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Year 2 Heme lymph > Pales PPT PArt I > Flashcards

Pales PPT PArt I Flashcards

1
Q

what constitutes lymphadenopathy in children and adults?

A

children- palpable nodes

adults- nodes larger than 1-2 cm in diameter(except in groin)

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2
Q

anterior cervical lymphadenopathy is usually caused by what?

A

local: strep staph, rubella, dental
systemic: EBC, CMV or toxo

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3
Q

posterior cervical lymphadenopathy is associated with what

A

malignancy

EBV, TB ,lymphoma, head/neck malignancy

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4
Q

supraclavicular lymphadenopathy is at high risk for

A

malignancy

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5
Q

right supraclavicular lymphadenopathy is significant for

A

cancer of mediastinum, lungs or esophagus

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6
Q

L supraclavicular lymphadenopathy is significant for

A 
Virchows node
abdominal malignancy (stomach, gall bladder, pancreas, kidneys, testicles, ovaries or prostate)
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7
Q

what infections can cause axillary lymphadenopathy

A

cat scratch disease

cellulitis

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8
Q

what cancers can cause localized axillary lymphadenopathy

A

breast

other metastasis

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9
Q

what can cause epitrochlear lymphadenopathy

A 
infections of forearm of hand
lymphoma
sarcoidosis
tularemia
secondary syphilis
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10
Q

what can cause inguinal lymphadenopathy

A

infection
STD
cancer: skin of lower extremities and trunk, cervix, vulva, and ovary, rectum and anus, penis

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11
Q

causes of mediastinal lymphadenopathy

A

infection: TB, fungal infection, anthrax
Neoplastic: lymphoma, lung cancer, germ cell tumor
other: sarcoidosis

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12
Q

what can cause retroperitoneal lymphadenopathy

A

infection: TB
neoplastic: lymphoma, testicular cancer, kidney cancer, upper GI malignancy
other: sarcoidosis

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13
Q

what can cause mesenteric lymphadenopathy

A

infection: appendicitis, cholecystitis, diverticulitis, whipple’s disease
neoplastic: lymphoma, GI cancer
other: IBD, panniculitis

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14
Q

What will lymphadenopathy present like in HIV

A

nontender
primarily axillary, cervical and occipital
usually during 2nd week acute symptomatic patient
dec in size but moderate overall

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15
Q

what will lymphadenopathy present like in mycobacterial infection

A 
lymphadenopathy alone (in neck)
usually TB in adults and atypical mycobacteria in children
nontender
enlarge wks- months without systemic Sx
can progress to matting and fluctuation
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16
Q

What will lymphadenopathy from infectious mononucleosis present like

A 
triad: fever, pharyngitis, lymphadenopathy
symmetric enlargement
posterior more than anterior
axillary and inguinal are common too
peaks in 1st week then subsides 2-3 wks
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17
Q

what other mono-like diseases can cause generalized lymphadenopathy

A 
CMV
herpes virus 6
HIV
adenovirus, herpes simplex
strep pyogenes
toxoplasma gondii
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18
Q

How does lymphadenopathy from SLE present

A

soft nontender
cervical, axillary and inguinal areas
develops onset of disease or in assoc with an exacerbation

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19
Q

what is serum sickness

A

fever, arthralgias, rash and generalized lymphadenopathy

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20
Q

what medication can cause generalized lymphadenopathy in absence of serum sickness reaction

A

phenytoin

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21
Q

What drugs have been known to cause lymphadenopathy

A 
allopurinol
atenolol
captopril
carbamazepine
cephalosporins
gold
hydralazine
penicillin
phenytoin
primidone
pyrimethamine
quinidine
sulfonamides
sulindac
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22
Q

how to Dx cause of generalized lymphadenopathy

A

biopsy

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23
Q

what is castlemans disease

A

uncommon lymphoproliferatic disorder

massive lymphadenopathy with fever, HSM, polyclonal hypergammaglobulinemia, amyloidosis

24
Q

What is kikuchi’s disease

A

rare, benign condition of unknown cause
affects young women
cervical lymphadenopathy only or generalized
fever

