Heme/lymph CIS

Question 1

differential for new back pain onset in child with Hx ewings sarcoma

Answer 1

recurrence of Ewings sarcoma
metastasis
fracture related to previous cancer and Tx
secondary malignancy
MSK pain
SD

Question 2

Contraindications in treating a patient with cancer

Answer 2

risk of hematogenous spread is high
Batsons plexus (no valves)
direct techniques directly over a tumor
direct techniques in presence of loss of boney integrity
risk of lymph spread is high

Question 3

what techniques passively move lymph flow

Answer 3

MFR thoracic inlet

MFR other areas

Question 4

what can you do to Tx thoracoabdominal cylinder in cancer patient

Answer 4

innominate(seated or supine): BLT, MET, or Stills
pelvic diaphragm: supine or seated MFR
vertebral spine: seated/stnading vertebral BLT
Ribs: seated/standing rib BLT, FPR, rib raising
Thoracic Inlet: seated standing MFR
Cervical spine: seated/standing FPR, soft tissue, MFR

Question 5

Labs to order for suspected DVT

Answer 5

D dimer
PT/INR
CBC
Factor 5
Homocysteine
Lipids

Question 6

imaging for suspected DVT

Answer 6

compression US

Question 7

What labs do you want to order in 69 y.o F with L arm swelling and PMH Breast CA 5 years ago

Answer 7

BNP (CHF)
Cr and UA (renal)
LFT, albumin (hepatic)
D dimer (thrombosis)
Na K Ca

Question 8

what imaging do you want to order in 69 y.o F with L arm swelling and PMH Breast CA 5 years ago

Answer 8

venous US to exclude DVT
MRI venography (CA Hx and obstruction)

Question 9

what OMT would you do in 69 y.o with PMH Breast CA that has lymphedema

Answer 9

lymphatic: fascial pattern, open duct, compression, effleurage, thoracic pump
autonomics T2-8 vagus
spencers, scapular release, counterstrain traps, ME T1-6
thoracic diaphragm

Question 10

OMT for patient with DVT

Answer 10

fascial pattern, thoacic inlet, lymphatic points for LE, pelvic thoracic diaphragm, pedal thoracic pump??? maybe not because DVT-risk embolism
T11-L2 sympathetics
sacrum parasympathetics