Lymph Nodes and Spleen Flashcards

1
Q

Precursor lymphoid cells which want to become B cells undergo maturation where?

A

Bone marrow

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2
Q

Precursor lymphoid cells which want to become T cells undergo maturation where?

A

Thymus

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3
Q

What are the two central (primary) components of the lymphoid system?

A

Bone marrow and thymus

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4
Q

What are some peripheral (secondary) components of the lymphoid system?

A

Lymph nodes, spleen, tonsils

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5
Q

The lymphatics return lymph fluid into the circulation. What are the purposes of this?

A

Important in fluid homeostasis and prevention of oedema

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6
Q

What are some lymph node groups that can be palpated?

A

Cervical, axillary and inguinal

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7
Q

What are some groups of lymph nodes which can be viewed radiologically?

A

Mediastinal and para-aortic

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8
Q

Describe the movement of fluid within lymph vessels?

A

Passive movement of fluid, with valves ensuring unidirectional flow

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9
Q

What are the main cell types found in a lymph node?

A

Lymphocytes, macrophages and endothelial cells

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10
Q

What are the ways of classifying lymphadenopathy?

A

Localised, widespread or generalised / peripheral or central

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11
Q

What are the main causes for lymphadenopathy?

A

Local or systemic inflammation and malignancy

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12
Q

Generalised lymphadenopathy suggests what?

A

A systemic inflammatory process or widespread malignancy (mainly leukaemia/lymphoma)

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13
Q

What is the best blood test to do if a patient presents with generalised lymphadenopathy?

A

FBC

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14
Q

If there is a predominantly B cell immune response in a lymph node, what are some likely causes?

A

Autoimmune conditions, infections

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15
Q

If there is a predominantly T cell immune response in a lymph node, what are some likely causes?

A

Viral infections, drugs e.g. phenytoin

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16
Q

If there is a predominantly phagocytic immune response in a lymph node, what is a likely cause?

A

Draining a tumour site

17
Q

Sarcoidosis typically presents with what? What is important to be aware of about sarcoid like reactions?

A

Predominantly hilar but also cervical lymphadenopathy / can mask an underlying malignancy

18
Q

Where is the spleen located? Is it usually palpable?

A

In the left upper quadrant / no, not unless it is substantially enlarged

19
Q

Describe the arterial supply to the spleen?

A

The splenic artery, which is a branch of the coeliac axis

20
Q

Describe the venous drainage from the spleen?

A

Via the splenic vein, which combines with the superior mesenteric vein to form the portal vein

21
Q

What is important to be aware about a diseased spleen?

A

It is more prone to rupture

22
Q

What is the function of the red pulp of the spleen?

A

It acts as a filter for the blood - it eliminates unwanted material and facilitates immune responses to blood borne viruses

23
Q

What is the function of the white pulp of the spleen?

A

Antigen presentation to immune reactive cells

24
Q

What are some clinical features of splenic enlargement?

A

Dragging sensation in the LUQ, discomfort with eating, pain if infarction

25
What can cause splenic enlargement?
Infection, congestion, haematological/ inflammatory/storage diseases
26
What is the most common cause of hyposplenism? What does this require?
Splenectomy / immunisations
27
What are some causes of hyposplenism aside from splenectomy?
Coeliac disease, sickle cell disease, sarcoidosis
28
The features of hyposplenism are mainly caused by reduced what? What abnormality may be seen?
Red pulp / Howell-Jolly bodies
29
Howell-Jolly bodies are a sign of what?
Hyposplenism
30
Hyposplenism due to splenectomy may cause some immune deficiency, especially if what is the case?
It was taken out in childhood
31
What is the triad of hypersplenism?
Splenomegaly, fall in one or more cellular components of blood, correction of cytopenias by splenectomy