Surgical Anatomy of the Spleen

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?

Splenic artery (D) Signup and view all the answers

What is the name of the lumen that contains the hepatic artery, portal vein, and common bile duct?

Free edge of the lesser omentum (C) Signup and view all the answers

What is the percentage of patients with spleneculi?

20% (B) Signup and view all the answers

What is a typical presentation of splenic infarction on a CT scan?

A wedge-shaped region of low attenuation (A) Signup and view all the answers

What is a common cause of massive splenomegaly?

Myelofibrosis (D) Signup and view all the answers

What is the purpose of ILAPS (Indium-labelled Autologous Platelet Scan)?

To predict platelet sequestration in spleen, liver or both (D) Signup and view all the answers

What is the hallmark of hypersplenism?

All of the above (D) Signup and view all the answers

What is the treatment approach for splenic infarction?

Conservative management, with splenectomy considered only for septic infarcts (B) Signup and view all the answers

What percentage of the population has splenunculi?

15-20% (C) Signup and view all the answers

What is the treatment for Grade 4 and 5 blunt injuries of the spleen?

Splenectomy (C) Signup and view all the answers

What is a common underlying cause of splenic infarction?

Sickle cell disease (B) Signup and view all the answers

Which of the following is a characteristic of RBCs after splenectomy?

Poikilocytosis (D) Signup and view all the answers

What is the term for splenic enlargement with a reduction in blood elements?

Hypersplenism (B) Signup and view all the answers

What is the classification of splenomegaly based on palpation?

Mild, moderate, and massive (B) Signup and view all the answers

What is a common cause of tropical splenomegaly?

Leishmaniasis (A) Signup and view all the answers

What is the formula to calculate the size of the spleen using US and CT scan?

Length x Width x Height x 0.52 (B) Signup and view all the answers

What is the transient change in WBC count after splenectomy?

Neutrophilia (C) Signup and view all the answers

What is the main mechanism of Overwhelming Post-Splenectomy Infection (OPSI)?

Loss of splenic macrophages and complement system proteins (C) Signup and view all the answers

What is the main function of the splenic macrophages that is lost after splenectomy?

RE screening function (D) Signup and view all the answers

What is the primary indication for splenectomy in patients with idiopathic portal hypertension?

Absence of liver cirrhosis or thrombosis (D) Signup and view all the answers

Which of the following is a specific complication of splenectomy?

Gastric erosion (B) Signup and view all the answers

What is the reason why Streptococcus pneumoniae, Neisseria meningitides, and Haemophylus influenzae are not identified by macrophages?

They have a polysaccharide capsule (A) Signup and view all the answers

What is the primary consequence of OPSI if left untreated?

Respiratory and circulatory collapse (C) Signup and view all the answers

What is the antibiotic treatment for established OPSI?

Vancomycin with 3rd generation Cephalosporin (D) Signup and view all the answers

For which patients is long-term antibiotic treatment usually reserved?

Children with low titres from vaccination or immune suppression (D) Signup and view all the answers

How often should the Pneumococcus vaccine be repeated?

Every 5 years (A) Signup and view all the answers

When are the four vaccines typically given to patients?

2 weeks before surgery or after surgery when hemodynamically stable (D) Signup and view all the answers