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Common splenomegaly exam questions for medical finals, OSCEs and MRCP PACES


Question 1. Spleen identification

How do you differential the spleen from the kidney on abdominal examination?

  • Spleen has a medial notch, kidney doesn’t
  • You can’t get above the spleen (ribs overly it)
  • The spleen moves towards RIF with inspiration, the kidney moves posterior only (if at all)
  • The spleen is not ballotable like the kidney


Question 2. Causes of splenomegaly

What are the causes of massive splenomgaly?

  • Myelofibrosis
  • CML
  • Malaria
  • VIsceral liesmaniasis

What are the causes of moderate splenomgaly?

  • Other myeloproliferative diseases (note CML and myelofibrosis can cause massive splenomegaly)
  • Portal hypertension
  • Thalassaemia
  • Glycogen storage disorders

What are the causes of mild splenomgaly?

  • Polycythaemia
  • Haemolytic anaemias
  • Infection
  • Infiltration
  • Connnective tissue diseases