2: Structure and function of lymph nodes and spleen

Question 1

Where do

a) B cells

b) T cells

mature?

Answer 1

a) Bone marrow

b) Thymus

Question 2

What are the two central lymphoid tissues?

Answer 2

Bone marrow

Thymus

Question 3

What are some peripheral lymphoid tissues?

Answer 3

Lymph nodes

Spleen

Tonsils

Question 4

A fraction of the circulation is filtered as ___.

Answer 4

lymph

Question 5

Lymphoid tissues contain ___ cells.

Answer 5

immune cells

i.e white blood cells

Question 6

The lymphatic system stops fluid from accumulating in the tissues.

What symptom do you have when this doesn’t happen?

Answer 6

Lymphoedema

Question 7

What is the dilated part of the thoracic duct which carries lymph from the intestines and lower limbs?

Answer 7

Cisterna chyli

Question 8

Describe the location of the

a) superficial
b) deep

inguinal nodes?

Answer 8

a) Superficial inguinal nodes - directly inferior to inguinal ligament, run horizontally

b) Deep inguinal nodes - run vertically along the medial aspect of the femoral vein

Question 9

Before draining at the thoracic duct or left lymphatic duct, where does lymph go?

Answer 9

Lymph nodes

Question 10

In which specific part of a lymph node are B cells found?

Answer 10

Primary follicles

Question 11

Which part of a lymph node follicle becomes activated?

Answer 11

Germinal centre

Question 12

What do B cells differentiate into?

Where in a lymph node are they found?

Answer 12

Plasma cells

Medulla

Question 13

What disease processes cause lymphadenopathy?

Answer 13

Inflammation (local or systemic)

Infection

Malignancy

Question 14

By which structures do cancers often metastasise?

Answer 14

Lymph nodes

causing lymphadenopathy

Question 15

What is the differential diagnosis for a patient with generalised lymphadenopathy?

Answer 15

Malignancy - specifically haematological cancers e.g lymphoma

Rheumatic disease e,g RA, SLE

Viral infection

Question 16

What granulomatous condition causes bilateral hilar lymphadenopathy and erythema nodosum in many patients?

Answer 16

Sarcoidosis

i.e buzzwords buzzwords buzzwords

Question 17

Where is the spleen found?

Answer 17

LUQ

Question 18

Why is splenic rupture, especially when enlarged, a medical emergency?

Answer 18

Massive haemorrhage

Question 19

Just like bone marrow, the spleen contains ___ which accept blood cells and release them into the circulation.

Answer 19

sinusoids

Question 20

What is the function of the spleen?

Answer 20

Lymphoid organ

so filters blood and immune surveillance

Question 21

What is the function of the

a) red pulp

b) white pulp of the spleen?

Answer 21

a) Highly vascular, carries blood to white pulp

b) Immune surveillance

Question 22

What are the symptoms of splenomegaly?

Answer 22

LUQ dragging sensation

Pain on eating

Question 23

What blood change occurs in hypersplenism?

Answer 23

Fall in 1+ blood components

Question 24

What anatomical change occurs in hypersplenism?

Answer 24

Splenomegaly

Question 25

What are some causes of splenomegaly?

Answer 25

Infection

Cardiovascular disease (e.g heart failure)

Blood malignancies

Rheumatic diseases

Question 26

What is the most common reason for hyposplenism?

Answer 26

Splenectomy

Your spleen function is reduced if you do not have a spleen

Question 27

What can be seen morphologically in hyposplenism?

Answer 27

Howell-Jolly bodies

Solid purple dots within normal-looking RBCs

Question 28

Which GI condition is associated with splenic atrophy?

Answer 28

Coeliac disease