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Chapter 17. Spleen
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Splenectomy results in the loss of what immunologic protein?
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C. Membrane attack complex
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Answer: A. 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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E. Antiphospholipid syndrome
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Answer: B. 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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B. Gastrosplenic ligament
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C. Phrenosplenic ligament
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Answer: B. The gastrosplenic ligament contains the splenic artery/vein and short gastric arteries. In the setting of portal hypertension, the splenorenal ligament may contain a vascular supply.
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What is the treatment for bleeding gastric varices in the setting of sinistral hypertension?
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B. Transjugular intrahepatic portosystemic shunt
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Answer: D. 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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C. Symptomatic and size = 1.5 cm
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D. Presence of collagen vascular disease
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Answer: D. 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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