Splenomegaly
1 Accessory spleens are seen in what percentage of persons ?
A. 5 %
B. 10 %
C. 15 %
D. 20 %
2 Which of the following about structure of spleen is false ?
A. White pulp is lymphoid in nature
B. To return to circulation, RBCs traverse sinusoidal pores
C. Pulp cords are dead ends
D. None of the above
3 Which of the following is a ‘Red cell inclusion body’ ?
A. RBC parasites
B. Howell-Jolly bodies
C. Heinz bodies
D. All of the above
4 Which of the following is false about spleen ?
A. Normal spleen contains ~one-third of total body platelets
B. Normal spleen contains significant no. of marginated neutrophils
C. Spleen is in the portal circulation
D. None of the above
5 Weight of a normal spleen is ?
A. < 150 grams
B. < 250 grams
C. < 350 grams
D. < 450 grams
6 Which of the following is false about spleen ?
A. Decreases in size with age
B. Lies entirely within rib cage
C. Maximum cephalocaudad diameter is 13 cm by USG
D. Maximum width of 14 cm by radionuclide scan
7 Katayama fever is characterized by all except ?
A. Fever
B. Generalized lymphadenopathy
C. Lymphocytosis
D. Hepatosplenomegaly
8 Middleton maneuver is used for splenic ?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
9 Which of the following is false in spleen examination ?
A. Auscultation may reveal venous hum or friction rub
B. Bimanual palpation in right lateral decubitus position adds nothing to supine examination
C. Reproducibility among examiners is better for palpation than percussion
D. None of the above
10 Nixon, Castell, or Barkun methods are used for splenic ?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
11 In Nixon’s method, splenic enlargement is indicated whenupper border of dullness above costal margin is ?
A. > 4 cm
B. > 8 cm
C. > 12 cm
D. > 16 cm
12 In Castell’s method, percussion in the lowest intercostal space is done in ?
A. Midclavicular line
B. Anterior axillary line
C. Midaxillary line
D. Posterior axillary line
13 Massive splenomegaly is defined as spleen extending ?
A. > 2 cm below left costal margin
B. > 4 cm below left costal margin
C. > 6 cm below left costal margin
D. > 8 cm below left costal margin
14 Massive splenomegaly is defined as spleen that weighs ?
A. > 250 gram
B. > 500 gram
C. > 750 gram
D. > 1000 gram
15 Causes of massive splenomegaly include ?
A. Chronic myelogenous leukemia
B. Lymphomas
C. Hairy cell leukemia
D. All of the above
16 Causes of massive splenomegaly include ?
A. Myelofibrosis with myeloid metaplasia
B. Polycythemia vera
C. Gaucher’s disease
D. All of the above
17 Causes of Massive splenomegaly include ?
A. Chronic lymphocytic leukemia
B. Sarcoidosis
C. Autoimmune hemolytic anemia
D. All of the above
18 ‘Abscopal effect’ refers to ?
A. Ultrafiltration of abnormal RBCs
B. Regression of systemic disease after splenectomy
C. Increased tendancy of enlarged splenic rupture
D. Peritoneal seeding of splenic fragments
19 Term “splenosis” best relates to ?
A. Regression of systemic disease after splenectomy
B. Ultrafiltration of abnormal RBCs
C. Iatrogenic splenic rupture
D. Ectopic spleen tissue
20 Which out of the following is a contraindication for splenectomy ?
A. Iatrogenic splenic rupture
B. Thrombocytopenia
C. Presence of bone marrow failure
D. Hairy cell leukemia
21 Chronic manifestations of splenectomy include ?
A. Howell-Jolly bodies
B. Heinz bodies
C. Basophilic stippling
D. All of the above
22 Frequency of a serious infection following splenectomy is highest within ?
A. First 6 months
B. First 1 year
C. First 3 years
D. First 5 years
23 Which of the following is false in postsplenectomy period ?
A. Increased susceptibility to capsulated bacterial infections
B. No increased risk of viral infection
C. Increased susceptibility to babesiosis
D. None of the above
24 In elective splenectomy, pneumococcal vaccine should be administered how many weeks before surgery ?
A. 1 weeks
B. 2 weeks
C. 3 weeks
D. 4 weeks
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