CLINICAL CARE OF THE LYMPHATIC SYSTEM Flashcards
Definition: Enlarged lymph node(s)
Has many possible etiologies.
Can present a diagnostic problem if no cause is identified after history and physical.
PERIPHERAL LYMPHADENOPATHY
What does generalized mean
More than one region
What does localized mean?
Only one region involved
________ may be a feature of a number of systemic diseases that can be recognized by
other clinical findings
Generalized lymphadenopathy
True/False
These issues will cause localized lymphadenopathy
(a) HIV
(b) TB
(c) Lupus
(d) Infectious Mono
1) Malignancy
False
Causes generalized lymphadenopathy
___________________ is a thorough history and physical will commonly lead to an appropriate differential diagnosis which will then guide work up and further evaluation. (imaging, biopsy, labs)
Evaluation
What do you look for in the Exam portion?
(a) Location
(b) Size
(c) Consistency:
(d) Fixation vs mobile
(e) Tenderness
Consistency:
1) Hard nodes are found in _____
2) Firm, rubbery nodes are found in ____
1) cancers
2) lymphomas
Fixation vs mobile
1) Normal lymph nodes are _____________ in the subcutaneous space
2) Abnormal nodes can _____________ by invading cancer
1) freely movable
2) become fixed to adjacent tissues
___________ suggests recent, rapid enlargement that has put pain receptors in the capsule under tension. This typically occurs with inflammatory
processes such as infection.
Tenderness
Patients with localized lymphadenopathy can be observed for _______ if there is nothing else in the history, physical examination, and laboratory screening to suggest malignancy.
Biopsy is appropriate if an abnormal node has not resolved after _______.
1) three to four weeks
2) four weeks
The evaluation of patients with generalized lymphadenopathy without suspected diagnosis based on history and physical examination should start with:
1) complete blood count (CBC)
2) chest radiograph
3) human immunodeficiency virus (HIV) testing.
These suggest what issue
(1) Painless persistent edema of one or both lower extremities, primarily in young women.
(2) Pitting edema without ulceration, varicosities, or stasis pigmentation.
(3) There may be episodes of lymphangitis and cellulitis.
Symptoms and physical findings
(1) Aching discomfort with sensation of heaviness or fullness.
(2) Hypertrophy of the limb with markedly thickened and fibrotic skin and subcutaneous
tissue in very advanced cases.
(3) Pitting Edema
Lymphedema
Primary or secondary Lymphedema
______ is due to congenital developmental abnormalities (lymphatic hypoplasia) impairing lymph flow from the extremity.
Primary
Primary or secondary Lymphedema
__________ form of lymphedema involves inflammatory or mechanical lymphatic obstruction from trauma, regional lymph node resection, irradiation, or extensive involvement of regional nodes by malignant disease or filariasis.
Secondary
