MEH - The Spleen Flashcards Preview

CJ: UoL Medicine Semester Two (ESA2) > MEH - The Spleen > Flashcards

Flashcards in MEH - The Spleen Deck (38):
1

What is 'red pulp' in the spleen?

Sinuses lined by endothelial macrophages and cords. Red cells pass through this preferentially

2

What is 'white pulp' in the spleen?

Similar structure to lymphoid follicles. White cells pass through this preferentially

3

Does an enlarged spleen cause pain in most cases?

No, it usually causes a feeling of fullness

4

What are the functions of the spleen in adults?

- sequestration and phagocytosis (old/abnormal red cells removed by macrophages)
- blood pooling (platelets and red cells can be rapidly mobilised during bleeding)
- extramedullary haemopoiesis (pluripotential stem cells proliferate during haematological stress/if bone marrow fails)
- immunological function

5

How should splenomegaly be palpated?

Start to palpate in right iliac fossa and feel the edge of the spleen move towards your hand on inspiration. Feel for splenic notch and measure in cm from costal margin in mid-clavicular line

6

Give some reasons for splenomegaly

- back pressure, eg due to portal hypertension in liver disease
- overworking red/white pulp
- extramedullary haemopoiesis
- expanding as infiltrated by foreign material/cells eg cancers, sarcoidosis

7

What are the three categories of splenomegaly?

Massive, moderate and mild

8

What is hyposplenism?

Lack of functioning splenic tissue - may be due to splenectomy, sickle cell disease, coeliac disease.

9

What is a risk of hyposplenism?

Patients are at risk of overwhelming sepsis, particularly from encapsulated organisms, eg. Pneumococcus

10

What are Howell Jolly bodies?

DNA remnants seen inside cells on a blood film which appear as dark spots. They suggest that the spleen has been removed.

11

What is cytopenia?

Umbrella term for a reduction in the number of blood cells.

12

What is the difference between anaemia and erythrocytosis?

Anaemia = low red cell count
Erythrocytosis = high red cell count

13

What is the difference between leucopenia and leucocytosis?

Leucopenia = low white blood cells
Leucocytosis = high white blood cells

14

What is the difference between neutropenia and neutrophilia?

Neutropenia = low neutrophil count
Neutrophilia = high neutrophil count

15

What is the term for a high lymphocyte count?

Lymphocytosis

16

What is pancytopenia?

Low red blood cells, white blood cells and platelets

17

What is the difference between thrombocytopenia and thrombocytosis?

Thrombocytopenia = low platelet count
Thrombocytosis = high platelet count

18

How do neutrophils appear on a slide?

Stain pink, have 3-5 segments

19

What does the hormone G-CSF do?

- increases production of neutrophils
- decreases time to release of mature cells from bone marrow
- enhances chemotaxis
- enhances phagocytosis and killing of pathogens

20

How long do neutrophils live for?

1-4 days

21

Why might recombinant G-CSF be injected post-chemotherapy?

Increases amount of neutrophils, so can reduce neutropenic infections

22

Give some examples of things which may cause neutropenia

- B12/folate deficiency
- infiltration of bone marrow by malignancy/fibrosis
- aplastic anaemia
- radiation
- drugs (chemotherapy, antibiotics, anti-epileptics etc.)
- viral infection
- congenital disorders

23

What are the roles of monocytes?

- respond to inflammation and antigenic stimuli
- migrate to tissues where they become macrophages and phagocytose pathogens

24

What is contained within lysosomes in monocytes?

Lysozyme, complement, interleukins, arachidonic acid, CSF

25

What may cause monocytosis?

Chronic inflammatory conditions, chronic infection, carcinoma, leukemias

26

How long do eosinophils live for?

8-12 days, of which 3-8 hours are spent in the circulation

27

What are the roles of eosinophils?

- deal with some parasites
- mediator of allergic response
- migrate to epithelial surfaces
- phagocytosis of antigen-antibody complexes
- mediate hypersensitivity reactions

28

What is contained in the granules of eosinophils?

Arginine, phospholipid, enzymes

29

How do eosinophils appear histologically?

Stain pink with two purple central segments

30

What can cause eosinophilia?

- allergic diseases, eg. asthma
- drug hypersensitivity
- Chung-Strauss
- parasitic infection
- skin diseases
- leukaemia/lymphoma

31

How do basophils appear histologically?

Stain purple, look a bit like blackberries. They are the largest immune cell

32

When are basophils active?

In allergic reactions and inflammatory conditions

33

What is contained within the granules of basophils?

Histamine, heparin, hyaluronic acid, serotonin

34

How do lymphocytes appear histologically?

Stain pink with a large pink/purple centre

35

Give some reactive causes of lymphocytosis

- viral infections
- bacterial infections
- stress related (MI/cardiac arrest)
- post-splenectomy
- smoking

36

Pnacytopenia can result due to increased removal of blood cells. Give some reasons for increased removal

Immune destruction, splenic pooling, haemophagocytosis

37

What is aplastic anaemia?

Pancytopenia with a hypocellular bone marrow in the absence of an abnormal infiltrate and with no increase in reticulin

38

What would be the symptoms of pancytopenia?

Symptoms of anaemia + symptoms of thrombocytopenia + symptoms of neutropenia + symptoms of underlying cause

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