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Skin Lymph Blood Exam 2 > Masses And Lymphadenopathy Pediatric - Dr. Newman > Flashcards

Masses And Lymphadenopathy Pediatric - Dr. Newman Flashcards

1
Q

Definition of LAD (lymphadenopathy)

A

LN abnormal in size and number and consistency

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2
Q

LAD from normal cell proliferation

A

Viral and bacterial infection

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3
Q

LAD rm infiltration of foreign or abnormal cells

A

Lymphoma
Leukemia
Other cancer

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4
Q

Reason you ask : are the LNs painful

A

Malignant enlarged LN : usually not painful

Infection enlarged LNs : usually painful

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5
Q 
Reason you ask : 
Weight loss
Fatigue
Arthralgias
Sight sweats
Pruritis 
Rash
A 
Weight loss : B sign 
Fatigue : infection or malignancy 
Arthralgia : onset of rheumatologic disorder 
Sight sweats : B- sign
Pruritis : Lymphoma 
Rash : tick illness
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6
Q

Reason you ask :MX in LAD

A

Seziures medication and bactrim/ septra, and some BP medications can cause LAD if you’re having a side effect

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7
Q

Exposure to uncooked meat and LAD

A

Trichinosis, salmonella, E. Coli

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8
Q

LAD and Animals around the pt

A

Rabbits : tularemia **

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9
Q

Unpasteurized milk / soft cheese and LAD

A

Brucellosis **

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10
Q

Size that makes a LN be considered enlarged

A

2cm

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11
Q

Good signs of a LAD quality

A

Soft, mobile, not warm, not red, not tender, pt feels okay

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12
Q

Not good signs of LAD quality

A

Multiple locations, vary large nodes, matted (stuck down and not moving), fluctuating, tender, if also splenomegaly or hepatomegaly

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13
Q

What does a localized LAD mean and what should I do

A

Figure out the field that drains into that LN (also see if there is an infection)

  1. Malignant childhood tumor : neuroblastoma, lymphoma/ leukemia
  2. Kawasaki disease : cervical lymphadenopathy that is usually very big
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14
Q

Generalized LAD means what could it be

A
  1. Systemic viral or bacterial infection
  2. HIV
  3. Leukemia/ Lymphoma
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15
Q

Splenohepatomegally can show what

A

Malignancy or systemic infection

= always check for this

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16
Q

Viral cause of LAD in children

A
  1. EBV : mono, severe pharyngitis, cervical LAD, splenomegally, fatigue
  2. HIV : diffuse LADs band wasting ( weaker and more and more unhealthy)
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17
Q

Bacteria cause of LAD in children

A
  1. Cat-scratch disease : Bartonella henselae, axillary LAD on side of scratch
  2. Tularemia : usually from skinning rabbits
  3. Staph/Strep : bacterial lesions on skin area that drains to the LAD
  4. Strep pyogenes: strep throat, CERVICAL LAD, headache, stomach ache, sore throat
18
Q

When should you order a chest X-ray for a child **

A

LAD + SOB

Lymphoma can be in the mediastinum

19
Q

Lymphoma cause of LAD in children SX

A

B-signs (night sweats, fever, weight loss)
Fatigue
SOB ——> order chest X-ray

20
Q

Which should make you worried

  1. Time of LAD
  2. Generalized or localized
A
  1. More then 4weeks

2. Generalized

21
Q

When to do a biopsy of a LAD

A
  1. Follow up and it gets bigger or worse, or stays past 4 weeks (only systemically healthy children)
  2. If anything is seen in chest X-ray , labs (children with B-signs, SOB, systemically ill) ** find results as fast as you can**
22
Q

What biopsy should you always try to do

A

Excisional biopsy

23
Q

2 tumor-like lesions is children

A
  1. Heterotopic : normal cells or tissues in abnormal place in body (rarely become malignant, not a problem)
  2. Hamartoma : excessive , focal overgrowth of cells and tissues in the organ it is from just maybe not same layer or area in the organ (can cause issues, benign)
  3. Hemangiomas *
24
Q

Hemangiomas **

A

Most common tumor like lesion in infancy (5%)
= port wine stain that is permanent (even after regression)
= cavernous (big, dilated, deformed vessels) or capillaries involved
= regressed usually with age (can become necrotic)

25
Q

Sturgeon Weber syndrome

A

In hemangiomas
= you get facial port wine stain**
= leptomeningeal angiomas
= can cause intellectual / development disability

26
Q

When should you be concerned about a hemangiomas and what do I do then

A

If I see any growth or deep dimple (esp. cant see the bottom of) over the lumbar and sacral area
= do MRI or US to check for spinal cord or vertebral abnormalities

27
Q

Lymphangiomas

A

Lymphatic malformation
= not cancer
= can be from hamartomatous (disorganized growth of normal cells)

28
Q

Lymphangiectasis

A

Dilation of Lymph Vessels

29
Q

Fibromatosis

A

= fibrous tumor
= soft tissue tumor
Non malignant
= invasive (infiltration growth pattern)—> growing into surrounding

30
Q

Teratoma what and locations

A

Germ cell tumor of many tissue types
= common in ovaries, testicles, coccyx
= benign or malignant

31
Q

5 most common places of pediatric cancer origins

A
  1. Hematopoietic system
  2. Nervous tissue
  3. Soft tissue
  4. Bone
  5. Kidney
32
Q

Neuroblastoma

A

Malignant
= sympathetic ganglia and adrenal gland
= high urine VMA, HVA (catacholamine breakdown products)
= blueberry muffin baby ——> cutaneous dissemination

33
Q

Wilms Tumor is what , age, and risks

A 
Malignant 
= primary renal tumor (peak 2yo-5yo)
1. Beckwith- Wiedenann syndrome
2. WAGR syndrome 
3. Denys-Drash syndrome
34
Q

Beckwith- Wiedenann syndrome

A

= macroglossia : enlarged tongue
= organ enlargement
= hemi-hypertrophy : overgrowth of one side of the body
= omphalocele : GI covered by transparent sac and outside umbilicus

35
Q

WAGR syndrome

A

= wilms tumor
= aniridia : abnormal or no IRIS in eye, usually bilateral, enlarged pupil (can effect other parts of the eyes also)
= genital anomalies
= mental problems

36
Q

Denys-Drash syndrome

A

= gonadal dysgenesis (males)
= early onset nephropathy : kidney failure
= 90% chance of wilms tumor

37
Q

Retinoblastoma what and how to test for it

A

Malignant (most common primary ocular)
= retinal malignancy (very young or infant children)
= CHECK red reflex in infant and children : you see white-gray dull irregular reflex**

38
Q

Ewing sarcoma

A 
Malignant
= bone and soft tissue around bone
= rare
= Chronic bone pain in area of tumor****
= can be cause fracture (pathologic caused fracture)
39
Q

Fibrosarcoma **

A

= malignant

= fibroblasts divide excessively with no control

40
Q

Most common malignancy in kids under 10yo

A

Leukemia (ALL)

41
Q

Most common malignancy in adolescents 15yo-19yo

A

Hodgkin’s lymphoma

Skin Lymph Blood Exam 2 (9 decks)

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