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SBL > Pediatric Masses/Lymphadenopathy > Flashcards

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
Q

In an overall well patient with LAD, what treatment can you try?

A

Watchful waiting and antibiotics

26
Q

If you are watching the LAD or trying antibiotics, when should you consider a biopsy?

A

If the node(s) gets bigger or persists for longer than 4-6 weeks

27
Q

If watching the LAD is the plan, what should you instruct your patient to do?

A

Return sooner if things worsen

28
Q

In an ill patient with B signs/respiratory symptoms a CXR is usually performed. What should do then do?

A

Look for the results ASAP and communicate with the family

29
Q

Are there any absolutes when deciding when to biopsy?

A

No

30
Q

What is the best biopsy type for LAD?

A

Excisional biopsy

31
Q

Most common benign tumor of childhood?

A

Hemangioma

- Cavernous (big dilated vessels) or Capillary (small vessels)

32
Q

Most common benign tumor of childhood?

A

Hemangioma

- Cavernous (big dilated vessels) or Capillary (small vessels)

33
Q

Hemangioma treatment?

A

None - usually regress with age

34
Q

Hemangiomas usually regress with age, what may they do before regressing?

A

Raise up and get bigger

35
Q

What is a type of Hemangioma that is usually permanent?

A

Port wine stain

36
Q

Sturge Weber Syndrome

A

Facial port wine stain + developmental delay

37
Q

Any growth that you can NOT see the bottom of over the ______ area you should get a ______

A

Lumber/sacral area

MRI or US

38
Q

Any growth that you can NOT see the bottom of over the Lumbar/Sacral area you should get?

A

MRI or US

39
Q

Why should you get an MRI or US for growths that you can NOT see the bottom of over the Lumber/Sacral area?

A

To check for spinal cord or vertebral abnormalities

40
Q

Why should you get an MRI or US for growths that you can NOT see the bottom of over the Lumbar/Sacral area?

A

To check for spinal cord or vertebral abnormalities

41
Q

Besides Hemangiomas, the rest of the tumors in this deck are?

A

Malignant tumors of childhood

42
Q

Neuroblastoma

A

Tumor of the sympathetic ganglion or adrenal medulla

43
Q

Symptoms of Neuroblastoma?

A

Blueberry muffin baby

- VMA and HVA in urine

44
Q

Symptoms of Neuroblastoma?

A

Blueberry muffin baby

- VMA and HVA in urine

45
Q

Wilms Tumor and when it commonly presents

A

Renal tumor presenting between ages 2-5

46
Q

Renal tumor presenting between ages 2-5

A

Wilms tumor

47
Q

What are 3 congenital malformations that increase chances of developing a Wilms (renal) tumor?

A
  1. Beckwith - Wiedemann Syndrome
  2. WAGR Syndrome
  3. Denys - Drash Syndrome
48
Q

Beckwith - Wiedemann Sydrome

A
  • increased risk of wilms tumor

= Macroglossia, hemi-hypertrophy, organomegaly

49
Q

WAGR Syndrome

A

= Wilms tumor, aniridia, genital anomalies, mental retardation

50
Q

Denys-Drash Syndrome

A
  • 90% chance of developing a wilms tumor

= Gonadal dysgenesis and nephropathy in males

51
Q

Retinoblastoma

A

Ocular malignancy

52
Q

Red reflex signs with Retinoblastoma

A

Dull, irregular and gray

53
Q

Ewing Sarcoma

A

Bone or soft tissue around bone affected

54
Q

Symptoms of Ewing Sarcoma

A

Chronic bone pain or associated fracture

55
Q

Fibrosarcomas

A

Fibroblasts that divide excessively without control

56
Q

What is the most common malignancy in kids less than 10?

A

Leukemia

57
Q

What is the most common malignancy in kids less than 10?

A

Leukemia

58
Q

What is the most common malignancy in kids between 15-19?

A

Hodgkin Lymphoma

59
Q

What is the most common malignancy in kids between 15-19?

A

Hodgkin Lymphoma

SBL (48 decks)

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