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My Decks > Clin- Lymphadenopathy & Splenomegaly Pales > Flashcards

Clin- Lymphadenopathy & Splenomegaly Pales Flashcards

1
Q

Lymph node contents

A

Macrophages
Dendritic cells
B lymphocytes
T lymphocytes

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2
Q

lymph node functions

A

Antigen processing
Antigen presentation
Antigen recognition
Effector B and T cell proliferation are part of normal immune response

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3
Q

localized bacterial causes of lymphadenopathy

A

Strep pharyngitis, skin infection, tularemia, plague, cat scratch disease, diphtheria, chancroid, rat bite fever

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4
Q

generalized bacterial causes of lymphadenopathy

A

Brucellosis, leptospirosis, lymphogranuloma venereum, typhoid fever

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5
Q

viral causes of lymphadenopathy

A

HIV, EBV, HSV, CMV, mumps, measles, rubella, Hep B, Dengue fever

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6
Q

mycobacterial causes of lymphadenopathy

A

Mycobacterium tuberculosis, atypical mycobacteria

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7
Q

fungal causes of lymphadenopathy

A

Histoplasmosis ,coccidiodomycosis, cryptococcosis

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8
Q

protozoal causes of lymphadenopathy

A

Toxoplasmosis, leishmaniasis

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9
Q

spirochetal causes of lymphadenopathy

A

Secondary syphilis, Lyme disease

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10
Q

lymphoproliferative causes of lymphadenopathy

A

Angioblastic lymphadenopathy with dysproteinemia, autonimmune lymphoproliferative disease, Rosai-Dorfman disease, Hemophagocytic lymphohistiocytosis

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11
Q

immunologic causes of lymphadenopathy

A

Serum sickness, drug reactions (i.e. phenytoin)

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12
Q

endocrine causes of lymphadenopathy

A

Hypothyroidism, Addison’s disease

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13
Q

miscellaneous causes of lymphadenopathy

A

Sarcoidosis, Lipid storage diseases, Amyloidosis, Histiocytosis, Chronic granulomatous disease, Kikuchi’s disease, Kawasaki disease, Inflammatory Pseudotumor, SLE, RA, Still’s disease, Dermatomyositis, Churg-Strauss Syndrome

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14
Q

anterior cervical lymphadenopathy

A

Localized: Strep or staph infection, Rubella, Dental
Systemic: EBV, CMV, Toxoplasmosis

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15
Q

posterior cervical lymphadenopathy

A

EBV, TB, Lymphoma, Head/neck malignancy

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16
Q

supraclavicular lymphadenopathy

A

Right: CA of medastinum, lungs, or esophagus

Left (Virchow’s node): Abdominal malignancy (stomach, gall bladder, pancreas, kidneys, testicles, ovaries, prostate)

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17
Q

axillary lymphadenopathy

A

Infectious: Cat scratch disease, Cellulitis
Cancer: Breast, Other metastases
Silicone breast implants (may cause both supraclavicular and axillary lymphadenopathy)

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18
Q

epitrochlear lymphadenopathy

A 
Infections of forearm or hand
Lymphoma
Sarcoidosis
Tularemia
Secondary syphilis
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19
Q

inguinal lymphadenopathy

A

Lower extremity infection
STD
Cancer: skin of LE or trunk, cervix, ovary, vulva, rectum, anus, penis

20
Q

mediastinal lymphadenopathy

A

Infectious: TB, Fungal infection, Anthrax
Neoplastic: Lymphoma, Lung CA, Germ cell tumor
Other: Sarcoidosis

21
Q

retroperitoneal lymphadenopathy

A

Infectious: TB
Neoplastic: Lymphoma, Testicular CA, Kidney CA, Upper GI malignancy
Other: Sarcoidosis

22
Q

mesenteric lymphadenopathy

A

Infectious: Appendicitis, Cholecystitis, Diverticulitis, Whipple’s disease
Neoplastic: Lymphoma, GI cancer
Other: IBD, Panniculitis

23
Q

generalized lymphadenopathy with HIV

A

Non-tender
Primarily axillary, cervical, occipital nodes
Usually develops during 2nd week of acute symptomatic HIV
Decrease in size, but modest degree of adenopathy persists

24
Q

generalized lymphadenopathy with mycobacteria

A

Can present with lymphadenopathy alone, especially in neck (scrofula)
M. tuberculosis in adults
Atypical mycobacteria in kids
Non-tender
Enlarge over weeks to months without prominent systems symptoms
Can progress to matting and fluctuation

