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Chapter 17. Spleen

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Splenectomy results in the loss of what immunologic protein?

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A. Tuftsin

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B. Immunoglobulin A

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C. Membrane attack complex

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D. C3 convertase

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Tuftsin and properdin are immunologic proteins produced by the spleen. After splenectomy these 2 immunologic proteins are absent, increasing the susceptibility to encapsulated organisms.

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What is the most common cause of splenic artery/vein thrombosis?

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A. Portal hypertension

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B. Pancreatitis

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C. Pancreatic cancer

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D. Factor V Leiden

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E. Antiphospholipid syndrome

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Pancreatitis is the most common cause of splenic artery/vein thrombosis.

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What ligament contains the vascular supply to the spleen?

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A. Splenocolic ligament

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B. Gastrosplenic ligament

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C. Phrenosplenic ligament

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D. Splenorenal ligament

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The gastrosplenic ligament contains the splenic artery/vein and short gastric arteries. In the setting of portal hypertension, the splenorenal ligament may contain vascular supply.

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What is the treatment for bleeding gastric varices in the setting of sinistral hypertension?

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A. Gastrectomy

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B. Transjugular intrahepatic portosystemic shunt

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C. Mesocaval shunt

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D. Splenectomy

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E. Sclerotherapy

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Splenectomy is the treatment for isolated gastric varices in the setting of sinistral hypertension.

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Which of the following is not an indication to repair a splenic artery aneurysm?

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A. Asymptomatic and size >2 cm

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B. Pregnancy

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C. Symptomatic and size = 1.5 cm

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D. Presence of collagen vascular disease

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Resection, with or without splenectomy, or embolization of a splenic artery aneurysm should be performed in pregnant patients, asymptomatic aneurysms >2 cm, and any symptomatic aneurysm.

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When should a patient be vaccinated prior to elective splenectomy?

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A. The day of surgery

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B. 7 days

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C. 14 days

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D. 21 days

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Patients should be vaccinated preoperatively if possible prior to ...

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