American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a standard recommendation for patients with hereditary spherocytosis prior to splenectomy?

1. Administer vitamin D supplements

2. Vaccination against encapsulated organisms

3. Initiate iron supplementation

4. Monitor hemoglobin levels weekly

The correct answer is: Vaccination against encapsulated organisms

For patients with hereditary spherocytosis, splenectomy is often a necessary intervention to alleviate the symptoms and complications associated with the disease. However, one of the significant risks following the loss of splenic function is the increased susceptibility to infections, particularly from encapsulated organisms such as Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b. Vaccination against encapsulated organisms is critical to help protect the patient from these infections, which can be severe and life-threatening. This vaccination is typically recommended to be administered at least two weeks prior to splenectomy. Ensuring patients are properly vaccinated helps mitigate the risk of post-splenectomy infections and is a standard part of the pre-surgical care process for individuals with hereditary spherocytosis. The other options, while they may have their own significance in different contexts (such as iron supplementation for patients with iron deficiency anemia), are not the primary focus or a standard recommendation specifically tied to the management of patients with hereditary spherocytosis prior to a splenectomy.