Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Heme/Lymph II Exam II > Lymphadenopathy, Coagulation and bleeding disorders (Pales CIS) > Flashcards

Lymphadenopathy, Coagulation and bleeding disorders (Pales CIS) Flashcards

1
Q

what populates lymph nodes

A

populated by macrophages, dendritic cells, B lymphocytes, and T lymphocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the functions of lymph nodes

A

Participate in antigen processing, antigen presentation, antigen recognition, and proliferation of effector B and T lymphocytes as part of the normal immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why do lymph nodes enlarge

A

Proliferation of WBCs inside of lymph nodes leads to lymph node enlargement.

In young children, palpable lymphadenopathy is the rule.

In adults, lymph nodes larger than 1 to 2cm in diameter are generally considered abnormal. (except for groin, where they can be bigger normally)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

localized lymphadenopathy

A

Local lymphadenopathy reflects the area those lymph nodes drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

generalized lymphadenopathy

A

Generalized lymphadenopathy occur with a systemic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

supraclavicular on the right

left

A

R mediastinum, lungs

L - abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

axillary lymph nodes

A

arm, breast, thorax, neck

Infections
Cat scratch disease
Cellulitis

Cancer
Breast
Other metastasis

Silicone breast implants
( may cause both supraclavicular and axillary lymphadenopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

inguinal lymph nodes drainage

problems?

A

lower extremity
genitalia
buttock
abdominal wall below umbilicus

Lower extremity infection

Sexually transmitted diseases

Cancer
Skin of the lower extremities and trunk
Cervix, vulva, and ovary
Rectum and anus 
Penis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some causes of peripheral lymphadenopathy

A 
bacterial
viral
mycobacterial
fungal
protozoal
spirochetal

Cancer

lymphoproliferative

immunologic
endocrine
miscellaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

localized lymphadenopathy of the cervical region?

anterior or posterior worse?

A

Anterior– usually benign
Localized strep** or staph infections, rubella, dental

Systemic infections: Epstein-Barr virus (EBV), cytomegalovirus infection, or toxoplasmosis

Posterior – could be benign, but malignancy*** is more common than with anterior lymph nodes
EBV infection, tuberculosis, lymphoma, or head and neck malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

supraclavicular lymphadenopathy

what does right side drain

left side?

A

High risk for malignancy***

Right
Cancer of mediastinum, lungs or esophagus

Left (Virchow’s node***)
Abdominal malignancy (stomach**, gall bladder, pancreas, kidneys, testicles, ovaries, or prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

mediastinal localized lymphadenopathy causes

A

Infectious
TB, fungal infection, anthrax

Neoplastic
Lymphoma, lung cancer, germ cell tumor

Other
Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

with HIV what kinds of lymph nodes do you see

when do they develop

A

Nontender.
Primarily axillary, cervical, and occipital nodes

Usually develops during the second week** of acute symptomatic HIV infection.

The nodes then decrease in size but a modest degree of adenopathy persists.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

with mycobacterial infection what kinds of lymph nodes do you see

A

Can present with lymphadenopathy alone, especially in the neck (scrofula)

M. tuberculosis in adults

Atypical mycobacteria (M. avium complex and M. scrofulaceum) in kids

Nontender
Enlarge over weeks to months without prominent systemic symptoms

Can progress to matting and fluctuation (necrosis, casseation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what kind of LAD is seen in the infectious mononucleosis

A

Triad of fever, pharyngitis, and lymphadenopathy***

Symmetric enlargement
Posterior cervical more than anterior cervical***

Axillary and inguinal are common too (as opposed to other causes of pharyngitis
Lymphadenopathy peaks in the first week and then gradually subsides over two to three weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Generalized LAD of SLE

A

In approximately 50 percent of patients
Lymph nodes are soft, nontender
Cervical, axillary, and inguinal areas
Usually develops at the onset of disease or in association with an exacerbation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are some drugs that cause LAD

A 
allopurinol
atenolol
carbamazepine
cephalosporins
phenytoin
quinidine
18
Q

Castleman’s disease

A 
Uncommon lymphoproliferative disorder
Massive lymphadenopathy with 
Fever
Hepatomegaly
Splenomegaly
polyclonal hypergammaglobulinemia
Amyloidosis
19
Q

Kikuchi’s disease

A

Rare, benign condition of unknown cause***

Affect young women***

Cervical lymphadenopathy only or generalized
Fever

20
Q

Kawasaki disease

A

Childhood vasculitis

Cervical lymphadenopathy with

Fever
Conjunctivitis
Mucositis (strawberry tongue)
Rash
Coronary artery aneurysms*** heart attacks in young age. need to take aspirin
21
Q

angioimmunoblastic T cell lymphoma

A 
Systemic disease
Generalized lymphadenopathy with 
Fever
Hepatosplenomegaly
Hemolytic anemia
Polyclonal hypergammaglobulinemia
22
Q

inflammatory pseudotumor

A

Syndrome of lymphadenopathy in one or more node groups
Systemic symptoms.
Nodes usually show a fibrosing and inflammatory process

23
Q

generalized LAD of amyloidosis

A

Systemic disease with deposition of specific type of protein called Amyloid.
Most often will have amyloid deposition in other organs, but occasionally can be deposited only in lymph nodes

24
Q

Kimura disease

A

Inflammatory condition of subcutaneous tissue and lymph nodes of the head and neck
Associated with elevations in serum IG E levels and eosinophilia

25
Q

on physical exam what are you looking for when looking at lymph nodes!

