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SBL Exam 1 WBCs, Spleen, and Thymus > Spleen > Flashcards

Flashcards in Spleen Deck (12)
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1

What are the major functions of the spleen?

 

Removal of elements in the blood:

-clearing blood cells and bacteria

-recycling iron and globins

 

Secondary lymphoid organ

-Ab production

-Ag capture and presentation to T/B cells

 

Hematopoiesis

-normal during fetal development

-compensatory extramedullary site in adults

 

Stores formed elements:

-stores 30-40% of platelets

-stores lymphocytes

2

What effects can be seen as result of splenomegaly/hypersplenism?

-pressure/pain in LUQ

-risk of rupture

 

Hypersplenism:

-anemia (sequestration of RBCs)

-leukopenia (sequestration of leukocytes)

-thrombocytopenia (sequestration of platelets, up to 80-90% of total

3

What are common causes of splenomegaly?

-infection

-portal hypertension

-blood cell disorders (neoplasms and anemias)

-autoimmune/inflammatory conditions

-IEM (Gaucher, Neimann-Pick, etc.)

-amyloidosis

-cancer of the spleen/metastasis to the spleen

4

What are causes of congestive splenomegaly?

-cardiac decompensation/right heart failure

-liver cirrhosis

-obstruction of portal or splenic vein

5

What are causes of splenic infarcts?

Occlusion of splenic artery (lack of collateral blood supply):

-cardiac emboli

-infectious endocarditis

-splenomegaly

-myeloproliferative disorders (MPD)

6

What are common effects of splenic infarcts?

-dramatic increased risk of infection by encapsulated bacteria (pneumococcus, H. influenzae, meningococcus)

7

What are the most common primary and secondary neoplasms of the spleen?

Primary:

-rare; lymphagiomas and hemangioma

 

Secondary:

-lymphoid/myeloid neoplasms

8

What conginital abnormalities of the spleen exist?

What is their significance if any?

Splenic aplasia:

-rare, typically associated with other abnormalities

 

Splenic hypoplasia:

-more common that aplasia

 

Accessory spleens:

-common (20-35%)

-splenectomy is used as treatment in immune thrombocytopenia and hereditary shperocytosis; if an accessory spleen is not removed, theraputic benefit is diminished

9

What are common causes of splenic rupture?

Trauma, especially to an acutely enlarged spleen

 

Uncommon in chronically enlarged spleens (fibrosis)

 

Especially in the setting of:

-mononucleosis

-malaria

-typhoid fever

-neoplasms of the spleen

10

What are the effects of splenic rupture?

massive intraperitoneal hemorrhage resulting in death if not treated with emergent splenectomy

11

What are signs of splenic rupture?

Can present with:

-LUQ pain

-left shoulder pain (Kehr sign)

-peritonitis

-hemodynamic instability

 

12

What is a possible post-splenectomy complication?

Overwhelming post-splenectomy infection (OPSI)

 

  • encapsulated bacteria are mainly eliminated by the spleen
    • Streptococcus pneumoniae
    • Neisseria meningitidis
    • Haemophilus influenae B
  • highest risk first 3 years following splenectomy