Lymphadenopathy and Splenomegaly I

Question 1

enlargment of lymph node

Answer 1

proliferation of WBCs

Question 2

abnormal lymph nodes

Answer 2

adults - larger than 1-2 cm

except groin where can be bigger normally

Question 3

lymphadenopathy

Answer 3

larger, painful, abnormal to touch

Question 4

local lymphadenopathy

Answer 4

reflects area they drain

Question 5

virchows node

Answer 5

left supraclavicular lymph node

abdominal malignancy**

Question 6

supraclavicular nodes

Answer 6

drain from abdomen and chest

high risk for malignancy

Question 7

axillary nodes

Answer 7

drain arm, thoracic wall, and breast

Question 8

silicone breast implants

Answer 8

may cause supraclavicular and axillary lymphadenopathy

Question 9

epitrochlear nodes

Answer 9

elbow fossa

infections of forearm and hand

Question 10

inguinal lymph nodes

Answer 10

lower extremity infection
-STDs

and cancer

Question 11

mesenteric nodes

Answer 11

around bowels
-appendicitis, cholecystitis, divertiulitis, whipples disease

neoplasm

IBS, panniculitis

Question 12

retroperitoneal nodes

Answer 12

kidney cancer

Question 13

panniculitis

Answer 13

inflammation of subQ adipose tissue

Question 14

nontender, axillary, cervical, occipital nodes - generalized lymphadenopathy

Answer 14

check for HIV

during second week of acute HIV infection
-nodes then decrease in size but modest degree of adenopathy persists

Question 15

nontender enlarged scrofula (neck) nodes over weeks to months without systemic symptoms

Answer 15

mycobacterial infection

m. tuberculosis in adults

children - mycobacterium avium complex or m. scrofulaceum

Question 16

fever, pharyngitis, lymphadenopathy with symmetric enlargement, posterior cervical, axillary, inguinal

Answer 16

infectious mononucleosis

lymphadenopathy peaks first week and subsides over 2-3 weeks

Question 17

soft, nontender lmyph nodes cervical axillary and inguinal

Answer 17

SLE

Question 18

phenytoin

Answer 18

can cause lymphadenopathy

Question 19

castleman disease

Answer 19

massive lymphadenopathy with fever, hepatomegaly, splenomegaly, polyclonal hypergammaglobulinemia

Question 20

kikuchi disease

Answer 20

rare, unknown cause

young women

cervical lymphadenopathy or fever

Question 21

kawasaki disease

Answer 21

childhood vasculitis

cervical lymphadenopathy with fever, conjunctivitis, mucositis, strawberry tongue, rash, coronary a aneurysms

Question 22

strawberry tongue

Answer 22

mucositis in kawasaki disease

Question 23

angioimmunoblastic T lymphoma

Answer 23

lymphadenopathy

Question 24

inflammatory pseudotumor

Answer 24

lymphadenopathy and systemic symptoms

-biopsy - fibrosing and inflammatory process

Question 25

amyloidosis

Answer 25

amyloid deposits systemically

occasionally deposited in nodes

Question 26

kimura disease

Answer 26

inflammation of subQ and lymph nodes of head and neck

Question 27

undercooked meat

Answer 27

toxoplasmosis

Question 28

tick bite

Answer 28

lyme disease

Question 29

hard nodes

Answer 29

cancers that induce fibrosis

Question 30

firm rubbery nodes

Answer 30

lymphomas and chronic leukemias

Question 31

heterophile test

Answer 31

mono - EBV

monospot test

Question 32

PPD

Answer 32

TB test

Question 33

RPR test

Answer 33

syphilis

Question 34

ANA test

Answer 34

autoimmune disease

Question 35

best for diagnosis

Answer 35

open biopsy

Question 36

fine need aspiration for cytology

Answer 36

most useful when searching for recurrence of cancer

areas where open biopsy is not available

Question 37

congestive splenomegaly

Answer 37

cirrhosis
heart failure
thrombosis of portal, hepatic, or splenic veins

Question 38

felty syndrome

Answer 38

rheumatoid arthritis and splenomegaly

Question 39

adult complaining of post-bath pruritis with ruddy complexion and splenomegaly

Answer 39

polycythemia vera