splenectomy

Question 1

what percent of cardiac ouput filters through the spleen?

Answer 1

25%

Question 2

tears of the ……… can result in massive hemmorrhage or tear of the splenic capsule

Answer 2

short gastric arteries

Question 3

these vessel may be ligated with no impact on organ viability

Answer 3

short gastric arteries

Question 4

this ligament poses a risk of tearing the splenic capsule during gastric surgeries

Answer 4

splenocolic ligament

Question 5

structures surrounding the spleen

Answer 5

stomach
diaphragm
splenic flexure of colon

Question 6

part of the spleen can be resected due to its

Answer 6

segmental internal vasculature

Question 7

the spleen produces …….. that aids in opsonization

Answer 7

IgG, IgM

Question 8

the spleen is vital to preventing infections from

Answer 8

encapsulated bacteria

Question 9

splenomegaly implies

Answer 9

advanced/late stage disease
the spleen must be quite large to be palpable

Question 10

the spleen produces …….. which accelerates opsonization

Answer 10

tuftsin

Question 11

major pathogens that pose risk to asplenic patients

Answer 11

Hib
N. meningitides
S. pneumo

Question 12

vaccination should be given…….prior to planned splenectomy

Answer 12

2 weeks

Question 13

asplenic patients should receive vaccinations every….

Answer 13

5 years

Question 14

asplenic patients should carry an Rx for

Answer 14

prophylactic antibiotics to be taken at symptom onset

Question 15

most critical for preventing OPSI in asplenic patients

Answer 15

patient education

Question 16

function of the spleen

Answer 16

filters blood
removes senescent RBCs

Question 17

asplenic patients are

Answer 17

immunologically impaired
do not clear bacteria well
more susceptible to DVT

Question 18

organisms not associated with OPSI

Answer 18

E. coli
S. aureus

Question 19

85% of splenic trauma bleeding

w

Answer 19

will self resolve

Question 20

if patient is hemodynamically unstable,

Answer 20

proceed to splenectomy

Question 21

indications for splenectomy

Answer 21

multiple organs injured
in shock
acidotic

Question 22

splenic embolization is an option if

Answer 22

the patient is stable

Question 23

if the patient is already in a conventional OR for massive hemorrhage

Answer 23

embolization is not primary option

Question 24

if possible, avoid splenectomy prior to …. years of age

Answer 24

7

Question 25

splenectomy used to be more common in cases of ITP, TTP, but has since been replaced with

Answer 25

plasmapharesis

Question 26

is sickle cell an indication for splenectomy?

Answer 26

no, they will auto infarct

Question 27

populations most susceptible to OSPI

Answer 27

elderly and very young

Question 28

what is critical in a blunt trauma situation to LUQ?

Answer 28

time and fluid resuscitation

Question 29

in a post-splenectomy patient, what structures may be present that can protect the immune status?

Answer 29

accesory spleens

can adversely effect ITP, TTP patients

Question 30

in a post-splenectomy patient, what structures may be present that can protect the immune status?

Answer 30

accesory spleens

can adversely effect ITP, TTP patients

Question 31

the main reason for splenectomy in myeloproliferative disorders is

Answer 31

QOL
spleen becomes an uncomfortable space occupying lesion