Spleen
c) There is colloid shift to the spleen and bone marrow on imaging
SPLEEN
- Massive enlargement: Splenomegaly
- Consistency: Soft and friable
- Color: Red/chocolate on cut section
- Microscopy: Reticulum cells loaded with LD bodies
What our notes say
- c) There is colloid shift to the spleen and bone marrow on imaging (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
- Response to treatment is usually very rapid and the spleen is likely to be impalpable after 4 weeks (Paediatrics Year 6 MBChB end of semester CAT: clinical case MCQs, 29 of 30 quest)
- The Circulatory system is a continuous circuit comprising of the cardiovascular system (heart and blood vessels) and lymphatic system (lymph vessels, lymph nodes and lymphoid-organs -spleen, thymus and tonsils). (Cardiovascular system examination revised 2012 — Past Paper Questions & Answers)
- • Discontinuous capillaries found in bone marrow, liver and spleen appear as little cavities(sinusoids) and have the distance between endothelial cells is so great (Cardiovascular system examination revised 2012 — Past Paper Questions & Answers)
- Though the small vegetations are bland, they often embolize, in this case in the systemic circulation to spleen and kidney. (CARDIOVASCULAR PATHOLOGY — Past Paper Questions & Answers)
- Ruptured spleen (splenic injury) with haemorrhagic shock. (General Surgery CAT 2 (MBSG 4600): 4 October 2021)
Study material on Spleen
- hematopathology
- Hematology MCQs
- Here are all 45 questions, complete with full stems, choices, and answers.
- MDS, Myelofibrosis & HLH: Key Blood Disorders Explained
- Malaria
- Medical Microbiology III Exam: Viruses, Fungi & Diagnosis
- Blood Biochemistry
- CARDIOVASCULAR PATHOLOGY
- Aponeurosis — Histology Question Bank
- Cranial Nerves, Eye Exam & Vital Signs: MBChB Clinical Revision
- Hematopathology MCQS
- ANATOMY MCQs
- Weekly Pathology Exam - July 3, 2026 (Section A: MCQs)
- Abdomen and Pelvis Anatomy MCQs
- Weekly Year 1: Anatomy Exam - June 12, 2026 (Section A: MCQs)
- Weekly Year 1: Anatomy Exam - June 5, 2026 (Section A: MCQs)
Images
Practice questions on Spleen
A patient with Hodgkin lymphoma has disease on both sides of the diaphragm involving multiple lymph node groups and the spleen, with no systemic symptoms. What is his Ann Arbor stage and what does the absence of systemic symptoms signify?
- Stage II-A — disease on same side of diaphragm, no systemic symptoms
- Stage III-A — disease on both sides of diaphragm including spleen, no systemic symptoms
- Stage IV-B — disseminated disease with no systemic symptoms
- Stage III-B — disease on both sides of diaphragm with systemic symptoms
Answer: B. Stage III involves lymph node regions on both sides of the diaphragm; the S suffix denotes splenic involvement giving Stage IIIS. The suffix A indicates absence of systemic symptoms (fever, night sweats, unexplained >10% weight loss). Stage B would indicate presence of these symptoms. Stage IV requires disseminated extralymphatic organ involvement which is not described here. ---
A 35-year-old delirious man with fever 39.3°C, BP 70/palpable, a heart murmur, palpable spleen, and splinter hemorrhages is brought to the ED. Most likely lab finding?
- Positive urine screen for opiates
- Elevated anti-streptolysin O
- Increased urinary free catecholamines
- Elevated Coxsackie B viral titer
Answer: A. The clinical picture is acute infective endocarditis. IV drug use is the major risk factor; positive opiate urine screen would confirm this predisposing condition. ---
A 17-year-old has 3 weeks of malaise, mild pharyngitis, tender axillary and inguinal lymphadenopathy, and a palpable spleen. CBC shows atypical lymphocytes on smear. Most likely acquisition mechanism?
- Congenital genetic abnormality
- Through an environmental exposure at work
- As a result of an insect bite
- From close contact on a date
Answer: D. Atypical lymphocytes + pharyngitis + generalized lymphadenopathy + splenomegaly in a teenager = infectious mononucleosis (EBV). Acquired through saliva via close personal contact — the 'kissing disease.' ---
A 30-year-old woman has mild chronic fatigue. Exam shows a palpable spleen tip. CBC: Hgb 11.1, MCV 77, reticulocyte count 3.9%. Peripheral smear shows small RBCs lacking central pallor. Most likely pattern of inheritance?
- Autosomal dominant, European ancestry
- X-linked recessive, Middle Eastern ancestry
- Autosomal recessive, West African ancestry
- Sporadic occurrence
Answer: A. Small RBCs lacking central pallor (spherocytes) + mild chronic hemolytic anemia + splenomegaly = hereditary spherocytosis. Most common inherited hemolytic anemia in northern Europeans, autosomal dominant, from ankyrin or spectrin defects. ---
A 30-year-old man has a month of worsening productive cough. Exam shows a palpable spleen tip and small axillary lymph nodes. CBC: WBC 67,000, Hgb 10.2, platelets 36,000. Peripheral smear shows many blasts with Auer rods. Most likely diagnosis?
- Leukemoid reaction
- Acute myelogenous leukemia
- Chronic lymphocytic leukemia
- Leukoerythroblastosis
Answer: B. High WBC + blasts with Auer rods in a young adult = acute myelogenous leukemia (AML). Auer rods are formed from cytoplasmic granules of myeloid blasts and are pathognomonic for AML. ---
A 16-year-old boy has had low energy his entire life. Exam shows a palpable spleen tip. CBC: Hgb 8.8, MCV 65, platelets 187,000, WBC 7400. Serum ferritin is 3740 ng/mL. Bone marrow shows myeloid:erythroid ratio of 1:4 and 4+ stainable iron. Most likely diagnosis?
- G6PD deficiency
- Beta-thalassemia
- Sickle cell anemia
- Hereditary spherocytosis
Answer: B. Lifelong microcytic anemia + massively elevated ferritin + increased stainable bone marrow iron + erythroid hyperplasia (1:4 ratio) = beta-thalassemia. Reduced beta-globin leads to ineffective erythropoiesis and excessive iron absorption. ---