Spleen - Part 4

Question 1

What causes a splenic rupture? (3)

Answer 1

1. Trauma
2. Splenomegaly
3. Infectious disorder

Question 2

What are the clinical findings for a splenic rupture? (5)

Answer 2

1. LUQ pain
2. Tachycardia
3. Palpable mass
4. Abdominal pain
5. Decrease in
   hematocrit

Question 3

What is the US appearance for a splenic rupture? (3)

Answer 3

1. Hypo echoic or complex mass
2. May demonstrate posterior acoustic enhancement
3. Subcapsular rupture appears as a crescent-shaped fluid collection

Question 4

What are 3 differential diagnosis for a splenic rupture?

Answer 4

1. Recent splenic infarction
2. Abscess
3. Cyst

Question 5

What are the clinical findings for hemangiosarcoma? (4)

Answer 5

1. Anemia is most common
2. LUQ pain
3. Leukocytosis
4. Weight loss

Question 6

What is the US appearance for a hemangiosarcoma? (2)

Answer 6

1. Hyper echoic or complex mass

2. Frequently metastasizes to the liver

Question 7

What are 3 differential diagnosis for hemangiosarcoma?

Answer 7

1. Abscess
2. Hematoma
3. Cavernous hemangioma

Question 8

Leukemia

Answer 8

Proliferation of white blood cells

Question 9

What are the clinical findings for leukemia? (7)

Answer 9

1. Lymphadenopathy
2. Palpable spleen
3. Joint pain
4. Weakness
5. Fever
6. Elevated WBC
7. Anemia

Question 10

What is the US appearance for leukemia? (3)

Answer 10

1. Splenomegaly
2. Diffuse increase in parenchyma echogenicity
3. Hypo echoic or hyper echoic nodules

Question 11

What are 3 differential diagnosis for leukemia?

Answer 11

1. Hematoma
2. Lymphoma
3. Metastases

Question 12

Lymphoma

Answer 12

Malignant disorder involving the lymphoreticular system

Question 13

What are the 2 types of lymphoma?

Answer 13

1. Hodgkin’s

2. Non-Hodgkin’s

Question 14

What are the clinical findings for lymphoma? (6)

Answer 14

1. Lymphadenopathy
2. Anemia
3. Unexplained fever
4. Weight loss
5. Fatigue
6. Decrease in WBC count

Question 15

What is the US appearance for lymphoma? (3)

Answer 15

1. Hypo echoic splenic masses
2. Ill-defined margins 3. May demonstrate
   splenomegaly

Question 16

What are 2 differential diagnosis for lymphoma?

Answer 16

1. Metastatic lesion

2. Hematoma

Question 17

What is the most common metastases?

Answer 17

Melanoma

Question 18

What is a clinical finding for metastases?

Answer 18

Asymptomatic

Question 19

What is the US appearance for metastases? (2)

Answer 19

1. Typically hypo echoic

2. Target lesions

Question 20

What are 4 differential diagnosis for metastases?

Answer 20

1. Multiple abscesses 2. Lymphoma

3. Splenic candidiasis 4. Leukemia

Question 21

Where is the most common location of an accessory spleen?

Answer 21

Near the splenic hilum

Question 22

Where should the gain settings be placed to demonstrate the normal spleen?

Answer 22

Isoechoic to the normal liver

Question 23

What is the most common benign neoplasm of the spleen?

Answer 23

Cavernous hemangioma

Question 24

What is the most common clinical finding associated with a hemangiosarcoma?

Answer 24

Anemia

Question 25

Hemangiosarcoma involving the spleen frequently metastasizes to which organ?

Answer 25

Liver

Question 26

Which splenic abnormality is most commonly linked to infective endocarditis?

Answer 26

Abscess

Question 27

The splenic artery is a branch of which of the following vascular structures?

Answer 27

Celiac axis

Question 28

What carries carbon dioxide back to the lungs?

Answer 28

Hb

Question 29

Which splenic pathology is associated with granulomatosis?

Answer 29

Calcification

Question 30

What splenic pathology is associated with a “wheel within a wheel” appearance on US?

Answer 30

Candidiasis

Question 31

A patient arrives at the emergency department following a motor vehicle accident. An abdominal US is most likely ordered to evaluate for which condition?

Answer 31

Hemoperitoneum

Question 32

In cases of portal hypertension, which the splenic vein is most likely to shunt blood directly into?

Answer 32

Left renal vein

Question 33

Normal Hb levels should not exceed?

Answer 33

20g/dL