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Abdomen Pathology > Spleen Pathology Ch 15 > Flashcards

Spleen Pathology Ch 15 Flashcards

1
Q
  • a spleen that has migrated from its normal location
  • results of an embrylogic anomaly of the supporting ligaments of the spleen
  • resents with a mass (abd or plevic), intermittent pain and splenic torsion (volvulus)
A

Wandering Spleen

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2
Q
  • largest single mass of lymphoid tissue in the body
  • active in the body’s defense against disease
  • is commonly involved in metabolic, hematopoietic, and infectious disorders
A

Spleen

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3
Q

major function of the spleen

A

filter the peripheral blood

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4
Q

-situs ambiguous is the disruption in the development of the normal asymmetric arrangement of abdominal organs and vessels; misarrangement of abdominal structures

A

visceral heterotaxy

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5
Q

normal asymmetrical arrangement of anatomy

A

situs solitus

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6
Q

mirror image of situs solitus

A

situs inversus

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7
Q

polysplenia and asplenia are two classifications of _______

A

heterotaxia

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8
Q
  • right sided organs are less or missing
  • bilateral left-sidedness** (associated with the following)
  • two morphologic left lungs
  • multiple LUQ spleens
  • polysplenia = biliary aterisa/absent gallbladder**
  • intestinal malrotation
  • azygous continuation of interrupted IVC
  • cardiac defects
A

Polysplenia

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9
Q

-rare condition and by itself causes no difficulties

A

asplenia

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10
Q

bilateral right-sidedness is associated with**…

A
  • two morphologic right lungs
  • absent spleen
  • midline liver and gallbaldder
  • intestinal malrotation
  • reversed position of aorta and IVC
  • cardiac defects
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11
Q
  • supernumerary spleens
  • common normal variant
    • may be confused with enlarged lymph nodes around the spleen or mass in the tail of the pancreas
A

accessory spleen/splenunculus

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12
Q
  • small homogenous rounded mass less than 5cm
  • located near the splenic hilum**
  • identical echogenicity to adjacent spleen
A

acessory spleen/spenuculus

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13
Q
  • may be seen
  • normal individuals
  • wasting diseases
  • chronic hemolytic anemias
    • sickle cell
A

splenic atrophy

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14
Q
  • opposite of spenomegaly
  • advanced atrophy**
  • almost complete disappearance of the spleen**
  • results from progressive fibrosis and shrinkage
    • may occur in late stages of sickle cell anemia
A

autosplenectomy

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15
Q
  • enlargement
  • most common feature of splenic disease
  • the spleen is located in the LUQ, so when it enlarges it extends in the anterior, medial and inferior direction**
  • left kidney may be displaced inferior and possibly lateral
  • long axis greater than or equal to 13 cm
A

splenomegaly

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16
Q

causes of congestive splenomegaly

A
  • congestive (portal hypertension due to cirrhosis, most common cause)
  • Infection (mononucleosis and TB)
  • hemolytic disease (sickle cell anemia)
  • neoplastic (metastic disease, leukemia, lymphoma)
  • most common finding in AIDS patients (mild to moderate splenomegaly)
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17
Q

storage diseases

A
  • Amyloidosis
  • Gaucher
  • Neiman-Pick
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18
Q

storage disease

  • nodular, found in walls of sheathed arteries
  • diffuse, splenomegaly
A

Amyloidosis**

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19
Q

storage disease

-50% involves children

A

Gaucher

20
Q

storage disease

  • rapidly fatal-primarily effects female infants
  • clinical features consist of hepatomegaly, digestive disturbances, and lymphadenopathy
A

Neiman- Pick

21
Q

Diffuse disease

-sickle cell, congenital spherocytosis, hemolytic anemia, autoimmune hemolytic anemia lymphoietic abnormalities

A

anemias

22
Q

Diffuse disease

-chronic disease of unknown cause that involves all bone marrow elements**

A

polycythemia vera

23
Q

Diffuse disease

-results in deficient syntheses of normal hemoglobin; occurs in Asian and Mediterranean polulations

