brah still what is retroperitoneal fibrosis

Question 1

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

Answer 1

retroperitoneal fibrosis

Question 2

what is lymph

Answer 2

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

Question 3

what is interstitial fluid

Answer 3

inside tissues

is lymph when in lymphatic circulation

Question 4

what does the lymphatic system do

Answer 4

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

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

Question 5

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

Answer 5

edema

Question 6

causes of edema

Answer 6

excessive fluid leaving capillaries and entering interstitium

lymphatic obstruction

Question 7

lymphatics drain into __ via RT and LT lymphatic ducts

Answer 7

subclavian veins

Question 8

what are the two major lymphatic trunks

Answer 8

LT and RT lymphatic ducts

**that drain into proximal subclavian veins

Question 9

approx how many LN are in the body

Answer 9

600

filter lymph

Question 10

what is inside LN

Answer 10

macrophages and lymphocytes

Question 11

diseased lymph nodes referred to as

Answer 11

lymphadenopathy
(adenopathy)

Question 12

what are the types of adenopathy

Answer 12

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

malignant
**primary or metastatic

Question 13

causes of reactive adenopathy

Answer 13

viral, bacterial infection

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

Question 14

types of primary adenopathy

Answer 14

Hodgkins
non-Hodgskins

Question 15

metastatic adenopathy most commonly associated with which primaries

Answer 15

lung, breast, GI

Question 16

common locations of adenopathy

Answer 16

para-aortic
paracaval
peripancreatic
renal hilum
splenic hilum
messenteric

Question 17

sono features of malignant adenopathy

Answer 17

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

Question 18

sono features of benign adenopathy

Answer 18

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

Question 19

sono sign associated with mesenteric adenopathy

Answer 19

‘sandwich’

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

Question 20

sono sign associated with para-aortic LN

Answer 20

‘floating’ aorta

‘lymph lifts’

Question 21

lymphatic drainage parallels __ drainage

Answer 21

venous

Question 22

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

Answer 22

level of the renal veins

Question 23

cancer of the lymphocytes

Answer 23

lymphoma

Question 24

malignant mature B cells

Answer 24

Hodgkin lymphoma

Question 25

B cells aka

Answer 25

Reed-Sternberg cells

Question 26

demographic of Hodgkins lymphoma

Answer 26

young adults *very treatable yay

Question 27

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

Answer 27

Hodgkins lymphoma

Question 28

cancer of the B cells and T cells

Answer 28

non-Hodgkins lymphoma

Question 29

which type of lymphoma can arise from LN or in organs

Answer 29

non-Hodgkins lymphoma *many subtypes

Question 30

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

Answer 30

non-Hodgkins lymphoma

Question 31

fever/chills, unexplained weight loss, night sweats, lethargy, pruritis + enlarged, painless LN

Answer 31

symptoms of lymphoma

Question 32

sono features of lymphoma

Answer 32

hypoechoic or anechoic masses solid, no backwall, no enhancement platelike mass surrounding Ao and IVC multiple, lobulated masses

Question 33

what is meant by a PET with FDG

Answer 33

a positron emission tomography scan using fluorodeoxyglucose to localize metabolically active tissue **used for tumour imaging

Question 34

nodes in the leaves of the mesentery

Answer 34

mesenteric adenopathy encasement of mesenteric vessels by nodal mass "sandwich sign" **may cause SMV thrombosis (bowel ishcemia)

Question 35

which type/location of adenopathy may cause bowel ischemia

Answer 35

mesenteric adenopathy due to thrombus in SMV

Question 36

majority of retroperitoneal tumours are __

Answer 36

malignant **most rarely discovered preoperatively

Question 37

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

Answer 37

retroperitoneal tumours **leiomyosarcoma **liposarcoma **histocytoma

Question 38

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

Answer 38

retroperitoneal fibrosis

Question 39

demographic involved with retroperitoneal fibrosis

Answer 39

older uncommon

Question 40

retroperitoneal fibrosis covers structures such as __

Answer 40

Ao IVC ureters psoas **2-6cm thick

Question 41

cause of retroperitoneal fibrosis

Answer 41

unknown ?autoimmune

Question 42

clinical signs of retroperitoneal fibrosis

Answer 42

clinically silent until ureteral or vascular obstruction

Question 43

sono features of retroperitoneal fibrosis

Answer 43

frequently surrounds Ao anteriolaterally smooth margins homogeneous

Question 44

what is the ddx for retroperitoneal fibrosis

Answer 44

horseshoe kidney inflammed AAA

Question 45

which retroperitoneal condition would you expect to displace the aorta

Answer 45

retroperitoneal adenopathy

Question 46

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

Answer 46

retroperitoneal fibrosis

Question 47

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

Answer 47

retroperitoneal abscess