Spleen disorders and Hypersplenism скачать в хорошем качестве

Spleen disorders and Hypersplenism

Check out our new USMLE prep video. Spleen Disorders and Hypersplenism: 1. Spleen: The spleen is a part of the immune system. It filters the blood, destroys old red blood cells, and provides a reserve of blood in case of hemorrhagic shock. 2. Hypersplenism: Hypersplenism refers to conditions where the spleen is overactive, leading to premature destruction of blood cells leading to cytopenias (reduction in the number of blood cells). Hypersplenism: 1. Definition: It's characterized by an enlarged spleen (splenomegaly) and cytopenias. It can lead to anemia, thrombocytopenia, and leukopenia. 2. Symptoms: Fatigue, shortness of breath, easy bruising or bleeding, recurrent or severe infections. 3. Signs: Palpable spleen on physical examination, confirmed by imaging tests like Ultrasound or CT scan. Etiologies of Hypersplenism: 1. Infections: Such as viral (mononucleosis), parasitic (malaria), or bacterial (typhoid). 2. Immune Disorders: Like rheumatoid arthritis or Lupus. 3. Hematologic Malignancies: Lymphomas or Leukemias can cause secondary hypersplenism. 4. Liver Disease: Cirrhosis and portal hypertension often result in splenomegaly and hypersplenism. 5. Other Causes: Includes congestive splenomegaly, Gaucher's disease, and Niemann-Pick disease. Laboratory Findings in Hypersplenism: 1. Peripheral blood smear may show Howell-Jolly bodies (nuclear remnants in red blood cells, which are usually removed by the spleen). 2. Pancytopenia (low counts of all three types of blood cells - red cells, white cells, and platelets) may be present. 3. The bone marrow is often hyperactive, trying to compensate for the cell loss. Treatment: 1. Management of the underlying cause. 2. Therapeutic options for symptomatic hypersplenism may include partial splenic embolization or immunosuppressive therapy. 3. Splenectomy (removal of the spleen) is a last-resort option, mainly if symptoms are severe or risk of splenic rupture. Key High-Yield Facts: 1. Howell-Jolly bodies are indicative of functional asplenia and are seen post-splenectomy or in conditions like sickle cell disease where the spleen function is compromised. 2. Postsplenectomy, patients are at a higher risk of infections, particularly by encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis). Vaccinations and prophylactic antibiotics are recommended. 3. Hypersplenism can present with B symptoms (fever, night sweats, and weight loss) if caused by malignancies. 4. Complications of splenectomy include post-splenectomy sepsis, thrombocytosis, and pulmonary complications.