Clinical Approach to Patients with Lymphadenopathy or Splenomegaly
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| show | It is composed of virgin(naive) B cells.
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| What type of cells are secondary follicles of the lymph node comprised of? | show 🗑
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| show | T cells with scattered B cells, macrophages, and interdigitating reticulum cells are present. Cells may be resting, unstimulated cells, or cells at various stages of transformation and differentation of clonted T cells.
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| What is frequently the cause of infarction seen on biopsy of a lymph node? | show 🗑
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| show | It is the proliferation of sinuses and is a non-specific finding and frequently a normal finding in mesenteric and axillary lymph nodes.
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| What is the appropriate management for lymphadenopathy in an adult with no apparent active infectious process? | show 🗑
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| What is most likely cause of localized or generalized lymphadenopathy in children? | show 🗑
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| show | False. Lymph node biopsies are unnecessary and often the histiopathologic interpretatio of these lymph nodes are very difficult.
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| (T or F) A tender, painful lymph node that appears and progresses over a period of a few days or wks are often secondary to an inflammatory process in the area drained by the lymph nodes. | show 🗑
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| What size lymph node is considered enlarged? | show 🗑
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| show | Biopsy are usually normal or show only hyperplasia.
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| What would a FNA biopsy of a irregular lymph node with rubbery or hard consistency show? | show 🗑
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| show | True.
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| What are some disease processes associated with posterior auricular lymphadenopathy? | show 🗑
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| show | Inflammatory disorders of eyelids and conjunctivae, carcinomas
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| What are some disease processes associated with anterior cervical (deep and superficial) lymphadenopathy? | show 🗑
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| What are some disease processes associated with submental and submaxillary lymphadenopathy? | show 🗑
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| show | Often involves a malignant process - intrathoracic and intra-abdominal carcinomas, lymphomas, sarcoidosis
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| What are some disease processes associated with axillary lymphadenopathy? | show 🗑
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| show | Inflammatory disorders of the upper extremities, non-Hodgkin's lymphomas
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| show | lymphomas (hodgkin's disease), thymomas, Castleman's disease
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| What are some disease processes associated with hilar lymphadenopathy? | show 🗑
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| What are some disease processes associated with retroperitoneal lymphadenopathy? | show 🗑
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| show | non-Hodgkin's lymphomas, carcinomas, nonspecific mesenteric lymphadenitis
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| show | Inflammatory disorder of the lower extremities, veneral diseases, lymphomas, melanomas, carcinomas
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| show | Bartonella henselae
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| show | Spirillum minus
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| What is the organism responsible for Talaremia? | show 🗑
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| What is the organism responsible for Anthrax? | show 🗑
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| show | Erysipelothrix
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| What is the organism responsible for Bubonic plaque? | show 🗑
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| What is the organism responsible for Lyme disease? | show 🗑
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| show | Pox virus
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| What is the vector for Orf? | show 🗑
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| What is the vector for Anthrax? | show 🗑
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| show | (1) Posterior auricular (most commonly) (2) Suboccipital (3) Posterior cervical
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| show | Posterior cervical node
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| A benign disorder of children and young adults that is characterized by painless massive bilateral cervical lymphadenopathy along with ever, neutrophilia, and elevated ESR. The lymphadenopathy lasts up to 6 mo to several yrs. | show 🗑
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| What is the differential diagnosis for bilateral epitrochlear lymphadenopathy? | show 🗑
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| show | Castleman's disease
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| What is the treatment for localized Castleman's disease? | show 🗑
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| show | False. Gonorrhea does not produce lymphadenopathy
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| show | Involvement of 2 or more noncontiguous lymph node regions
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| (T or F) Lymph node biopsy is warranted ingeneralized lymphadenopathy | show 🗑
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| show | True.
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| Why should biopsy of inguinal lymph nodes be avoided? | show 🗑
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| show | The largest lymph nodes should be selected. Certain regions should be avoided if possible (eg inguinal, femoral, epitrochlear).
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| show | Splenic cords which are extravascular collections of hematopoietic cells, mostly red cells.
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| What percentage of the cardiac output is utilized by the spleen? | show 🗑
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| show | Venous blood flows from spleen via portal vein through the liver back to the systemic circulation. The spleen is enlarged due to any obstruction of the splenic or portal veins, liver disease, or chronic increase in systemic venous pressure.
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| What percentage of red blood cells are normally sequestered in the spleen? | show 🗑
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| show | 20%
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| What percentage of platelets are normally sequestered in the spleen? | show 🗑
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| show | Splenic cords
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| show | Up to 90% of platelet cell mass
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| What type of granulocyte is mainly sequestered in normal spleen? | show 🗑
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| (T or F) Lymphocytosis and thrombocytosis typically occurs post-splenectomy | show 🗑
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| What is the normal size of a spleen? | show 🗑
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| What is the normal weight for a spleen? | show 🗑
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| show | The spleen moves downward during inspiration whereas other retroperitoneal masses and other enlarged organs do not move downward on deep inspiration.
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| show | True.
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| What age groups can a normal sized spleen be palpated on physical exam? | show 🗑
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| show | 1) LUQ pain 2) Left supraclavicular pain 3) Early saiety 4) Weight loss 5) Excess sweating 6) Manifestations of cytopenia 7) Hematemesis from varices
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| What are the mechanisms of cytopenias in splenomegaly? | show 🗑
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| show | Infectious mononucleosis
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| Clinical manifestations of the Big Spleen Syndrome | show 🗑
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