an encapsulated fluid collection in the spleen. The following are the possible mechanism of disease causation, EXCEPT
A. Malignancy
B. Hematogenous infx
C. Trauma
D. Hemoglobinopathy
E. Immunosuppression

A

A. Malignancy

Other 5 are distinct mechanisms of splenic abscess formation

57
Q

Splenectomy for splenic artery aneurysm is for _____ purposes.
A. Palliative B. Curative C. Staging

A

Curative

SAA- CURA

58
Q

. The following statements are true about the spleens function, EXCEPT
A. The spleen also produces opsonins, tuftsin, and properdin
B. The spleen acts as the major site for clearance from the blood of damaged or aged red blood cells
C. The spleen serves as an extra medullary site for hematopoiesis
D. All of the choices are correct E. None of the choices is correct

A

E NOTA

59
Q

. This condition is characterized as the presence of one or more cytopenias in the context of a normally functioning bone marrow
A. Purpura
B. Hypersplenism C. Leukemia
D. Splenomegaly E. Blood dyscrasia

A

B hypersplenism

BM biopsy will show proliferation of precursor cells

60
Q

Regarding the function of the spleen, Heinz bodies are usually associated with
A. Filtration
B. Cytopoiesis C. Defense
D. Storage

A

Filtration
“Filtr-HEINZ”

61
Q

What is the most common primary tumor of the spleen?
A. Lymphoma
B. Lymphosarcoma C. Splenoblastoma D. Adenocarcinoma E. Sarcoma

A

E. Sarcoma

Remember by heart

62
Q

Patients for splenectomy with concomitant thrombocytopenia should be transfused. The following is true about platelet transfusion in these patients.
A. Transfuse intra op before the ligation of the splenic artery
B. Transfuse a day prior to surgery
C. Transfuse only if with persistent thrombocytopenia post op
D. Transfuse intra op during the ligation of the splenic artery
E. Transfuse intra op after the ligation of the splenic artery

A

C. Transfuse ONLY if with persistent thrombocytopenia post op

63
Q

This part of the spleen serves as a dynamic filtration system, enabling macrophages to remove microorganisms, cellular debris, antigen- antibody complexes, and erythrocytes from circulation
A. Splenic capsule
B. White pulp
C. Red pulp
D. Trabeculae
E. All answers are correct

A

Red pulp

Aka the DYNAMIC FILTER OF THE SPLEEN
———
White: lymph node with lymphocytes, macrophage and plasma cells

64
Q

What is the triad of rheumatoid arthritis, splenomegaly, and neutropenia?
A. Reynauds Triad
B. Gauchers disease
C. Feltys Syndrome
D. Niemann-Pick disease
E. None of the choices is correct

A

C. Feltys Syndrome

RNS TRIAD

65
Q

The factors which predispose asplenic patients to life threatening infections, EXCEPT
A. Diminished tuftsin production
B.elimination of pathogens from the bloodstream by the liver
C. Loss of splenic macrophages
D. Loss of the spleen reticuloendothelial screening
function
E. None of the choices is correct

A

E NOTA

66
Q

What is the most common cause of inadvertent intra operative splenic injury?
A. Ligation of the splenic vein
B. Improper traction of the spleen
C. Electrocautery burns
D. Direct trauma to the spleen
E. Ligation of the short gastric vessels

A

B. Improper traction of the spleen

Kay mga intern mn gud ang in charge mag retract ba chz

67
Q

Splenectomy is expected to improve hereditary spherocytosis because the _____ function of the spleen is eliminated
A. Filtration
B. Cytopoiesis
C. Immune
D. Storage

A

A. Filtration

“Filter HERE”

68
Q

With growth, the ligamentous attachments to the spleen adapt. Among the spleens attachment are to all of the following, EXCEPT

A. Distal end of transverse colon
b. Tail of the pancreas
c. Peritoneum of posterior abdominal wall
d. Adrenal gland

A

C.

Of particular clinical relevance, the spleen is suspended
in position by several ligaments and peritoneal folds to the
colon (splenocolic ligament), the stomach (gastrosplenic ligament), diaphragm (phrenosplenic) and the kidney, adrenal gland, and tail of pancreas (splenorenal ligament)

69
Q

While on vacation here in Davao City, a 7-year-old African- American girl was rushed to the ER due to abdominal pain. Her mother said she is diagnosed with a case of sickle cell disease . An ultrasound was done which showed the enlarged spleen in its expected position. Questionable masses that have the similar echo-textures with the spleen were also noted, prompting a diagnosis of accessory spleens. The most likely locations of these masses are all of the following, EXCEPT

A. Pancreatic tail
B. Left ovary
C. Sigmoid mesocolon
D. Falciform ligament

A

B. Left ovary
—-
(Descending order)
1 hilum
2 pedicle
3 Gastrocolic
4 tail
5 greater omentum
6 greater curvature of stomach
7 splenocolic ligament
8 SI and LI mesentery
9 left BROAD ligament
9 left SPERMATIC CORD

70
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is diagnosed case of sickle cell disease . On your pain score assessment, the abdominal pain was of moderate to severe grade. The most probable cause of the pain is which of the following ?