25
Q

generalized lymphadenopathy with infectious mononucleosis

A

Triad: fever, pharyngitis, lymphadenopathy
Symmetric enlargement
Posterior > anterior cervical nodes
Axillary and inguinal are common too (as opposed to other causes of pharyngitis)
Lymphadenopathy peaks in 1st week and then gradually subsides over 2-3 weeks

26
Q

generalized lymphadenopathy with SLE

A

Seen in ~50% of patients
Soft, non-tender
Cervical, axillary, inguinal nodes
Usually develops at onset of disease, or in association with exacerbation

27
Q

generalized lymphadenopathy with medications

A

Drugs causing serum sickness (fever, arthralgias, rash)
Phenytoin can cause generalized lymphadenopathy in absence of serum sickness reaction
Other drugs that cause lymphadenopathy: allopurinol, atenolol, captopril, carbamazepine, cephalosporins, gold, hydralazine, PCN, primidone, pyrimethamine, quinidine, sulfonamides, sulindac

28
Q

Cattleman’s syndrome

A

Uncommon lymphoproliferative disorder

Massive lymphadenopathy with fever, hepatosplenomegaly polyclonal hypergammaglobulinemia, amyloidosis

29
Q

Other causes of mono-like disease

A

CMV, HHV6, HIV, Adenovirus, HSV, S. pyogenes, Toxoplasma gondii

30
Q

Kikuchi’s disease

A

Rare, benign condition of unknown cause
Affects young women
Cervical lymphadenopathy only or generalized
Fever

31
Q

Kawasaki disease

A

Childhood vasculitis

Cervical lymphadenopathy with fever, conjunctivitis, mucositis (strawberry tongue), rash, coronary artery aneurysms

32
Q

angioimmunoblastic T cell lymphoma

A

Systemic disease

Generalized lymphadenopathy with fever, hepatosplenomegaly, hemolytic anemia, polyclonal hypergammaglobulinemia

33
Q

inflammatory pseudotumor

A

Syndrome of lymphadenopathy in 1+ node groups
Systemic symptoms
Nodes usually show a fibrosing and inflammatory process

34
Q

amyloidosis

A

Systemic disease with deposition of amyloid protein.

Most often will have amyloid deposition in other organs, but occasionally can be deposited only in nodes

35
Q

Kimura disease

A

Inflammatory condition of subQ tissue and lymph nodes of head/neck
Associated with elevated serum IgE and eosinophilia.

36
Q

firm, rubbery lymphadenopathy

A

lymphomas, chronic leukemia

37
Q

causes of splenomegaly

A 
congestive 
malignancy 
infiltrative 
infectious 
inflammation 
hematologic
38
Q

congestive causes of splenomegaly

A

Cirrhosis
CHF
Thrombosis of portal, hepatic, or splenic veins

39
Q

malignant causes of splenomegaly

A 
Hematologic malignancies (lymphoma, acute and chronic leukemias, polycythemia vera, multiple myeloma, essential thrombocythemia)
Primary splenic tumors 
Non-hematologic metastatic solid tumors
40
Q

infiltrative (non-malignant) causes of splenomegaly

A 
Gaucher's disease 
Niemann-Pick disease 
Amyloid 
Glycogen storage disease 
Langerhans cell histiocytosis 
Hemophagocytic lymphohistiocytosis
41
Q

infectious causes of splenomegaly

A

Viral (hepatitis, infectious mononucleosis, CMV)
Bacterial (salmonella, brucella, TB)
Parasitic (malaria, schistosomiasis, toxoplasmosis, leishmaniasis)
Infective endocarditis (embolic)
Fungal

42
Q

inflammatory causes of splenomegaly

A

Sarcoid
Serum sickness
SLE
RA (Felty syndrome)

43
Q

hematologic causes of splenomegaly

A

Acute and chronic hemolytic anemias, all etiologies
Sickle cell disease (children)
Following use of recombinant human granulocyte colony-stimulating factor
Myelofibrosis

44
Q

Chronic ETOH or hepatitis & ascites

A

splenomegaly secondary to cirrhosis and portal HTN

45
Q

Young adult with fatigue, fever, sore throat, splenomegaly

A

infectious mononucleosis or other viral infection

46
Q

Older adult c/o post-bath pruritis with ruddy complexion and splenomegaly

A

polycythemia vera

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