Surgical Anatomy of the Spleen

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Questions and Answers

What is the origin of the spleen?

  • Mesodermal origin (correct)
  • Neural crest origin
  • Ectodermal origin
  • Endodermal origin

What is the percentage of white pulp in the spleen?

  • 50%
  • 10%
  • 25% (correct)
  • 75%

What is the name of the ligament that suspends the spleen to the stomach?

  • Lienorenal ligament
  • Gastrosplenic ligament (correct)
  • Splenodiaphragmatic ligament
  • Splenocolic ligament

What is the name of the artery that supplies blood to the spleen?

<p>Splenic artery (D)</p>
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What is the name of the lumen that contains the hepatic artery, portal vein, and common bile duct?

<p>Free edge of the lesser omentum (C)</p>
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What is the percentage of patients with spleneculi?

<p>20% (B)</p>
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What is a typical presentation of splenic infarction on a CT scan?

<p>A wedge-shaped region of low attenuation (A)</p>
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What is a common cause of massive splenomegaly?

<p>Myelofibrosis (D)</p>
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What is the purpose of ILAPS (Indium-labelled Autologous Platelet Scan)?

<p>To predict platelet sequestration in spleen, liver or both (D)</p>
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What is the hallmark of hypersplenism?

<p>All of the above (D)</p>
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What is the treatment approach for splenic infarction?

<p>Conservative management, with splenectomy considered only for septic infarcts (B)</p>
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What percentage of the population has splenunculi?

<p>15-20% (C)</p>
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What is the treatment for Grade 4 and 5 blunt injuries of the spleen?

<p>Splenectomy (C)</p>
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What is a common underlying cause of splenic infarction?

<p>Sickle cell disease (B)</p>
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Which of the following is a characteristic of RBCs after splenectomy?

<p>Poikilocytosis (D)</p>
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What is the term for splenic enlargement with a reduction in blood elements?

<p>Hypersplenism (B)</p>
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What is the classification of splenomegaly based on palpation?

<p>Mild, moderate, and massive (B)</p>
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What is a common cause of tropical splenomegaly?

<p>Leishmaniasis (A)</p>
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What is the formula to calculate the size of the spleen using US and CT scan?

<p>Length x Width x Height x 0.52 (B)</p>
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What is the transient change in WBC count after splenectomy?

<p>Neutrophilia (C)</p>
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What is the main mechanism of Overwhelming Post-Splenectomy Infection (OPSI)?

<p>Loss of splenic macrophages and complement system proteins (C)</p>
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What is the main function of the splenic macrophages that is lost after splenectomy?

<p>RE screening function (D)</p>
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What is the primary indication for splenectomy in patients with idiopathic portal hypertension?

<p>Absence of liver cirrhosis or thrombosis (D)</p>
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Which of the following is a specific complication of splenectomy?

<p>Gastric erosion (B)</p>
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What is the reason why Streptococcus pneumoniae, Neisseria meningitides, and Haemophylus influenzae are not identified by macrophages?

<p>They have a polysaccharide capsule (A)</p>
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What is the primary consequence of OPSI if left untreated?

<p>Respiratory and circulatory collapse (C)</p>
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What is the antibiotic treatment for established OPSI?

<p>Vancomycin with 3rd generation Cephalosporin (D)</p>
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For which patients is long-term antibiotic treatment usually reserved?

<p>Children with low titres from vaccination or immune suppression (D)</p>
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How often should the Pneumococcus vaccine be repeated?

<p>Every 5 years (A)</p>
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When are the four vaccines typically given to patients?

<p>2 weeks before surgery or after surgery when hemodynamically stable (D)</p>
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