A

thalassemia

24
Q
  • polycythemia vera-involves bone marrow elements**
    • splenomegaly**
    • acute and chronic leukemias
  • granulocytopoietic abnormalities
  • reticuloendotheliosis
    • varying amounts of lipid storage in phagocytes
    • hyperactivity of reticuloendothelial cells
A

myeloproliferative disorders

25
Q
  • usually involves children under 2 years

- rapidly fatal

A

Letterer-Siwe disease

26
Q
  • usually involves children over 2 years

- chronic and benign disorder

A

Hand-Schiller-Christian

27
Q

-Hodgkin’s disease, non-hodgkin’s lymphoma, and leukemia

A

Lymphoietic

28
Q
  • diffusely hyopechoic splenic pattern
  • focal lesions possibly present
  • isoechoic
A

acute myelogeneous leukemia

29
Q
  • uncommon
  • associated with general abdominal sepsis
  • patients present with fever LUQ tenderness, abdominal pain, and splenomegaly
  • may be history of trama
A

abscess

30
Q
  • complex cystic-mixed echo
  • thick or shaggy walls/poor definition
  • increased/decreased transmission
    • depends on presence of gas (comet-tail artifact)
A

absecess

31
Q
  • one of the more common causes of focal spenic lesions
  • caused by occlusion of the major splenic artery or any of its braches
  • almost always the result of emboli that arise in the heart
A

splenic infarct**

32
Q

common in patients

  • with bacterial endocarditis
  • splenic artery aneurysm
  • hemolytic anemias
  • leukemia
A

splenic infarct **

33
Q

sonographic appearance of splenic infarct

A
  • fresh hemorrhage (hypoechoic**)
  • healed infarct with scar tissue
    • echogenic
    • wedge-shaped lesion**
    • base toward the subcapsular surface of the spleen**
34
Q
  • CT is modality of choice in evaluating abdominal trauma
  • blunt trauma most common cause
    • if capsule remains intact
      • intraparenchymal or subcapsular hematoma**
    • if capsule ruptures
      • Intraperitoneal or perisplenic**
      • focal or free intraperisplenic hematoma
      • possible to demonstrate fluid surrounding spleen in LUQ
A

Trauma-Splenic Rupture

35
Q

clinical findings of splenic rupture

A
  • LUQ pain
  • left shoulder pain
  • left flank pain
  • dizziness
  • signs
    • LUQ tenderness
    • hypotension
    • decreased hemoglobin
36
Q

FAST

A

focused Assessment with Sonography for Trama

37
Q
  • rare and usually of no clinical significance
  • classified as parasitic or non-parasitic
  • most are considered secondary cysts caused by trauma, infection, or infarction
  • echoinococcus is the only parasite that form splenic cysts
A

splenic cysts

38
Q
  • occurs as a result of previous trauma or infarction

- Ex: pseudocyst, old infarcts or hematomas

A

nonparasitic (false cyst)

39
Q
  • asymptomatic
  • may be solitary or multiple
  • well defined and not encapsulated
  • composed of lymphoid tissue
  • have solid and cystic components (complex)
  • generally appear hyperechoic
A

Hamartomas

40
Q
  • most common benign neoplasm of the spleen
  • large complex inhomogeneous echogenic mass
    • has multiple, small hypoechoic area
  • asymptomatic-
    • only show symptoms when large size compresses other organs
  • complications occur when the tumor increases in size to cause splenic rupture with peritoneal symptoms **
A

cavernous hemangioma

41
Q
  • benign malformation of lymphatics, consisting of endothelium-lined cystic spaces
  • may involve multiple organ systems or may be confined to solitary organs such as the liver, spleen, kidney, or colon
  • splenic involvement is rare, appears as a mass with extensive cystic replacement of splenic parenchyma but when it occurs, multicystic appearance is characteristic
A

cystic lymphangiomas

42
Q
  • resulting from previous infections**

- associated with liver and lung calcifications

A

granulomas

43
Q

most common causes of granulomas**

A

-histoplasmosis and tuberculosis

44
Q

malignant tumors of the spleen are uncommon may be _______,________, or_________

A

lymphoma, Hodgkins tumor, or hemangiosarcoma

45
Q
  • rare-arising from vascular endothelium of the spleen
  • similar appearance of hemangioma
    • mixed cystic pattern
    • can also be hyperechoic
A

hemangiosarcoma (rare)

46
Q
  • spleen commonly involved in lymphoma
  • difficult to detect
    • typically hyopechoic
    • focal areas
A

lymphoma

47
Q
  • 10th most common site
  • result from hematogenous spread from primary site**
    • lung, breast, ovary, stomach/colon, kidney, melanoma, renal, and prostate **
    • melanoma more frequently metastasize to the spleen followed by breast and lung cancer**
  • may show as focal with hypoechoic or hyperechoic pattern
A

metastases

Abdomen Pathology (9 decks)

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