Chapter 4 Lymph MDT

Question 1

Enlarged lymph nodes

Answer 1

Lymphadenopathy

Question 2

Normal lymph nodes are generally less than:

Answer 2

1 cm

Question 3

Only one region involved

Answer 3

Localized

Question 4

More than one region involved

Answer 4

Generalized

Question 5

May be a feature of a number of systemic diseases like:

HIV 
TB
Infectious Mono
Lupus
Malignancy

Answer 5

Generalized lymphadenopathy

Question 6

Lymphadenopathy:

Localizing signs or symptoms suggest:

Answer 6

Infection or malignancy

Question 7

Constitutional symptoms such as fever, night sweats, or weight loss suggest:

Answer 7

TB, lymphoma, or other malignancy

Question 8

Medications that can cause lymphadenopathy

Answer 8

Atenolol

Cephalosporins

Penicillin

Sulfonamides

Question 9

Lymph node exam should include:

Answer 9

Location

Size

Consistency

Fixation vs mobile

Tenderness

Question 10

Hard nodes are found in:

Answer 10

Cancers

Question 11

Firm, rubbery nodes are found in:

Answer 11

Lymphomas

Question 12

Abnormal nodes can become fixed to adjacent tissues by:

Answer 12

Invading cancers

Question 13

Tenderness in nodes is commonly caused by:

Answer 13

Infection

Question 14

Patients with localized lymphadenopathy can be observed for

Answer 14

3-4 weeks

Question 15

Evaluation of patients with generalized lymphadenopathy without suspected diagnoses should start with:

Answer 15

CBC

Chest radiograph

HIV testing

Question 16

Painless persistent edema of one or both lower extremities, primarily in young women

Putting edema without ulceration, varicosities, or stasis pigmentation

There may be episodes of lymphangitis and cellulitis

Answer 16

Lymphedema

Question 17

Primary form of lymphedema is due to:

Answer 17

Congenital developmental abnormalities (lymphatic hypoplasia)

Question 18

Secondary form of lymphedema involves inflammatory or mechanical lymphatic obstruction from:

Answer 18

Trauma

Regional lymph node resection

Irradiation

Extensive involvement of regional nodes by malignant disease or filariasis

Question 19

Symptoms/Physical findings:

• Aching discomfort with sensation of heaviness or fullness
• Hypertrophy of the limb with markedly thickened and fibrotic skin and subcutaneous tissue in very advanced cases
• Pitting edema

Answer 19

Lymphedema

Question 20

Imaging for:

Lymphedema

Answer 20

MRI

Lymphangiography

U/S for DVT

Question 21

Treatment for:

Lymphedema

Answer 21

Referral

Elevation, especially during sleeping hours

Compression stockings

Diuretics

• Furosemide 40mg PO daily
• Bumetanide 1mg PO daily

Question 22

Eliminates toxic byproducts by end organs (kidneys, liver, colon, skin, lungs)

Answer 22

Lymphatic system

Question 23

Organized lymphoid tissue which filters lymph fluid to identify and fight infection

Answer 23

Lymph node

Question 24

Commonly occurs secondary to bacterial infection usually caused by Streptococci or Staph Aureus (or both)

Generally, in response to an infected wound

Answer 24

Lymphangitis

Lymphadenitis

Question 25

Symptoms and Exam:

• Throbbing pain
• Fever, Chills, Malaise, Anorexia
• Red streaking from the wound
• Indurated and painful tissue at site of cellulitis
• Regional lymph nodes enlarged and tender
• Tachycardia

Answer 25

Lymphadenitis and lymphangitis

Question 26

Lab findings:

Leukocytosis with left shift

Positive cultures of purulent material

U/S of infected site

Answer 26

Lymphadenitis and lymphangitis

Question 27

Treatment for Lymphadenitis and lymphangitis

Answer 27

General measures

• Heat
• Elevation
• Immobilization
• Acetaminophen and NSAIDS

Question 28

Antibiotic treatment for:

Lymphadenitis and lymphangitis caused by strep or staph

Answer 28

Cephalexin

Trimethoprim/sulfamethoxazole (Bactrim)