Spleen

Question 1

Sources of thrombocytopenia

Answer 1

Meds, HIV, lymphoma, leukemia, AI

Question 2

Vaccines and when splenectomy

Answer 2

Strep pneumo, H flu, Meningococcus
2wks prior to elective and 2wks post-emergent

Question 3

ITP failed medical management; next step

Answer 3

Splenectomy

Question 4

Portal vein thrombosis s/p splenectomy; tx

Answer 4

Systemic anticoagulation

Question 5

When to transfuse platelets during splenectomy

Answer 5

After splenic artery ligation

Question 6

Spherocytosis s/p splenectomy; next step

Answer 6

Search for accessory spleen

Question 7

Most common locations for accessory spleen

Answer 7

Splenic hilum, tail of pancreas, greater omentum

Question 8

Hx of sickle cell with post-op fever and new pulmonary infiltrates; dx and tx

Answer 8

Acute chest syndrome, aggressive pulm toilet, abxs, judicious fluids, multimodal non-opioids

Question 9

Most common benign primary neoplasm of the spleen

Answer 9

Hemangioma

Question 10

Hx of splenectomy, college dorm, fevers, diffuse purpura; dx and tx

Answer 10

Meningococcal infxn from Neisseria meningitidis, abx (ceftriaxone)