TAILIEUCHUNG - Ebook Essentials for the canadian medical licensing exam - Review and prep for MCCQE part I: Phần 2

(BQ) Part 2 book "Essentials for the Canadian medical licensing exam - Review and prep for MCCQE part I" presents the following contents: Hematology, neurology, obstetrics and gynecology, oncology, ophthalmology, orthopedics and rheumatology, psychiatry, pulmonary medicine, urology. | SPLENOMEGALY Major Causes of Splenomegaly ICE MASS Infectious Congestive splenomegaly Chronic liver disease Extramedullar hematopoiesis Malignancy Amyloidosis Sarcoidosis Storage disease CHAPTER Hematology Surabhi Rawal Dr. Sapna Rawal and Dr. Ahmed Galal RATIONALE Splenomegaly is usually suggestive of an underlying disorder rather than a 1 splenic pathology. Therefore Rx is aimed at the underlying etiology. CAUSAL CONDITIONS Table Causal Conditions of Splenomegaly Demand for Ỳ Clearance of Abnormalities of RBC shape hereditary spherocytosis elliptocytosis splenic abnormal RBCs Hemoglobinopathies thalassemias function Nutritional anemias Infection Acute infectious mononucleosis hepatitis SBE Chronic TB AIDS malaria brucellosis syphilis Bacterial septicemia Splenic abscess Autoimmune RA Felty syndrome SLE Collagen vascular diseases Drug reactions Extramedullary Myelofibrosis hematopoiesis Marrow toxicity chemotherapeutic agents radiotherapy Marrow infiltration solid tumors leukemia storage diseases Altered splenic circulation Cirrhosis Portal vein obstruction Splenic vein obstruction CHF Splenic infiltration Storage diseases Niemann-Pick Gaucher nonlipoid Amyloidosis Malignancy leukemias lymphomas metastases Splenic cysts Myeloproliferative disorders 289 290 Essentials for the Canadian Medical Licensing Exam Review and Prep for MCCQE Part I APPROACH See Figure . 1 A Hypersplenism Cytopenia 2 to splenomegaly of most etiologies Key features are splenomegaly hyperplastic bone marrow modest pancytopenia Occasional RBC spherocytosis typically reticulocytosis Treat underlying disease Avoid splenectomy when possible to avoid risk of OPSI If necessary administer vaccines versus Strep pneumo HiB N. meningitidis and annual influenza vaccine and prophylactic Abx Tx CLINICAL BOX Dx of Splenomegaly on Exam Percuss last interspace Castell method If the spleen is normal percussion in the lowest intercostal space eighth to ninth in the left anterior axillary .

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