NBME 24 Ruptured spleen (NBME Answers)

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nbme24/Block 1/Question#49 (reveal difficulty score)
A 58-year-old man is brought to the emergency ...
Ruptured spleen 🔍 / 📺 / 🌳 / 📖
tags:

+7 upvote downvote
submitted by ∗sympathetikey(1600)

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Pretty straightforward, but a good reminder that myelofibrosis can cause an enlarged spleen.

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sympathetikey Due to extramedullary hematopoesis +31

zoggybiscuits I thought it was spleen but the fact that hematocrit was 24% 4 HOURs later made me think otherwise. It was my understanding that the spleen would bleed you out quick! +1

need_answers couldn't also be ruptured spleen because they said intraperitoneal fluid and everything else is retroperitoneal ?? +4

peqmd Spleen is most commonly ruptured in blunt trauma so along with myelofibrosis and being kicked on the left side it's just asking to be ruptured +3

limberry @need_answers the bladder is intraperitoneal, not retro +

limberry bladder is sub*peritoneal, sorry +

+6 upvote downvote
submitted by ∗aneurysmclip(209)

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Kicked in the side 1 hour ago. diagnosed with chronic myelofibros -> extra-medullary hematopoiesis > splenomegaly; therefore easier to rupture spleen. USG showing intraperitoneal bleed. and he has LUQ guardiang and tenderness. All points to spleen

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+0 upvote downvote
submitted by ∗jbrito718(48)

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Fucked up thinking the S in SADPUCKER was for spleen when its actually suprarenal arteries. Such an easy question to miss.

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