Which of the following symptoms is associated with a ruptured spleen?

A ruptured spleen often presents with specific symptoms, one of which is pain in the upper left quadrant of the abdomen due to its location within the body. This pain can be quite intense and is a hallmark sign of splenic injury. Alongside this pain, Kehr's sign is particularly notable in cases of a ruptured spleen; it refers to referred pain in the left shoulder due to irritation of the diaphragm and is a classic indicator of splenic issues.

Pain and nausea can occur with a ruptured spleen, but the combination of upper left quadrant pain and Kehr's sign specifically points to the splenic injury. The other symptoms listed in different answer choices, such as abdominal cramping and diarrhea, or seizures and muscle spasms, are not typically associated with a ruptured spleen and are more indicative of other conditions or injuries. Thus, the symptoms associated with a ruptured spleen are correctly highlighted by the mention of pain in the upper left quadrant along with Kehr's sign.