Spleen

Question 1

location of the spleen

Answer 1

Located in the left upper quadrant between the fundus of the stomach, the diaphragm, the splenic flexure of the left colon and the left kidney

Question 2

blood supply for spleen

Answer 2

splenic artery

short gastrics

Question 3

the tail of the pancreas is right near what?

Answer 3

spleen

Question 4

main 2 functions of the spleen

Answer 4

erythrocyte maintenance

immune function

Question 5

causes of hypersplenism

Answer 5

Neoplastic disorders
Hematopoietic disorders
Metabolic or storage disorders
antibodies to platelets or RBCS causing spleen to destroy them

Question 6

diseases associated w/ secondary hypersplenism

Answer 6

Portal HTN
Splenic vein thrombosis
Leukemias/lymphoma
SLE
Gaucher disease
Mononucleosis
Felty syndrome

Question 7

with primary hypersplenism what is indicated

Answer 7

splenectomy

Question 8

bleeding of gastric varcies w/ chronic pancreatitis

Answer 8

splenic vein thrombosis (blood can’t get out of the spleen through splenic vein)

Question 9

what is tx for splenic vein thrombosis

Answer 9

splenectomy

Question 10

what autoimmune disease requires a splenecomty (if they have warm antibodies)

Answer 10

acquired hemolytic anemia

Question 11

what meds is acquired hemolytic anemia associated w/

Answer 11

PCN and quinidine

Question 12

what is first line tx for acquire hemolytic anemia?

Answer 12

glucocorticoids

Question 13

Antibodies to platelet antigens
No splenomegaly
Petechiae, ecchymosis, epistaxis and easy bruising

Answer 13

ITP Immune/Idiopathic thrombocytopeniaPurpura

Question 14

when do you tx ITP

Answer 14

moderate or severe purpura

Question 15

Tx for ITP

Answer 15

glucocorticoids high dose until platelets go to normal

Question 16

when is splenectomy needed for ITP

Answer 16

people with ITP who fail steroids

Question 17

do you ever get anyone with ITP platelets?

Answer 17

No

Question 18

when do you give platelets in a splenectomy for ITP

Answer 18

clamp across splenic artery

Question 19

common congenital hemolytic anemia
Related to abnormalities in the erythrocyte structure
Affected RBCs have a deficiency in spectrin, an essential component of the cell membrane

Answer 19

hereditary spherocytosis

Question 20

how can someone w/ hereditary spherocytosis present

Answer 20

w/i first 3 decades
splenomegaly common
can present w/ abdominal discomfort and jaundice

Question 21

when should a splenectomy be done with ehreditary spherocytosis

Answer 21

at least age 6

also take the gallbladder out

Question 22

aD trait that results in elliptical erythrocytes increasing rate of destruction of RBC> don’t always need a splenectoy

Answer 22

Hereditory Elliptocytosis

Question 23

when do you do a splenectomy with a splenic cyst

Answer 23

if persitss or becomes symptomatic

can be from hydatid dz

Question 24

Relatively rare condition that may follow a splenectomy. Infection is with encapsulated organisms (S pneumonia, H influenza, N meningitidis)

Answer 24

Overwhelming postsplenectomy sepsis (OPSS)

Question 25

when shoudl the pneumococcal vaccine be given before an elective splenectomy

Answer 25

2 weeks prior

Question 26

what are other recommended vaccines for someone w/ a splenectomy

Answer 26

pneumococcus

haempholis and meningococcus

Question 27

when do people w/ a splenectomy need abx prophylaxis

Answer 27

invasive medical procedures and dental work

Question 28

what must you look for when doing a splenectomy?

Answer 28

accessory spleen