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ABD & SMALL PARTS > brah still what is retroperitoneal fibrosis > Flashcards

brah still what is retroperitoneal fibrosis Flashcards

1
Q

older males, painless, can encase ureters and cause hydro - typically anterior to aorta

A

retroperitoneal fibrosis

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2
Q

what is lymph

A

fluid collected from tissues in body, returned to blood via lymphatic system

95% water with plasma proteins, etc. in blood plasma as well as lymphocytes

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3
Q

what is interstitial fluid

A

inside tissues

is lymph when in lymphatic circulation

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4
Q

what does the lymphatic system do

A

drains interstitial fluid
** helps maintain body’s fluid balance and removes bacteria from circulation

facilitates immune response
** initiates T and B cell lymphocyte response

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5
Q

excessive accumulation of fluid in interstitium (extracellular space) is called

A

edema

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6
Q

causes of edema

A

excessive fluid leaving capillaries and entering interstitium

lymphatic obstruction

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7
Q

lymphatics drain into __ via RT and LT lymphatic ducts

A

subclavian veins

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8
Q

what are the two major lymphatic trunks

A

LT and RT lymphatic ducts

**that drain into proximal subclavian veins

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9
Q

approx how many LN are in the body

A

600

filter lymph

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10
Q

what is inside LN

A

macrophages and lymphocytes

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11
Q

diseased lymph nodes referred to as

A

lymphadenopathy
(adenopathy)

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12
Q

what are the types of adenopathy

A

benign (reactive)
**inflammatory or infectious (lymphadenitis)

malignant
**primary or metastatic

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13
Q

causes of reactive adenopathy

A

viral, bacterial infection

inflammation from various processes
**sarcoidosis
Crohn’s diesease
AIDS

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14
Q

types of primary adenopathy

A

Hodgkins
non-Hodgskins

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15
Q

metastatic adenopathy most commonly associated with which primaries

A

lung, breast, GI

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16
Q

common locations of adenopathy

A

para-aortic
paracaval
peripancreatic
renal hilum
splenic hilum
messenteric

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17
Q

sono features of malignant adenopathy

A

larger
more round (L/T <2)
less mobile
less tender

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18
Q

sono features of benign adenopathy

A

fewer, smaller
more ovoid (L/T >2)
more mobile
likely tender

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19
Q

sono sign associated with mesenteric adenopathy

A

‘sandwich’

LN (bread) surrounding mesenteric vessels (meat)
**makes the angle from Ao too steep

20
Q

sono sign associated with para-aortic LN

A

‘floating’ aorta

‘lymph lifts’

21
Q

lymphatic drainage parallels __ drainage

A

venous

22
Q

look for lymphadenopathy at the level of __ when concerned RE drainage of the gonads

A

level of the renal veins

23
Q

cancer of the lymphocytes

A

lymphoma

24
Q

malignant mature B cells

A

Hodgkin lymphoma

25
Q

B cells aka

A

Reed-Sternberg cells

26
Q

demographic of Hodgkins lymphoma

A

young adults

*very treatable yay

27
Q

which type of lymphoma typically arises in the LN of the neck, axilla and chest

A

Hodgkins lymphoma

28
Q

cancer of the B cells and T cells

A

non-Hodgkins lymphoma

29
Q

which type of lymphoma can arise from LN or in organs

A

non-Hodgkins lymphoma

*many subtypes

30
Q

which type of lymphoma typically occurs in older adults (60+)

A

non-Hodgkins lymphoma

31
Q

fever/chills, unexplained weight loss, night sweats, lethargy, pruritis

+ enlarged, painless LN

A

symptoms of lymphoma

32
Q

sono features of lymphoma

A

hypoechoic or anechoic masses

solid, no backwall, no enhancement

platelike mass surrounding Ao and IVC

multiple, lobulated masses

33
Q

what is meant by a PET with FDG

A

a positron emission tomography scan using fluorodeoxyglucose to localize metabolically active tissue

**used for tumour imaging

34
Q

nodes in the leaves of the mesentery

A

mesenteric adenopathy

encasement of mesenteric vessels by nodal mass “sandwich sign”

**may cause SMV thrombosis (bowel ishcemia)

35
Q

which type/location of adenopathy may cause bowel ischemia

A

mesenteric adenopathy due to thrombus in SMV

36
Q

majority of retroperitoneal tumours are __

A

malignant

**most rarely discovered preoperatively

37
Q

__ tumours arise from connective tissue, muscle, fat, nerves, vessels, lymphatics, embryonic rests

A

retroperitoneal tumours

**leiomyosarcoma
**liposarcoma
**histocytoma

38
Q

dense, fibrous proliferation in paravertebral region (sheet-like bulky mass)

A

retroperitoneal fibrosis

39
Q

demographic involved with retroperitoneal fibrosis

A

older

uncommon

40
Q

retroperitoneal fibrosis covers structures such as __

A

Ao
IVC
ureters
psoas

**2-6cm thick

41
Q

cause of retroperitoneal fibrosis

A

unknown
?autoimmune

42
Q

clinical signs of retroperitoneal fibrosis

A

clinically silent until ureteral or vascular obstruction

43
Q

sono features of retroperitoneal fibrosis

A

frequently surrounds Ao anteriolaterally

smooth margins

homogeneous

44
Q

what is the ddx for retroperitoneal fibrosis

A

horseshoe kidney

inflammed AAA

45
Q

which retroperitoneal condition would you expect to displace the aorta

A

retroperitoneal adenopathy

46
Q

which retroperitoneal condition would you expect would NOT displace the aorta despite being near it

A

retroperitoneal fibrosis

47
Q

uncommon but serious condition of the retroperitoneum usually involving immunocompromised pts (ie. renal transplant, leukemia) and alcoholics

A

retroperitoneal abscess

ABD & SMALL PARTS (16 decks)

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