Spleen Flashcards
What is the difference between splenomegaly and hypersplenism?
Hypersplenism is just one cause of splenomegaly. Hypersplenism is when there is increased destruction of RBCs by spleen
Primary hypersplenism
Idiopathic. Very rare. Diagnosis of exclusion. Seen in women more
Causes of secondary hypersplenism
Hemolytic anemia, neoplasms (leukemia, lymphoma, metastatic carcinoma), myelodysplastic syndromes, chronic inflammatory disease (Felty syndrome, sarcoidosis, SLE), congestive splenomegaly (portal HTN, cirrhosis, portal or splenic vein obstruction, severe CHF), infection, metabolic or storage diseases (eg amyloid, niemann pick)
Treatment of hypersplenism
Primary: must get splenectomy. Secondary might need is depending on how much it is affecting patient.
If get splenectomy, must get Pneumococcal, Hib, and meningococcus vaccines
Hyposplenism
Spleen is anatomically present but not functional. Results in increased risk of infection particularly with encapsulated organisms.
Causes of hyposplenism
Sickle cell disease, IBD, collagen vascular disease, autoimmune.
What does the peripheral smear look likening hyposplenism?
Howell-Jolly bodies (basophilic nuclear remnants in circulating RBCs), Heinz bodies (inclusions of denatured Hg), acanthocytes (spur cells)
Review leukemia and lymphoma flashcards in medicine section
Cool beans
Review pathophys of TTP
vWF is abnormal, in multimers, due to ADAMTS13 deficiency. These multimers attract platelets to site of clot but cause abnormal clumping. This leads to obstruction and shearing of RBCs in microvasculature.
Pentad to TTP
Fever, anemia, thrombocytopenia, renal failure, neurological sx (may have waxing and waning mental status)
Causes of TTP
Infection (HIV, E. coli), malignancy, pregnancy, drugs, autoimmune disorders
Where is spleen located?
LUQ between ribs 8 and 11
