Anatomy/Physiology
A wandering spleen occurs when the attachments to the spleen are stretched, missing, or weakened, putting the patient at risk for what complication?
splenic torsion
How is ITP diagnosed
It is a diagnosis of exclusion
What vaccines are given for splenectomy patients?
pneumococcal conjugate vaccine, meningococcal vaccine, Haemophilus Influenzae type B conjugate vaccine.
What complication can occur if a hydatid cyst ruptures during a splenectomy?
Anaphylaxis
Justin's favorite state is also the birthplace of ATLS. What is this state?
Nabraska
If you said Nebraska you lose 100 points
Name the two functional compartments of the spleen, one containing Periarteriolar lymphoid tissue and the other containing cords of billroth and venous sinuses
White pulp and red pulp
Splenectomy indicated in ITP when platelet count is less than ___ for 6 weeks
platelet count less than 10,000/µL for 6 weeks
True or False: Patient's do not need vaccination after splenic artery embolization
True
Abscesses most commonly form in the spleen through what mechanism? (how does the infection reach the spleen?)
Hematogenous spread
Justin's favorite animal is known to be the whale, but which type of whale is his favorite?
The humpback whale
Fun fact: Bubble-net feeding is a specialized feeding behavior primarily seen in humpback whales, in which groups of whales use exhaled air to create a "net" of bubbles that corrals schools of small fish or krill before a coordinated surface lunge
What structures are contained within the splenorenal ligament?
Splenic Artery and vein and tail of the pancreas
The risk of post splenectomy sepsis is highest during what time period following surgery?
2 years
How soon after emergent splenectomy should vaccination be done?
14 days after surgery or prior to discharge
Splenic cysts that lack an epithelial lining are classified as ...
Secondary cysts (false cysts)
Usually be post traumatic but can be related to infection (mononucleosis, tuberculosis, or malaria)
Prior to deciding to pursue surgery what specialty was Justin planning on going into?
Endocrinology
Imagine consulting medicine and getting me
The gastrosplenic ligament contains what structure
The short gastric arteries
Identify the mode of inheritance (Autosomal dominant, recessive, X linked) for sickle cell disease, Thalassemia, G6PD deficiency, and hereditary spherocytosis
Thalassemia - autosomal dominant
hereditary spherocytosis - autosomal dominant
G6PD - x linked
Sickle cell - autosomal recessive
What is the most common bacteria associated with overwhelming post splenectomy sepsis
Streptococcus pneumoniae is the most common organism (50%-90% of cases)
What is the most common benign primary neoplasm of the spleen?
Hemangioma (generally recommend MRI for evaluation over biopsy due to bleeding risk)
It is well known that Justin keeps a nemesis in each department as a source of personal development. Who is Justin's general surgery nemesis?
Nawal Peracha
The ligaments that hold the spleen in place, which need to be divided, are .... (There are 4)
gastrosplenic, splenocolic, splenorenal, and splenophrenic ligaments
In patients with hereditary spherocytosis, splenectomy should be performed after what age in order to preserve immune function and reduce the risk of postsplenectomy sepsis
Age 5
When should vaccination be done for elective splenectomy?
Name one of the two common parasites associated with hydatid disease
Echinococcus granulosus
Echinococcus multilocularis
Don't pick this one
I told you not to pick it. Your team loses 100 points. Whatever team Joey is on also loses 100 points