CLINICAL CARE OF THE LYMPHATIC SYSTEM

Question 1

What is lymphadenopathy?

Answer 1

Enlarged lymph nodes

Question 2

How large are normal lymph nodes?

Answer 2

less than 1cm

Question 3

What is generalized lymphadenopathy?

Answer 3

Involves more than 1 region

Question 4

What is localized lymphadenopathy?

Answer 4

only one region is involved

Question 5

What may be a feature of a number of systemic diseases that can be recognized by other clinical findings?

Answer 5

Generalized lymphadenopathy

Question 6

When examining lymph nodes what are some things you should note?

Answer 6

1. location
2. size
3. consistency
   a. hard nodes are found in cancers
   b. firm rubbery nodes are found in lymphomas
4. fixation vs. mobile
   a. normal lymph nodes are mobile in the subcutaneous tissue

Question 7

What is the treatment for lymphadenopathy ?

Answer 7

treatment is based on specific etiology

Question 8

Patients with what form of lymphadenopathy can be observed for 3 to 4 weeks if there is nothing else in the history, physical exam, and lab screening to suggest malignancy.

Answer 8

Localized lymphadenopathy

Question 9

What is an appropriate action if an abnormal lymph nodes has not resolved after 4 weeks?

Answer 9

Biopsy

Question 10

What is known as painless persistent edema of one or both lower extremities, usually affecting young women?

Answer 10

Lymphedema

Question 11

What is pitting edema without ulceration, varicosities, or stasis pigmentation?

Answer 11

Lyphedema

Question 12

What is the primary form of lymphedema due to?

Answer 12

congenital developmental abnormalities impairing lymph flow from the extremities

Question 13

What is the form of lymphedema involving inflammatory or mechanical lymphatic obstruction from trauma, regional lymph nodes resection, irradiation, or extensive involvement or regional lymph nodes by malignant diseases or filariasis?

Answer 13

Secondary Lymphedema

Question 14

A patient presents to you with an aching discomfort with sensation of heaviness and fullness in her left leg. Upon exam you notice hypertrophy of the limb with markedly thickened and fibrotic skin. Further examination reveals pitting edema in the affected leg. What would your most appropriate diagnosis be?

Answer 14

Lymphedema

Question 15

What are some forms of imaging you can do for a lymphedema patient ?

Answer 15

1. MRI
2. Lymphangiography
3. Ultrasound to evaluate for DVT

Question 16

What are some of the treatments for a patient with lymphedema?

Answer 16

1. Elevation during sleeping hours
2. Compression stockings
3. Diuretic therapy
   a. Furosemide (lasix) 40mg po daily
   b. Bumetanide (bumex) 1mg po daily

Question 17

True or False

There is an effective cure for lymphedema

Answer 17

False

There is no effective cure for lymphedema, treatment strategies are designed to control the problem and allow for normal activity and function