Splenic Disorders Flashcards
What is hypersplenism?
A pathologic condition wherein blood cells are removed by the spleen
What can cause a crisis in sickle cell anemia?
What can reduce need for transfusions?
Repeated vaso-occlusive events may eventually cause?
1) Splenic sequestration of red cells
2) Splenectomy
3) Autosplenectomy
With hereditary spherocytosis, what can worsen the anemia?
What improves the anemia?
1) Splenic sequestration and lysis
2) Splenectomy
When is splenectomy appropriate for idiopathic thrombocytopenic purpura?
When pharmaceutical therapy is not working or cases with life threatening thrombocytopenia
In idiopathic thrombocytopenic purpura what is traveling through the spleen and are destroyed by
the reticuloendothelial system?
Antibody-coated platelets
In hereditary spherocytosis what do rounded, stiff spherocytes experience while traveling through the spleen?
Hemolysis
What hematologic malignancies involving the spleen will result in the largest splenomegaly?
Hairy cell leukemia and CLL
What is the most common type of splenic rupture?
Traumatic
What are common non traumatic causes of splenomegaly?
1) Mononucleosis
2) CLL
3) Hairy Cell Leukemia
When diagnosing splenic rupture, in what quadrant would there be pain?
LUQ
What is the Kehr’s sign?
What is it caused by?
When is it elicited?
1) Referred pain in left shoulder
2) Irritation of the phrenic nerve by subdiaphragmatic bleeding
3) In recumbent position with legs raised
When performing a splenectomy what is the order in vascular ligation done?
What structure should you make sure to avoid?
1) Ligate the splenic artery, then the splenic vein
2) Avoid the pancreatic tail
Bacteria that are resistant to opsonization (encapsulated) are uniquely dealt with by feature of the spleen?
Reticuloendothelial system
How does overwhelming post-splenectomy infection present?
When is the risk highest?
1) Starts with vague illness progressing to severe sepsis in 2-3 days
2) 3 years after splenectomy
What do you want to vaccinate your splenectomized patients against?
Why do these bacteria need to be specifically vaccinated against?
1) Streptococcus pneumoniae
2) Neisseria meningitidis
3) Haemophilus influenzae B
1) They are all encapsulated
