Correct Answer for : USMLE step 2 Mcq 5:A 34 year old patient is urgently admitted to the Emergency department



Correct Answer: A

Explanation:

(the normal spleen never ruptures spontaneously. spontaneous rupture is encountered most often in infectious mononeucleosis, malaria, typhoid fever, leukemia etc)The spleen lies in the left hypochondrium. Surface marking- 9-11th ribs on the left side. So, recent crushing injury or severe blow to the left upper abdomen, flank or left side of the lower chest may cause a ruptured spleen. The significance of haemorrhage depends on the volume of blood loss, the rate of loss and the site of haemorrhage. The haemorrhagic shock may develop due to sudden rupture of spleen Rupture usually followed by massive intraperitoniale haemorrhage. It may lead to hypovolemic shock. The kidneys may be severely affected and so oliguria, anuria and electrolyte imbalances constitute major clinical problems


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