CIS: Pediatric Lymphadenitis/Lymphadenopathy

Question 1

where is lymph not existent?

Answer 1

the brain and the heart

Question 2

How will this usually present?

Answer 2

parent will come in worried about a lump that recently appeared on the child

Question 3

Where are lymph nodes worriesome?

Answer 3

Cervical
supraclavicular
axillary
inguinal

Question 4

Which place for lymph nodes is really not common and we should worry about?

Answer 4

supra-clavicular!!!

Question 5

What are the three other common lymph node spots?

Answer 5

Cervical
axiallary
inguinal

Question 6

What do we examine if we find an enlarged lymph node?

Answer 6

• just examine where that node drains from
• right inguinal, right leg
• suboccipital, check the scalp

Question 7

What size of the lymph node is considered enlarged?

Answer 7

> 2cm

Question 8

What location of nodes is NOT normal?

Answer 8

supraclavicular

Question 9

are palpable lymph nodes are usual in nerwborn babies?

Answer 9

nope

Question 10

shotty nodes, what are they common with?

Answer 10

early childhood with viral illness

Question 11

How common is reactive cervical LAD?

Answer 11

VERY COMMON

-in preschool/early school age

Question 12

What do we think of if we see generalized LAD in 2 or more nodal groups?

Answer 12

HIV

Question 13

What do we do for the Plan?

Answer 13

• not shotgun approach
• watchful waiting
• finish this…

Question 14

What was the important lab work that we do if the etiology of the LAD is unclear?

Answer 14

LDH

-lactate dehydrogenase, a marker for hematologic malignancies

Question 15

When do we biopsy?

Answer 15

• if watchful waiting but the nodes never get better
• if the abx don’t work
• right away if an enlarged supraclavicular node

Question 16

What kind of infection is associated with and isolated enlarged lymph nodes?

Answer 16

bacterial is more common

Question 17

parinaud’s syndrome

Answer 17

• conjunctivitis
• preauricular adenitis
• conjunctival granuloma

Question 18

Painless testicular mass w/o hx of injury, what do we do?

Answer 18

a chest Xray!

Question 19

Taratomas

Answer 19

• shows up in the anterior mediastium
• sacrococcygeal are the most common
• they are crazy looking

Question 20

Neuroblastoma

Answer 20

• <10 y/o
• tumors of the symp ganglia and adrenal medulla
• derived from primordial neural crest cells wich populate these sites
• most common extracranial solid tumor of childhood
• produce catecholamines*****
• BLUEBERRY BABIES!!!

Question 21

Wilm’s Tumor

Answer 21

• most common primary renal tumor of childhood
• <10 y/o
• WAGR syndrome: Wilms tumor, aniridia, genital anomalies, mental retardation
• del 11p13
• Denys-Drash syndrome: gondal dysgenesis, 90% chance of developing wilms tumor

Question 22

Define lymphadenopathy

Answer 22

lymph nodes that are abnormal in

• size
• number
• consistency

Question 23

What location of lymph nodes should worry us?

Answer 23

supra-clavicular

Question 24

What is the most important component of the workup for LAD?

Answer 24

History and physical

Question 25

What size of lymph nodes is considered enlarged?

Answer 25

> 2cm

Question 26

where is the weird location again?

Answer 26

supraclavicular

-HIV

Question 27

When do we biopsy a lymph node?

Answer 27

• if it isn’t getting better
• if abx aren’t making it any better
• right away if supraclavicular

Question 28

What was the sign of Cat scratch disease that had an asterix next to it?

Answer 28

Neuroretinits

Question 29

If there is a testicular mass, especially painless without hx of trauma/injury, what is indicated?

Answer 29

a chest radiograph!

Question 30

What is a marker for most hematologic entities?

Answer 30

LDH

Question 31

How will a Wilms tumor present?

Answer 31

• large abdominal mass
• hematuria
• pain int he abdomen after some traumatic incident
• intestinal obstruction
• hypertension
• pulmonary metastases are often present at diagnosis