Spleen

Question 1

Where is the spleen located in the body

Answer 1

In the left hypochondrium
Convex surface resting on diaphragm
visceral surface in contact with the stomach and left kidney

Question 2

Normal weight of the spleen

Answer 2

150 g to 250 g

Question 3

What is the length of the spleen

Answer 3

5 cm to 13 cm

Question 4

What is an accessory spleen

Answer 4

Small nodule of splenic tissue found apart from the main body of the spleen

Question 5

Percentage of population with accessory spleen

Answer 5

10%

Question 6

When is the spleen palpable

Answer 6

When size over 14 cm

Question 7

From where does the blood enter spleen

Answer 7

From the splenic artery which divides into the trabecular arteries and give rise to Central arterioles

Question 8

Why is arterioles ends in the spleen unique

Answer 8

Because they form cords which lack endothelial lining which creates an open blood system with lose reticular connective tissue network lined by fibroblasts and macrophages

Question 9

How is blood drawn from the spleen

Answer 9

Enters venous sinuses which goes into splenic vein and get back to general circulation

Question 10

Percentage of red pulp in spleen

Answer 10

75%

Question 11

What forms the red pulp

Answer 11

The cords and sinuses

Question 12

What is the function of the Red pulp

Answer 12

Monitoring integrity of red blood cells

Question 13

What is the white pulp

Answer 13

Lymphatic tissue surrounding central arterioles

Question 14

What is the periarteriolar lymphoid sheath

Answer 14

It’s a Sheath that is found around the central material which contains T cells

Question 15

Immune cells found in the white pulp

Answer 15

B cells

Question 16

Which zones are rich in macrophages and dendritic cells

Answer 16

The marginal and the perifollicular zones

Question 17

How fast is rapid blood circulation in the spleen

Answer 17

1 or 2 minutes

Question 18

How slow is slow blood circulation through the spleen

Answer 18

30 to 60 minutes

Question 19

Major functions of the spleen

Answer 19

Filtration of red cells
Quality control of red cells
Capture and destruction of blood-borne pathogens
Generation of adaptive immune responses

Question 20

Should you worry if there’s enlarged spleen

Answer 20

Yes

Question 21

Where do you feel “regular” splenomegaly

Answer 21

Under left costal margin

Question 22

How far can you expect a massive splenomegaly to be felt

Answer 22

As far as the right iliac fossa

Question 23

Hematological causes of splenomegaly

Answer 23

Chronic myeloid leukemia
Chronic lymphocytic leukemia
Acute leukemia
Malignant lymphoma
Primary myelofibrosis
Polycythemia vera
Hairy cell leukemia
Thalassemia major or intermedia
Sickle cell disease
Hemolytic anemia’s
Megaloblastic anemia

Question 24

Causes of splenomegaly in portal hypertension

Answer 24

Cirrhosis

Hepatic or portal or splenic vein thrombosis

Question 25

Storage disease causes of splenomegaly

Answer 25

Gauche disease
Niemann pick disease
Histocytosis x

Question 26

InfectiousCauses of. Splenomegaly

Answer 26

Acute septicemia 
acute bacterial endocarditis
 Acute typhoid 
Acute infectious mononucleosis 
chronic tuberculosis 
Chronic brucellosis 
chronic syphilis 
chronic malaria 
chronic leishmaniasis 
Clinic schistosomiasis

Question 27

Systemic disease causing splenomegaly

Answer 27

Sarcoidosis 
amyloidosis 
collagen disease
 systemic lupus erythematosus
Rheumatoid arthritis 
systemic mastocytosis

Question 28

Percentage of total red cell mess present in the spleen

Answer 28

5% or 30 to 70 mL

Question 29

Portion of total marginating neutrophil pool in the spleen

Answer 29

Half

Question 30

Percentage of platelet mass in the spleen

Answer 30

30%

Question 31

Percentages of Retsil mess and platelets in an enlarged spleen

Answer 31

Can go up to 40% of red cell mass and 90% of platelets mass

Question 32

What is Hypersplenism

Answer 32

Clinical syndrome with no specific causal mechanism but with an enlarged spleen with reduction of one or more cell lines in peripheral blood and normal or hyperplastic cellularity of the bone marrow

Question 33

How do you confirm hypersplenism

Answer 33

By response to splenectomy

Question 34

How do you treat Hypersplenism

Answer 34

Treat underlying cause of Hypersplenism or splenomegaly

Splenectomy shen severe anemia or benefits outweigh the risks

Question 35

What are the risks of splenectomy

Answer 35

Sepsis

Thrombophilia

Question 36

What is Hyposplenism

Answer 36

Medical condition Occurring due to the range of medical conditions or splenectomy

Question 37

What conditions are associated with congenital absence of the spleen

Answer 37

Oregon transposition or severe malformations of the heart and lungs

Question 38

What are some common causes of Hyposplenism

Answer 38

Asplenia Due to sickle cell anemia by one year of age and auto infarction at 6 years of age
Congenital absence of the spleen
Atrophy of the spleen by 65 years of age

Splenectomy 
sickle cell disease 
essential thrombocythemia 
adult gluten induced enteropathy
 dermatitis herpetiformis 
Amyloidosis
Rarely inflammatory bowel disease 
splenic arterial thrombosis

Question 39

What is the risk of hyposplenism for patients

Answer 39

Increased risk of infection especially by strep pneumonia ,Haemophilus influenza type B , Neisseria meningitides

Severe form of malaria

Question 40

Red cells features in Hyposplenism

Answer 40

Target cells 
Acanthocytes
Irregularly contracted or crenated cells
Howell jolly bodies 
Siderotic granules
Pappenheimer bodies

Question 41

White cell features of Hyposplenism

Answer 41

Miles lymphocytosis

monocytosis

Question 42

Platelets features of Hyposplenism

Answer 42

Thrombocytosis

Question 43

What prevention measures must be taken by patients with Hyposplenism

Answer 43

Information about susceptibility to infection
carry cards about condition
prophylactic oral penicillin
erythromycin if patient allergic to penicillin
vaccination against pneumococcus Haemophilus meningococcus influenza