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SBL Exam 2 > Masses, Lymphadenophathy, Splenomegaly - Hubbard > Flashcards

Masses, Lymphadenophathy, Splenomegaly - Hubbard Flashcards

1
Q

Infection with EBV, CMV or toxoplasma localizes to which lymph nodes?

A

anterior cervical

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2
Q

lymphoma, CLL, head/neck cancer localizes to which lymph nodes?

A

anterior cervical

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3
Q

infection with EBV or Tb localizes to which lymph nodes?

A

posterior cervical

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4
Q

lymphoma, CLL, head/neck cancer localize to which lymph nodes?

A

posterior cervical

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5
Q

what is a high risk area for malignancy?

A

supraclavicular

  • 35-50% incidence
  • increased risk in >40 years of age
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6
Q

right supraclavicular lymphadenopathy means what?

A

cancer in mediastinum, lung, esophagus

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7
Q

left supraclavicular (Virchow’s node) means what?

A

abdominal malignancy

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8
Q

axillary lymphadenopathy most likely means what kind of infection?

A

cat scratch disease

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9
Q

axillary lymphadenopathy most likely means what kind of malignancy?

A

skin or breast cancer

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10
Q

axillary lymphadenopathy most likely means what kind of inflammation?

A

silicone breast implants

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11
Q

palpable epitrochlear noes always mean what kind of infection?

A

forearms/hand, tularemia, strep infection, cat scratch dz, secondary syphilis
- always pathologic!

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12
Q

epitrochlear lymphadenopathy most likely means what kind of inflammation?

A

sarcoid

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13
Q

epitrochlear lymphadenopathy most likely means what kind of malignancy?

A

lymphoma

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14
Q

inguinal lymphadenopathy most likely means what kind of infection?

A

lower extremity or STI

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15
Q

inguinal lymphadenopathy most likely means what kind of malignancy?

A

lymphoma, melanoma, non-melanoma skin cancer, GU, anus/rectum

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16
Q

palpable nodule in the umbilicus (not truly a lymph node)

  • represents a metastasis from intraabdonimal or intrapelvic malignancy
  • most commonly GI cancer, but in 25% women can be GYN cancer
A

sister mary joseph nodule

- bad prognostic sign

17
Q

what should always be on your DDX for lymphadenopathy?

A
  • HIV
  • mycobacterium
  • infectious mononucleosis
  • SLE
18
Q

what should always be on your DDX for cervical adenopathy?

A
  • infection
  • lymphoma
  • unusual disorders (Kikuchi disease, Tb)
19
Q

what does localized lymphadenopathy usually suggest?

A

local causes

20
Q

what does generalized adenopathy usually manifest as?

A

systemic disease

21
Q

abnormal nodes are generally larger than what?

22
Q

what is the term “shotty” used to describe?

A

multiple, small nodes

- has no particular diagnostic significance

23
Q

when do you usually find hard nodes?

A

cancers that induce fibrosis and when previous inflammation has left fibrosis

24
Q

what do you usually find firm, rubbery nodes?

A

lymphomas and chronic leukemia

25
Q

nodes in acute leukemia tend to be what consistency?

26
Q

what is fixation?

A

abnormal nodes become fixed to adjacent tissues by invading cancers or inflammation in tissue surrounds the nodes
- NL LN’s are freely movable in the subQ space

27
Q

what should be kept in mind with tenderness of LN’s?

A

typically occurs with inflammatory processes, but can also result from hemorrhage into a node, immunologic stimulation, and malignancy
- suggests recent, rapid enlargement that has put pain receptors in the capsule under tension

28
Q

pt with pre-exsistent CLL developing a diffuse large B-cell lymphoma

  • represents clonal evolution with additional cytogenic abnormalities
  • tough to kill
A

Richter’s syndrome

29
Q

fever, drenching night sweats, 10% wt loss in 6 months

- likely paraneoplastic and assoc with worse prognosis

A

B symptoms

30
Q

what pts are at increased risk for primary CNS lymphoma?

A

immunosuppressed pts

- HIV, organ transplant, etc

31
Q

what lab tests should be run for generalized lymphadenopathy?

32
Q

what if CBC and CXR are clear on pt w/ generalized lymphadenopathy?

A

consider

  • PPD
  • HIV
  • RPR
  • ANA
  • serologies for EBV, CMV
33
Q

what are the benign causes of splenomegaly?

A
  • congestive
  • inflammation
  • infection
  • infiltration
  • hypersplenism
34
Q

what are the malignant causes of splenomegaly?

A
  • lymphoma
  • leukemia (acute and chronic)
  • myeloproliferative neoplasm
  • primary splenic tumors
  • metastatic solid tumors
35
Q

what are the common complaints of splenomegaly?

A
  • heaviness/pain in LUQ
  • early satiety
  • fullness or mass in LUQ
36
Q

primary myeoproliferative disorder characterized by marrow fibrosis and extramedullary hematopoiesis

A

myelofibrosis

37
Q

what is the triad of myelofibrosis?

A
  • leukoerythroblastic anemia
  • poikilocytosis
  • splenomegaly

SBL Exam 2 (13 decks)

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