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Pediatric Masses/Lymphadenopathy Flashcards

1
Q

What is Lymphadenopathy?

A

Lymph nodes that are abnormal in size, consistency or number

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2
Q

What is Lymphadenopathy?

A

Lymph nodes that are abnormal in size, consistency or number

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3
Q

Lymphadenopathy is often interchangeable with?

A

Lymphadenitis

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4
Q

Lymphadenopathy is usually due to what 2 general categories?

A
  1. Proliferation of normal cells due to infection

2. Infiltration by foreign/malignant cells

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5
Q

What is the most important part of a work-up of a child with lymphadenopathy?

A

HISTORY AND PHYSICAL

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6
Q

What is the most important part of a work-up of a child with lymphadenopathy?

A

HISTORY AND PHYSICAL

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7
Q

Lymph nodes greater than ____ are considered “enlarged”

A

2 cm

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8
Q

What qualities of lymph nodes are more reassuring?

A

Expected location
Soft and mobile
Not warm, red or tender
Child is feeling overall ok

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9
Q

What qualities of lymph nodes are less reassuring?

A

Unusual location
Large, hard and “stuck down” (fixed)
Associated with a big liver/spleen

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10
Q

If a child present with lymphadenopathy, what should you always check?

A

Liver and Spleen size

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11
Q

If the liver/spleen are enlarged, what could that indicate?

A

Systemic infection

Malignancy

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12
Q

2 common viruses that can cause pediatric LAD?

A

EBV

HIV

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13
Q

EBV symptoms

A

Mononucleosis

- Pharyngitis, fatigue, splenomegaly

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14
Q

HIV symptoms

A

Child wasting with diffuse LAD

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15
Q

4 common bacteria/illness that can cause pediatric LAD?

A

Cat Scratch Disease
Tularemia
Staph/Strep
Strep. Pyogenes

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16
Q

Bartonella Henselae

A

Cat Scratch Disease

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17
Q

Cat Scratch Disease symptoms

A

Axillary LAD on SAME side as cat scratch

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18
Q

Tularemia is caused by?

A

Skinning rabbits

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19
Q

Staph/Strep LAD is common. What should you look for?

A

Lesions in region that would drain into the lymph node

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20
Q

Strep. Pyogenes symptoms

A

Strep throat

- Sore throat, headache/stomachache and cervical LAD

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21
Q

What signs may be present with Lymphoma?

A

B signs

= Fever, weight loss, night sweats

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22
Q

Fever, weight loss, night sweats and LAD could indicate?

A

Lymphoma

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23
Q

In a child that presents with LAD and dyspnea, what should you order?

A

CXR!

- check for mediastinal mass to rule in/out Lymphoma

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24
Q

In a child that presents with LAD and dyspnea, what should you order?

A

CXR!

- check for mediastinal mass to rule in/out Lymphoma

25
In an overall well patient with LAD, what treatment can you try?
Watchful waiting and antibiotics
26
If you are watching the LAD or trying antibiotics, when should you consider a biopsy?
If the node(s) gets bigger or persists for longer than 4-6 weeks
27
If watching the LAD is the plan, what should you instruct your patient to do?
Return sooner if things worsen
28
In an ill patient with B signs/respiratory symptoms a CXR is usually performed. What should do then do?
Look for the results ASAP and communicate with the family
29
Are there any absolutes when deciding when to biopsy?
No
30
What is the best biopsy type for LAD?
Excisional biopsy
31
Most common benign tumor of childhood?
Hemangioma | - Cavernous (big dilated vessels) or Capillary (small vessels)
32
Most common benign tumor of childhood?
Hemangioma | - Cavernous (big dilated vessels) or Capillary (small vessels)
33
Hemangioma treatment?
None - usually regress with age
34
Hemangiomas usually regress with age, what may they do before regressing?
Raise up and get bigger
35
What is a type of Hemangioma that is usually permanent?
Port wine stain
36
Sturge Weber Syndrome
Facial port wine stain + developmental delay
37
Any growth that you can NOT see the bottom of over the ______ area you should get a ______
Lumber/sacral area | MRI or US
38
Any growth that you can NOT see the bottom of over the Lumbar/Sacral area you should get?
MRI or US
39
Why should you get an MRI or US for growths that you can NOT see the bottom of over the Lumber/Sacral area?
To check for spinal cord or vertebral abnormalities
40
Why should you get an MRI or US for growths that you can NOT see the bottom of over the Lumbar/Sacral area?
To check for spinal cord or vertebral abnormalities
41
Besides Hemangiomas, the rest of the tumors in this deck are?
Malignant tumors of childhood
42
Neuroblastoma
Tumor of the sympathetic ganglion or adrenal medulla
43
Symptoms of Neuroblastoma?
Blueberry muffin baby | - VMA and HVA in urine
44
Symptoms of Neuroblastoma?
Blueberry muffin baby | - VMA and HVA in urine
45
Wilms Tumor and when it commonly presents
Renal tumor presenting between ages 2-5
46
Renal tumor presenting between ages 2-5
Wilms tumor
47
What are 3 congenital malformations that increase chances of developing a Wilms (renal) tumor?
1. Beckwith - Wiedemann Syndrome 2. WAGR Syndrome 3. Denys - Drash Syndrome
48
Beckwith - Wiedemann Sydrome
- increased risk of wilms tumor | = Macroglossia, hemi-hypertrophy, organomegaly
49
WAGR Syndrome
= Wilms tumor, aniridia, genital anomalies, mental retardation
50
Denys-Drash Syndrome
- 90% chance of developing a wilms tumor | = Gonadal dysgenesis and nephropathy in males
51
Retinoblastoma
Ocular malignancy
52
Red reflex signs with Retinoblastoma
Dull, irregular and gray
53
Ewing Sarcoma
Bone or soft tissue around bone affected
54
Symptoms of Ewing Sarcoma
Chronic bone pain or associated fracture
55
Fibrosarcomas
Fibroblasts that divide excessively without control
56
What is the most common malignancy in kids less than 10?
Leukemia
57
What is the most common malignancy in kids less than 10?
Leukemia
58
What is the most common malignancy in kids between 15-19?
Hodgkin Lymphoma
59
What is the most common malignancy in kids between 15-19?
Hodgkin Lymphoma

SBL (48 decks)

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