Spleen

Question 1

Which splenic ligament contains the short gastrics?

Answer 1

Gastrosplenic ligament

Question 2

Which splenic ligament contains the splenic vessels and tail of the pancreas?

Answer 2

Splenorenal ligament

Question 3

Red Pulp

Answer 3

Filters damaged red blood cells - More predominant

Question 4

White pulp

Answer 4

Immune function
Lymphoid follices- B cells
PALS- T cells

Question 5

Angiographic intervention for splenic injuries?

Answer 5

> Grade III injuries (subcapsular hematoma >50% or expanding, subcapsular hematoma, lacteration >3cm, involving trabecular vessels), contrast blush, moderate hemoperitoneum, ongoing splenic bleeding

Question 6

Heinz Body

Answer 6

Bite Cells- Intracellular denatured protein

Question 7

Hereditary spherocytosis is caused by?

Answer 7

Autosomal dominant defect in Spectrin

Question 8

Howell-Jolly Body

Answer 8

Nuclear remnants of red blood cells

Question 9

If you don’t see abnormal cells post-splenectomy ?

Answer 9

Accessory spleen

Question 10

In addition to splenectomy in patients with hereditary spherocytosis, what other procedure do they need?

Answer 10

Cholecystectomy

Question 11

Indications for splenectomy

Answer 11

Unstable trauma patient, hematologic disorder, splenic abscess, symptomatic cyst, primary malignancy, splenic vein thrombosis

Question 12

ITP is caused by?

Answer 12

Autoantibodies to glycoprotein IIb/IIIa and Ia/IIa

Question 13

Most common location for an accessory spleen?

Answer 13

Splenic hilum

Question 14

Most common source of post-splenectomy bleeding?

Answer 14

Short gastrics

Question 15

Multi-locoular, thin walled splenic abscess?

Answer 15

Suspect echinococcal, splenectomy

Question 16

PappenheImer Body

Answer 16

Iron deposits

Question 17

Primary lymphoid organs

Answer 17

Liver, bone and thymus

Question 18

Red Pulp

Answer 18

Filters damaged RBC’s

Question 19

Secondary lymphoid organs

Answer 19

Lymph node, spleen, peyers patches, tonsils

Question 20

Spurr Cell

Answer 20

Deformed membrane

Question 21

Systemic vascular resistance is high in which types of shock?

Answer 21

Hypovolemic (low CVP) and cardiogenic (high CVP)

Question 22

Target Cell

Answer 22

Immature RBC

Question 23

Thrombotic thrombocytopenic purpura (TTP)

Answer 23

Defective ADAMTS13 -platelet aggregation (Tx= plasmapharesis)

Question 24

Unilocular thick wall in stable patient splenic abscess treatment?

Answer 24

Percutaneous drainage

Question 25

When do you transfuse platelets in ITP?

Answer 25

Intraoperative after ligating the splenic artery (prevents consumption of platelets).

Question 26

When to treat splenic artery aneurysm?

Answer 26

>2cm, pregnant women or women of child bearing age regardless of age

Question 27

When to vaccinate patients post-splenectomy?

Answer 27

2 weeks prior to elective splenectomy, 2 weeks post-op (2 weeks prior to discharge)

Question 28

Which size of cysts need surgical intervention?

Answer 28

>5cm or symptomatic

Question 29

Which splenic ligament contains the short gastrics?

Answer 29

Gastrosplenic ligament

Question 30

Which splenic ligament contains the splenic vessels and tail of the pancreas?

Answer 30

Splenorenal ligament

Question 31

White pulp

Answer 31

Immune function Lymphoid follices- B cells PALS- T cells

Question 32

Most common benign neoplasm of the spleen

Answer 32

Hemangioma

Question 33

Fuel source for stomach, enterocytes, pancreas and spleen

Answer 33

Glutamine

Question 34

Grades of Splenic Injuries