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PA H9 | Spleen Disorders — Practice Quiz
Practice
10 questions · Untimed · Unlimited attempts
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Which of the following is NOT a recognised function of the normal spleen?
A
Filtration and destruction of senescent red blood cells
B
Production of opsonins (properdin and tuftsin)
C
Synthesis of clotting factor VIII
✓
D
Reservoir function for platelets and granulocytes
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A 35-year-old man presents with gradual-onset massive splenomegaly, anaemia, and hepatomegaly. Bone marrow biopsy shows a 'dry tap', and trephine reveals hypercellular marrow with prominent reticulin fibrosis and immature myeloid precursors. The most likely diagnosis is:
A
Chronic myeloid leukaemia (CML)
B
Primary myelofibrosis
✓
C
Kala-azar (visceral leishmaniasis)
D
β-thalassaemia major
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Which mechanism best explains the splenomegaly seen in portal hypertension due to hepatic cirrhosis?
A
Infiltration of the splenic parenchyma by macrophages laden with storage material
B
Passive congestion due to impaired venous drainage from the spleen
✓
C
Reactive lymphoid hyperplasia in response to portal bacteraemia
D
Extramedullary haematopoiesis compensating for bone marrow failure
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Hypersplenism is defined as:
A
Splenomegaly with peripheral cytopenias that improve after splenectomy
✓
B
Absolute spleen weight exceeding 500 g with any cytopenia
C
Splenomegaly causing portal hypertension via splenic vein compression
D
Excessive splenic production of immunoglobulins causing haemolysis
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A peripheral blood smear from a 28-year-old who underwent splenectomy three years ago for hereditary spherocytosis shows red cells containing small, dense nuclear remnants. These inclusions are:
A
Heinz bodies (denatured haemoglobin)
B
Howell-Jolly bodies (nuclear remnants)
✓
C
Pappenheimer bodies (iron granules)
D
Cabot rings (remnant spindle fibre)
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Following splenectomy, patients are at highest risk for overwhelming post-splenectomy infection (OPSI) from which group of organisms?
A
Intracellular organisms such as Mycobacterium tuberculosis and Listeria
B
Encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis
✓
C
Gram-negative enteric bacilli such as Escherichia coli and Klebsiella
D
Anaerobes such as Bacteroides fragilis and Clostridium species
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A 19-year-old woman from Bihar presents with 3-month history of fever, weight loss, and massive splenomegaly. Serology is positive for anti-rK39 antibody. Bone marrow aspirate shows macrophages laden with oval, non-flagellated organisms (2–4 µm). The causative vector is:
A
Anopheles mosquito
B
Female Phlebotomus sandfly
✓
C
Ixodes tick
D
Culex mosquito
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Which of the following pairings of disease and mechanism of splenomegaly is CORRECT?
A
Infective endocarditis — infiltrative (tumour cells)
B
Systemic lupus erythematosus (SLE) — immune (lymphoid hyperplasia and antibody production)
✓
C
Gaucher disease — congestive (sinusoidal congestion)
D
Beta-thalassaemia major — infective (parasitic infiltration)
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A 12-year-old boy from Odisha presents in June with high-grade fever, rigors, and massive splenomegaly. His blood smear shows RBCs with multiple ring-form trophozoites and banana-shaped gametocytes. Which complication is MOST life-threatening in this form of malaria?
A
Spontaneous splenic rupture
B
Cerebral malaria from sequestration of parasitised RBCs in cerebral microvessels
✓
C
Blackwater fever from immune-complex glomerulonephritis
D
Burkitt lymphoma from EBV reactivation
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A 16-year-old boy with known β-thalassaemia major on regular blood transfusions develops progressive splenomegaly with increasing transfusion requirements (from 2-unit every 4 weeks to every 2 weeks). Serum ferritin is 4,200 ng/mL. Which is the MOST likely cause of his increasing transfusion requirement?
A
Iron-overload cardiomyopathy reducing cardiac output
B
Hypersplenism causing sequestration and destruction of transfused red cells
✓
C
Alloimmunisation developing antibodies against transfused red cell antigens
D
Ineffective erythropoiesis worsening due to iron toxicity to erythroid progenitors
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