Flashcards in Spleen Deck (28):
1
location of the spleen
Located in the left upper quadrant between the fundus of the stomach, the diaphragm, the splenic flexure of the left colon and the left kidney
2
blood supply for spleen
splenic artery
short gastrics
3
the tail of the pancreas is right near what?
spleen
4
main 2 functions of the spleen
erythrocyte maintenance
immune function
5
causes of hypersplenism
Neoplastic disorders
Hematopoietic disorders
Metabolic or storage disorders
antibodies to platelets or RBCS causing spleen to destroy them
6
diseases associated w/ secondary hypersplenism
Portal HTN
Splenic vein thrombosis
Leukemias/lymphoma
SLE
Gaucher disease
Mononucleosis
Felty syndrome
7
with primary hypersplenism what is indicated
splenectomy
8
bleeding of gastric varcies w/ chronic pancreatitis
splenic vein thrombosis (blood can't get out of the spleen through splenic vein)
9
what is tx for splenic vein thrombosis
splenectomy
10
what autoimmune disease requires a splenecomty (if they have warm antibodies)
acquired hemolytic anemia
11
what meds is acquired hemolytic anemia associated w/
PCN and quinidine
12
what is first line tx for acquire hemolytic anemia?
glucocorticoids
13
Antibodies to platelet antigens
No splenomegaly
Petechiae, ecchymosis, epistaxis and easy bruising
ITP Immune/Idiopathic thrombocytopenia Purpura
14
when do you tx ITP
moderate or severe purpura
15
Tx for ITP
glucocorticoids high dose until platelets go to normal
16
when is splenectomy needed for ITP
people with ITP who fail steroids
17
do you ever get anyone with ITP platelets?
No
18
when do you give platelets in a splenectomy for ITP
clamp across splenic artery
19
common congenital hemolytic anemia
Related to abnormalities in the erythrocyte structure
Affected RBCs have a deficiency in spectrin, an essential component of the cell membrane
hereditary spherocytosis
20
how can someone w/ hereditary spherocytosis present
w/i first 3 decades
splenomegaly common
can present w/ abdominal discomfort and jaundice
21
when should a splenectomy be done with ehreditary spherocytosis
at least age 6
also take the gallbladder out
22
aD trait that results in elliptical erythrocytes increasing rate of destruction of RBC> don't always need a splenectoy
Hereditory Elliptocytosis
23
when do you do a splenectomy with a splenic cyst
if persitss or becomes symptomatic
(can be from hydatid dz)
24
Relatively rare condition that may follow a splenectomy. Infection is with encapsulated organisms (S pneumonia, H influenza, N meningitidis)
Overwhelming postsplenectomy sepsis (OPSS)
25
when shoudl the pneumococcal vaccine be given before an elective splenectomy
2 weeks prior
26
what are other recommended vaccines for someone w/ a splenectomy
pneumococcus
haempholis and meningococcus
27
when do people w/ a splenectomy need abx prophylaxis
invasive medical procedures and dental work
28