A. Auto-splenectomy
b. Splenic infarction
c. Sequestration crisis
d. Splenomegaly

A

C. Sequestration crisis
Crisis is real!

——

The occurrence of one major acute sequestration crisis, characterized by rapid painful enlargement of the spleen and circulatory collapse, generally is considered sufficient grounds for splenectomy

71
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . A splenectomy was performed. Post op biopsy described by the pathologist the white pulp to be which of the following

a. Increased in number
b. Increased in size
c. Normal in size
d. Normal in number

A

Ambot review na lang but sa NIH it should be reduced
C nlg ahha

72
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . After adequate hydration & other necessary preparations, the patient is now in the operating room for the planned splenectomy. This operative procedure is

A. Palliative for splenomegaly
b. Curative for splenomegaly
c. Palliative for the sickling process
d. Curative for the sickling process

A

C. Pallative for SICKLING process

73
Q

Which cell are involved in sickle cell
disease?

a. Erythrocytes
B lymphocytes
C neutrophil
D monocytes

A

A. Erythrocytes

Sis…

74
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . On PE you know that the spleen is enlarged as the inferior pole can be palpated at the left subcostal margin. With further growth, the splenic notch could be palpable at the _____ aspect of the spleen.

A. Anterior
b. Medial
c. Lateral
d. Inferior

A

A. Anterior

Notch ni ante

75
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . A splenectomy was performed. Vaccinations are recommended before discharge to protect her from the common sources of infection causing OPSI. The most frequently involved organism is

a. Neisseria meningitidis
b. Klebsiela pneumoniae
c. Streptococcus
pneumoniae
d. Haemophilus influenzae

A

C. Strep pneumoniae

76
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease .The disease is transmitted genetically from which of the following?

A. Both parents
b. Her mother
c. Her father
d. Both maternal
grandparents

A

A. Both

1 parent= carrier

77
Q

The mutation behind the sickling process is the interchange of which of the following?

A. Isoleucine to valine
b. Threonine to isoleucine
c. Glutamic acid to
threonine
d. Valine to glutamic acid

A

D. Valine to GA

78
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . On PE you know that the spleen is enlarged as the inferior pole can be palpated at the left subcostal margin. This is because the spleen has at least grown to _____ in size.

a. 3x
b. 4x
c. 1.5x
d. 2x

A

D 2.

79
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . An ultrasound was done which showed the enlarged spleen in its expected position. Questionable masses that have the similar echo-textures with the spleen were also noted, prompting a diagnosis of accessory spleens. These masses are due to the remnants of the migration of the _____ to its present position in the abdomen.

A Pachyderm b. Endoderm c. Ectoderm d. Mesoderm

A

D mesoderm

80
Q

While on vacation here in Davao City, a 7-year-old African-American girl was rushed to the ER due to abdominal pain. Her mother said she is a diagnosed case of sickle cell disease . A splenectomy was performed. Post op biopsy described by the pathologist the red pulp to be composed of the following ?

A. Venous sinuses
b. Lymphoid follicles c. Arterial arcades d. Connective tissue

A

A. Venous sinuses

B is white pulp

81
Q

Regarding risk factors for developing OPSI, Hodgkins lymphoma has

AHigh risk b. Low risk c. no risk

A

High

Mnemonic: HIGH-MA THA HO

82
Q
  1. Regarding risk factors for developing OPSI, sickle-cell anemia has
    High
    Low no risk?
A

High
Basta hematologic, malignancy or myelodysplasia

83
Q

Regarding the function of the spleen, erythroblasts are usually associated with
A. Storage
b. Filtration
c. Cytopoiesis d. Defense

A

C cytopoiesis

84
Q

Splenectomy is expected to improve non- Hodgkins lymphoma because the ___ function of the spleen is eliminated

a. Immune
b. Cytopoiesis C. Filtration
d. Storage

A

B. Cytopoeisis.

Mnemonics: CYTO KINS

85
Q

Regarding the function of the spleen, tuftsin is usually associated with

a. Defense
b. Cytopoiesis C. Filtration
d. Storage

A

Defense

Tough= defense

86
Q

Splenectomy is expected to improve ITP because the ___ function of the spleen is eliminated

a. Immune
b. Cytopoiesis C. Filtration d. Storage

A

Filltration

87
Q

Reticular cells with sinuses are seen in the

A. Red pulp
b. White pulp
c. Marginal zone
d. Capsule

A

C. Marginal zone

Between the white pulp and the red pulp is the marginal zone, a vascular region that is devoid of sinuses. It contains blood cells, lymphocytes, macrophages, and reticular cells.

88
Q

Reticular cells with sinuses are seen in the

A. Red pulp
b. White pulp
c. Marginal zone
d. Capsule

A

C. Marginal zone

MaRe

89
Q

The most readily available diagnostic tool to investigate the spleen is the
a. Chest X-ray
b. Ultrasound
c. MRI
d. CT scan

A

B. Ultrasound

90
Q

A patient with splenic sarcoma will have

A.Splenomegaly b. Hypersplenism c. Both
d. Neither

A

A. Splenomegaly

91
Q

Hypersplenism has two elements. They are
Cytosis & abnormally responding bone marrow
b. Cytosis & normally responding bone marrow
c. Cytopenia & abnormally responding bone marrow
d. Cytopenia & normally responding bone marrow

A

D. Cytopenia and normally responding bone marrow

92
Q

OPSS starts with

A

Cough & colds

93
Q

The spleen originates from the mesoderm. Other tissues derived from this germ layer include the

a. Thyroid gland b. Pancreas
c. Dermis
d. Spinal cord

A

A thyroid gland