SB82 Spleen - loosely taken from Fiser's ABSITE review
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Which organ is the largest producer of IgM? __________ | Spleen
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| What comprises Howell-Jolly bodies? __________ | Nuclear remnants
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| What comprises Heinz bodies? __________ | Hemoglobin
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| What is the definition of culling? | Removal of less deformable RBCs
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| What is the main site of clearance of bacteria that do not have pre-existing antibodies? ___________ | Spleen
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| Which opsonin that facilitates phagocytosis is produced in the spleen? ___________ | Tuftsin
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| Which substance produced in the spleen activated the alternate complement pathway? _______________ | Properdin
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| Accessory spleens are most commonly found in this location | Splenic hilum (20%)
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| Pathophysiology of ITP | IgG antiplatelet antibodies bind platelets, causing thrombocytopenia
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| Therapy for ITP | Steroids (primary therapy), plasmapheresis, gammaglobulin, splenectomy
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| What percentage of patients with ITP respond to splenectomy? | 80%
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| When should you give platelets prior to splenectomy for ITP? | One hour before surgery
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| What is the pathophysiology of TTP? | Loss of platelet inhibition causes thrombosis and infarction with profound thrombocytopenia
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| What percent of patients with TTP respond to medical therapy? | 80%
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| What is the treatment of TTP? | Plasmapheresis (primary); steroids, aspiring
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| Post-splenectomy sepsis is highest in patients who required splenectomy for what conditions? | Hemolytic disorders or malignancy
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| Most episodes of post-splenectomy sepsis occur within what time frame? | Within 2 years of splenectomy
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| Post-splenectomy changes in blood studies | Increased RBCs, increased WBCs, increased platelets
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| What is the most common benign splenic tumor? ___________ | Hemangioma
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| What is the indication for resection of splenic hemangioma? | Symptomatic
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| What is the most common malignant splenic tumor? ___________ | Non-Hodgkin’s lymphoma
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| When should you perform surgery for splenic cysts? | If they become symptomatic or are > 10 cm
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| This syndrome is characterized by rheumatoid arthritis, hepatomegaly, splenomegaly _________ | Felty’s syndrome
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| This lipid disorder leads to splenomegaly __________ | Gaucher’s disease
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| What is the most common congenital hemolytic anemia requiring splenectomy? _________ | Spherocytosis
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| What is the mutated protein causing spherocytosis? __________ | Spectrin
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| Why do you perform cholecystectomy with splenectomy in patients > 5 yo with spherocytosis? | It causes pigmented gallstones
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| Protein mutations in elliptocytosis ___________ | Spectrin and protein 4.1
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| Definition of Stage I Hodgkin’s lymphoma | 1 area or 2 contiguous areas on the same side of the diaphragm
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| Definition of Stage II Hodgkin’s lymphoma | 2 non-contiguous areas on the same side of the diaphragm
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| Definition of Stage I Hodgkin’s lymphoma | Involved on each side of the diaphragm
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| Definition of Stage I Hodgkin’s lymphoma | Involves any non-lymphoid tissue (other than the spleen)
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| Most common form of Hodgkin’s lymphoma _________ | Nodular sclerosing
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| Treatment for hairy cell leukemia | Splenectomy and interferon-gamma
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| Splenosis is usually related to this event ___________ | Trauma
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| The most common cause of splenic artery or splenic vein thrombosis __________ | Pancreatitis
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| Most common cause of splenic artery aneurysms __________ | Fibromuscular dysplasia or atherosclerosis
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