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

Flashcards in MEH - The Spleen Deck (38)
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What is 'red pulp' in the spleen?

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


What is 'white pulp' in the spleen?

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


Does an enlarged spleen cause pain in most cases?

No, it usually causes a feeling of fullness


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


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


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


What are the three categories of splenomegaly?

Massive, moderate and mild


What is hyposplenism?

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


What is a risk of hyposplenism?

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


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.


What is cytopenia?

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


What is the difference between anaemia and erythrocytosis?

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


What is the difference between leucopenia and leucocytosis?

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


What is the difference between neutropenia and neutrophilia?

Neutropenia = low neutrophil count
Neutrophilia = high neutrophil count


What is the term for a high lymphocyte count?



What is pancytopenia?

Low red blood cells, white blood cells and platelets


What is the difference between thrombocytopenia and thrombocytosis?

Thrombocytopenia = low platelet count
Thrombocytosis = high platelet count


How do neutrophils appear on a slide?

Stain pink, have 3-5 segments


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


How long do neutrophils live for?

1-4 days


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

Increases amount of neutrophils, so can reduce neutropenic infections


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


What are the roles of monocytes?

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


What is contained within lysosomes in monocytes?

Lysozyme, complement, interleukins, arachidonic acid, CSF


What may cause monocytosis?

Chronic inflammatory conditions, chronic infection, carcinoma, leukemias


How long do eosinophils live for?

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


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


What is contained in the granules of eosinophils?

Arginine, phospholipid, enzymes


How do eosinophils appear histologically?

Stain pink with two purple central segments


What can cause eosinophilia?

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

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