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