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SPLEEN > SPLEEN > Flashcards

SPLEEN Flashcards

1
Q

blood supply to spleen

A 
#1 splenic artery cephalad
#2 splenic vein caudad (inferior mesenteric vein)
#3 short gastrics ( from the left gastroepiploic artery)
#4 left gastroepiploic artery
#5 right gastroepiploic artery (off gastroduodenal artery)
#6
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2
Q

where our accessory spleens found

A 
#1 splenic hilum
#2 splenocolic ligament
#3 gastrocolic ligament
#4 splenorenal ligament
#5  greater omentum
#6  Tail pancreas
#7 mesentery
#8 gonadal: left ovary and testicular area
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3
Q

asplenia Iver Marks syndrome

A

right arterial isomerism
double right side!
Central liver big

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4
Q

polysplenia

A

double left-sided anatomy

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5
Q

general of B cells

A

makes antibodies

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6
Q

general of T cells

A

cellular immunity

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7
Q

Howell-Jolly bodies

A

remnants of red blood cells

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8
Q

Heinz bodies

A

the major hemoglobin

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9
Q

nonspecific immune mechanisms of spleen

A 
# antibody
#2  opsonin
#3 Tuftsin
#4 largest producer IgM
 (IgM equals of immediate)
#5 fibronectin
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10
Q

white pulp

A 
#1 T cells
#2 macrophage
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11
Q

red pulp

A

Red = Reticular

Removal of particular matter

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12
Q

where should splenic abscess be drained external landmarks

A

below the 11th rib

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13
Q

indications for splenectomy

A 
#1 hereditary sohgericytosis
 #2 splenic artery aneurysm
( first choice with thrombosis and aneurysm is endovascular)
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14
Q

workup for missed accessory spleen

A

look up

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15
Q

indications for trauma splenectomy

A 
#1 developed hemodynamic instability regardless of transfusion history
#2 transfusion 40 cc per kilogram
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16
Q

hereditary spherocytosis

A 
#1 Spectrin
#2  autosomal dominant
#3   osmotic fragility test
#4 treatment  SPLENECTOMY
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17
Q

sickle cell anemia

A 
#1 beta chain of hemoglobin a
#2 most follows normal recessive
#3 auto infarct spleen
#4 pigmented gallstones get cholecystectomy
#5 Salmonella-> osteomyelitis with
18
Q

Splenectomy vaccinations

A 
Encapsulated organisms:
#1 Streptococcus pneumonia: Most common-75%
#2  Haemophilus influenza the second most common
#3 Neisseria meningitidis
#4 beta-hemolytic Streptococcus
#5 Staphylococcus aureus
#6 Escherichia coli
 viral infections:
Herpes zoster
Parasite:
19
Q

ITP

A 
Idiopathic thrombocytopenic purpura
 FAT RN:
#1 steroids
#2 gammaglobulin
#3 RhoGAM
#4 monoclonal-up Rituxan (chemotherapy)
#5 splenectomy
75-85 response rate (Drops to 60% if failed medical management)
Transfuse if platelets less than 20,000
After splenic artery ligation
20
Q

TTP

A 
Thrombotic  thrombocytopenic purpura
#1 multilevel organ syndrome-
Renal
Neuro
#2 treat with PLASMA  PHERESIS
#3 NO splenectomy
21
Q

HIV-associated thrombocytopenia

A 
#1 resistant to medical therapy
#2 splenectomy recommended in does not appear at maxillary conversion rate AIDS
22
Q

Immunization post trauma splenectomy

A

Immunization before he leaves the hospital

23
Q

Treatment of elevated platelet count status post splenectomy

A

700,000-1,000,000 and to quietly with aspirin

Greater than 1 million anticoagulate Cameron (Cameron)

24
Q

Congestive splenomegaly

A 
#1 caused by lives at liver failure portal hypertension
#2 the treat by dressing portal hypertension
#3 NO splenectomy (this would preclude possible future splenorenal shunt)
Ultimately lead to portal vein thrombosis and complicate potential liver transplantation
25
Q

Felty’s syndrome

A 
The #1 rheumatoid arthritis #2 splenectomy controversial
#3 methotrexate steroids
26
Q

Hodgkin’s disease

A

RARELY splenectomy for staging anymore

Treatment chemotherapy

27
Q

Non-Hodgkin’s lymphoma

A

RARELY splenectomy except for massive splenomegaly symptoms

28
Q

Name vaccinations for postsplenectomy

A

Polyvalent pneumococcal polysaccharide
(Children younger than 2 years old not effectively immunized in parentheses
H. influenzae vaccination type B
Neisseria meningitidis vaccination

Caution: Children less than 6 oral penicillin prophylaxis

29
Q

relationship of superior mesenteric artery and superior mesenteric vein

A

superior mesenteric ARTERY is to the LEFT
Superior mesenteric VEIN is to be RIGHT
(CAREFUL:This is reversed in malrotation)

30
Q

most common place to find accessory spleen

A 
Splenic hilum/vascular pedicle
#1 gastrocolic ligament
#2 tail of pancreas
#3 greater omentum
#4 greater curvature stomach
#5 splenocolic ligament
#6 small large bowel mesentery
#7 left broad ligament and uterus in women
#8 left spermatic cord and men
31
Q

Most common cause a spontaneous splenic rupture worldwide

A

MALARIA
UNITED STATES: Mononucleosis!
Other causes: Plasmodium vivax infection Other

32
Q

Hypersplenism

A 
#1 sickle cell
#2 radiation
#3 celiac disease
#4 malignancy
#5 ulcerative  colitis
#6 alcoholism/drug addiction
#7 tropical   sprue
#8 lupus
#9 anemia
#10 HIV
#11 splenic trauma
#12 amyloidosis
33
Q

Highest risk for postsplenectomy sepsis

A

HEMATOLOGIC:
THALASSEMIA MAJOR
SICKLE CELL
Children higher than adult

34
Q

Optimal timing for pneumococcal vaccination post trauma splenectomy

A

14 days

35
Q

Felty’s syndrome triad

A 
#1 rheumatoid arthritis
#2 splenomegaly
#3 neutropenia

Methotrexate/steroids
Leg ulcers

36
Q

Indications for splenectomy with Felty’s syndrome

A 
#1 transfusion-dependent anemia
#2 profound thrombocytopenia

Splenectomy response excellent-80% durable increase in white blood cell count
Immediate neutrophil count improvement

37
Q

ectopic wandering spleen

A 
#1 lack of peritoneal attachments
#2 multiparous women
#3 most asymptomatic
#4 provided spleen is not infarcted treat with   splenopexy
38
Q

cell findings after splenectomy

A 
#1 target cells
#2 Howell-Jolly  bodies
#3 Heinz  bodies
#4 Pappenheimer bodies
 #5 prolonged leukocytosis
39
Q

time course of WBC findings post splenectomy

A

WBC count increasing within one day

may remain elevated prolonged several months and

40
Q

most common source for splenic abscess

A 
#1-most common hematogenous spread
  - infective endocarditis
  - typhoid fever
  - malaria
 -- urinary tract infection
  - osteomyelitis
#2 contiguous infection
#3 hemoglobinopathy
#4 immunosuppression
#5 trauma
41
Q

medical treatment of hairy cell leukemia

A

Leustatin (cladribine)

42
Q

splenectomy indication hairy cell leukemia

A

early satiety

Cell counts fell to increase

SPLEEN (1 decks)

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