25
Q

What is Kawasaki disease

A

childhood vasculitis

cervical lymphadenopathy with fever, conjunctivitis, mucositis, rash and coronary artery aneurysms

26
Q

what is mucositis

A

strawberry tongue

27
Q

Describe presentation of angioimmunoblastic T cell lymphoma

A

generalized lymphadenopathy with fever HSM
hemolytic anemia
polyclonal hypergammaglobulinemia

28
Q

What is an Inflammatory pseudotumor and signs

A

syndrome of lymphadenopathy in one or more node groups
systemic Sx
nodes show fibrosing and inflammatory process

29
Q

What is amyloidosis

A

systemic disease with deposition of amyloid, can be in nodes

30
Q

What is Kimura disease and characteristics

A

inflammatory condition of subcutaneous tissue and lymph nodes of head/neck
elevations in serum IgE and eos

31
Q

What do you investigate in Hx for generalized lymphadenopathy

A

URI Sx
Dental pain
chest pain
Abdominal/pelvic pain

32
Q

What exposures are key in Hx for generalized lymphadenopathy

A 
cat
undercooked meat
tick bite
travel
high risk behavior
33
Q

What constitutional Sx are assoc with lymphadenopathy

A

fever, night sweats, weight loss

34
Q

firm rubbery nodes are characteristic in what conditions

A

lymphomas and chronic leukemia

35
Q

tender lymph nodes tell you what

A

recent rapid enlargement with inflammation, hemorrhage, immunologic stimulation and malignancu

36
Q

What labs do you do for generalized lymphadenopathy

A

CBC, heterophile test and CXR

37
Q

if CBC heterophile test and CXR are normal what labs should you do for generalized lymphadenopathy

A

PPD HIV Ab determination
RPR
ANA

38
Q

What imaging do you do for generalized lymphadeopathy

A 
CXR
US
CT
MRI
PET
39
Q

when is fine needle aspiration used over biopsy of nodes

A

recurrence of cancer
when open biopsy too risky
HIV infection patients

40
Q

what is largest lymph node in body

A

spleen

41
Q

what are causes of splenomegaly

A

congestive, malignancy, infection, inflammation, infiltrative, hematologic

42
Q

causes of congestive splenomegaly

A

cirrhosis
heart failure
thrombosis of portal hepatic or splenic vv

43
Q

malignant causes of splenomegaly

A

hematologic: lymphoma, acute and chronic leukemias, polycythemia vera, multiple myeloma, essential thrombythemia
primary splenic tumors
non-hematologic metastatic solid tumors

44
Q

what are viral causes of splenomegaly

A

hepatitis, CMV, infecitous mononucleosis

45
Q

bacterial causes of splenomegaly

A

salmonella, brucella TB

46
Q

parasitic causes of splenomegaly

A

malaria, schistosomiasis, toxoplasmosis, leishmaniasis

47
Q

what are inflammatory causes of splenomegal

A

sarcoid
serum sickness
SLE
RA(felty syndrome)

48
Q

what are infiltrative nonmalignant causes of splenomegaly

A 
gauchers disease
Niemann Pick disease
amyloid
glycogen storage disease
langerhans cell histiocytosis
hemophagocytic lymphohistiocytosis
49
Q

what are the hematologic causes of splenomegaly

A

acute and chronic hemolytic anemias
sicke cell disease
after use of g-CSF drugs
myelofibrosis

50
Q

LUQ spain with splenomegaly means what

A

may be acute or chronic

if acute- splenic infarct or rupture

51
Q

what are signs of splenic rupture

A

LUQ pain suddenly

dizziness, hypotension

52
Q

What will CBC show with splenomegaly

A

neutropenia, anemia and or thrombocytopenia

53
Q

what CBC suggests splenic infarct

A

absolute neutrophilia with or without left shift

54
Q

splenomegaly

PS helps Dx

A

invading organisms, schistocytes and spherocytes

55
Q

older adult complains of pruritis with ruddy complexion after getting out of bath and has splenomegaly
dx?

A

polycythemia vera

56
Q

young adult with fatigue, fever, sore throat and splenomegaly

A

infectious mononucleosis or other viral infection

Year 2 Heme lymph (28 decks)

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