Answer 5
Following splenectomy for trauma
False a. thrombocytopaenia is typical
True b. pneumococcal vaccine should be given
True c. malaria is more severe
False d. prophylactic penicillin should be taken for six weeks
False e. Heinz bodies are characteristically seen on the blood film
Splenectomy typically results in thrombocytosis.
Howell-Jolly bodies are small pieces of nuclear material usually removed from erythrocytes by the spleen.
Heinz bodies are oxidised, denatured bits of haemoglobin found in G-6-PD deficiency for example. Special stains are required to see Heinz bodies.
Asplenic patients are at particular risk of severe pneumococcal infections. They should receive Pneumovax and lifelong prophylactic penicillin. Further, if possible, some splenic tissue should be preserved :-e.g. in the rectus sheath.
Asplenic patients also suffer more severe disease following infection with Plasmodium falciparum and Haemophilus influenzae.
