Spleen Flashcards
What causes ITP and what is the treatment?
Auto antibodies to GP IIB/IIIA and Ia/IIa
Tx: Steroids, IVIG, splenectomy if refractory
When should you give platelets for intraoperative bleed during splenectomy?
After stapling splenic artery
Describe the following peripheral blood smears: Howell-Jolly body, Pappenheimer, Target cells, Heinz body, spur cell
Howell Jolly: Nuclear remnant seen in patients post splenectomy
Pappenheimer: Iron deposits
Target cell: Immature RBC
Heinz: Intracellular denatured Hgb
Spur: Deformed membrane
What causes hereditary spherocytosis?
Spektrin deficiency; patients need splenectomy if symptomatic by age 6
What is pyruvate kinase deficiency?
hemolytic anemia 2/2 impaired glucose metabolism
What is angiosarcoma and what is it associated with?
Primary malignant tumor of the spleen; see increased risk with vinyl chloride and thorium dioxide exposure
Which six findings are worrisome for malignancy in a lymph node?
- Increased size
- Round shape
- Loss of central fatty hilum
- Peripheral or mixed vascularity
- Microcalcifications
- Ill-defined margins
When do you treat a splenic artery aneurysm?
> 2 cm; tx any size in pregnant patients
Tx of choice is endovascular coil embolization
What bacteria are you at risk for post splenectomy?
Encapsulated organisms
S. Pneumo
N. meningitidis
H. influenzae
See decrease in optinizations 2/2 to IgM
B thalasemia patients are at highest risk for OPSI
What are the symptoms associated with TTP?
Caused 2/2 defective Adam TS- 13 (causes platelet aggregation in microvasculature)
Fever
Anemia
Thrombocytopenia
Renal issues
Neurological isue
(FAT - RN)
Tx: Plasmapheresis