Hemat: Spleen

Front 1

Types of spleen

Back 1

● Sinusal/Defensive spleen

● Non-sinusal/Storage spleen

Front 2

Which spleen is found in human?

Back 2

● Sinusal spleen (possess venous sinuses)

Front 3

White pulp is predominant in what kind of spleen

Back 3

Sinusal spleen (that's why it is called defensive because WBCs in white pulp defends against non-viable cells)

Front 4

What fraction of cardiac output does the spleen get?

Back 4

1-10% of cardiac output (about 6% in humans 300ml/min)

Front 5

Weight of spleen

Back 5

Weight about 135g

Front 6

What is the weight of the spleen when completely drained of blood

Back 6

80g

Front 7

The sinuses of the spleen are surrounded by what?

Back 7

Reticulum (reticular fibres and cells)

Front 8

The cords of the red pulp are called

Back 8

Cords of Bilroth

Front 9

Function of spleen

Back 9

● Immune functions (white pulp)

● Clearing old and non-viable cells (red pulp and macrophages)

● Storage of platelets (in Cords of bilroth)

Front 10

What fraction of total platelet is stored in SPLEEN

Back 10

1/3 of total platelets

Front 11

Causes of hypersplenism

Back 11

● Appropriate increased activity of the spleen due to hereditary spherocytosis (to clear bad red cells) and ITP

● Inappropriate increased activity of the spleen due to portal hypertesion (blood pools in the spleen, causing spleen to be engorged and by default, blood cells not taken up by sinuses are destroyed)

Front 12

Treatment for hypersplenism is

Back 12

Splenectomy

Front 13

Hypersplenism causes cytopenia. T/F

Back 13

True. Hypersplenism causes increased destruction of RBCs and other cells (WBCs), higher than normal meaning rate of destruction of cells is higher than rate of production, hence CYTOPENIA

Front 14

How does hypersplenism cause bone marrow hyperplasia

Back 14

Hypersplenism causes cytopenia leading to increased production of cells by bone marrow to compensate for loss. This leads to bone marrow hyperplasia.

Front 15

Causes of splenomegaly

Back 15

● Hereditary disease (eg Thalassemia, Hereditary spherocytosis)

● Metabolic disorders (glycogen storage diseases, Niemann-picks disease, Amyloidosis)

● Malignancies (CLL, CML,leukaemia)

● Connective tissue disorder (eg Lupus)

● Idiopathic cause (Tropical Splenomegaly syndrome)

● Cardiovascular disorders (eg splenic/portal vein obstruction

Front 16

What is Tropical Splenomegaly Syndrome

Back 16

● aka Hyperactive Malarial Splenomegaly

● It is due to continuous/recurrent malaria infection that induces overstimulation of B cells to produce immunoglobulins majorly IgM.

● IgM is produced because it is non-specific to malaria parasites and can attack any.

● It occurs in regions endemic with malaria like the tropics (hence tropical)topical

● Seen in Africa and India

Front 17

Clinical findings of Tropical splenomegaly syndrome

Back 17

● Splenomegaly

● Hepatomegaly (together with splenomegaly cause abdominal distension)

● Elevated serum IgM

● Elevated antimalarial antibodies

● Marked phagocytosis of RBCs by macrophages and lymphocytic infiltrations

● Marked dilated sinusoids

● Anaemia

● Thrombocytopenia

Front 18

Does blood smear usually reveal the malarial parasite in Tropical splenomegaly syndrome (Hyperactive Malaria Splenomegaly)

Back 18

No, it usually doesn't show the parasites

Front 19

Is there thrombocytopenia in TSS

Back 19

YES

Front 20

Management of TSS

Back 20

● Prevent malaria reinfection by given Antimalarial drugs (since that's what causes the whole process)