A

Location
Localized vs. generalized adenopathy

Size
Greater than 1 cm in diameter (Except for groin)

Consistency
Hard in cancers that induce fibrosis and when previous inflammation has left fibrosis.
Firm, rubbery nodes in lymphomas and chronic leukemia

Fixation
fixed to adjacent tissues by invading cancers or inflammation

Tenderness ***
Suggests recent, rapid enlargement with inflammation, hemorrhage, immunologic stimulation, and malignancy.

26
Q

what labs do you order for generalized LAD

A

Complete blood count, Heterophile test, and chest x-ray.

If above normal
PPD- TB

HIV antibody determination

RPR- syphilis
ANA- lupus

27
Q

what is the best way to diagnose LAD

A

CT scan first-

open biopsy

find biggest node

Fine needle aspiration for cytology
most useful when searching for recurrence of cancer
substantial false-negative rate due to sampling error
Used in areas where open biopsy is not available or risky
Good in patients with HIV infection for evaluating lymph nodes that are believed to harbor other disease

28
Q

what are the functions of the spleen

A

Largest lymph node in the body.

Functions:
Participates in the primary immune response

Acts as a filter for the blood

Responsible for removing from the circulation red blood cells, that are old, sick or if they are coated with immunoglobulins.

29
Q

what are 6 causes of splenomegaly

A 
congestive
infection
infiltrative
malignancy 
inflammation
hematologic
30
Q

congestive causes of splenomegaly

A

Cirrhosis

Heart failure

Thrombosis of portal, hepatic, or splenic veins

31
Q

malignant causes of splenomegaly

A 
Hematologic malignancies
Lymphoma
Acute and chronic leukemias
Polycythemia vera 
Multiple myeloma
Essential thrombocythemia

Primary splenic tumors

Non-hematologic metastatic solid tumors

32
Q

infectious causes of splenomegaly

A

Viral - hepatitis, infectious mononucleosis, cytomegalovirus

Bacterial - salmonella, brucella, tuberculosis

Parasitic -malaria, schistosomiasis,toxoplasmosis, leishmaniasis

Infective endocarditis (embolic)

Fungal

33
Q

inflammation causes of splenomegaly

A

sarcoid
serum sickness
SLE
RA- felty syndrome

34
Q

infiltrative nonmalignant causes of splenomegaly

A 
Gaucher's disease 
Niemann-Pick disease 
Amyloid 
Glycogen storage disease 
Langerhans cell histiocytosis 
Hemophagocytic lymphohistiocytosis
35
Q

hematologic (hypersplenic) causes of splenomegaly

A

Acute and chronic hemolytic anemias, all etiologies

Sickle cell disease (children)

Following use of recombinant human granulocyte colony-stimulatingfactor

Myelofibrosis

36
Q

symptoms of splenomegaly

A

LUQ pain
May be acute or chronic depending on the disease
Acute if splenic infarct or rupture present

Dizziness/hypotension with splenic rupture

Signs of the disease causing splenomegaly
Fever, chills etc with infections
Fatigue, weight loss with cancer
Jaundice, ascitis with cirrhosis

37
Q

CBC in splenomegaly

A

CBC:
Neutropenia, anemia, and/or thrombocytopenia may be present without abnormal morphology (hypersplenism)

Absolute neutrophillia with or without Left shift suggest presence of splenic infarction
Atypical lymphocytes
Blasts/young cells

38
Q

Peripheral smear in splenomegaly

A

Invading organisms (bartonellosis, babesiosis, and malaria)
Schistocytes
Abnormal cell morphology (spherocytes)

39
Q

A young adult with fatigue, fever, sore throat, and splenomegaly

A

infectious mononucleosis or other viral infection

40
Q

older adult complaining of post-bath pruritus with a ruddy complexion and splenomegaly

A

polycythemia vera

41
Q

A patient with chronic alcoholism or hepatitis and ascites

A

splenomegaly secondary to cirrhosis and portal HTN

42
Q

what is important in pt history in pt with LAD

A

Localizing signs or symptoms suggesting infection or malignancy

URI symptoms
Dental pain
Chest pain
Abdominal/pelvic pain

Exposures:

  • cat
  • undercooked meat
  • tick bite
  • travel
  • high risk behavior

Constitutional symptoms
fever, night sweats, or weight loss (tuberculosis, lymphoma, or other malignancy)
fever (majority of the infectious diseases)
Use of medications that can cause lymphadenopathy

Heme/Lymph II Exam II (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions