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37 Cards in this Set
- Front
- Back
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how many lymph nodes are in the human body?
-100 -300 -600 -750 |
about 600
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in healthy pt's what lymph nodes are typically palpable?
all but which? -submandibular -axillary -post auricular -inguinal |
not post auricular
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are most pt's who present with swollen LN localized or not localized?
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most are localized 75%, 25 % were generalized lymphadenopathy
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of lacalized LN what is the typical breakdown?
-neck -inguinal -axillary -supraclavicular |
neck 55%
inguinal 14% axillary 5% supraclavicular 1% |
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what percentage of LN adenopathy is typically are malignant
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1.1% of 2500 pt's in general practice
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what percentage of enlarged LN in a person >40 are malignant? a person <40 what percentage are malignant?
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>40 4.4% are malignant
<40 0.4% are malignant |
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what is the name of the bug of cat scratch disease?
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bartonella
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which bacteria are the found with a cat bite?
-pasturella -bartonella -toxoplasmosis |
pasturella
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what bug do you get from kitty litter or under cooked pork?
-bartonella -toxoplasmosis -pasturella |
toxoplasmosis
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what type of disease can you get from a tick bite?
-lymes disease -toluremia -bubonic plague |
lymes and toluremia
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if a person travels to the SW part of the US what bugs are common? all but ?
-toxoplasmosis -bubonic plague -coxidiocomycosis |
all but toxplasmosis which is common in cat litter and under cooked pork
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if a person travels to china, mexico, or the phillipines and comes to you with an enlarged LN, what must you think about?
-toxoplasmosis -toluremia -TB |
TB
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in IV drug abusers with an enlarged LN, what diseases must you think about?
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hiv, hepatitis b, endocarditis
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in person's with high risk sexual behaviors what must you think about with swollen LN?
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hiv
hepatitis std's syphillis |
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a swollen LN appears with what pathophysiology in the body?
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when lymphocytes are exposed to antigens, the lymphocytes have increased infiltration to LN
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t/f
LN enlargement can be a result of local infection or systemic infection |
true
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what are viral causes of enlarged LN?
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ebv
cmv hiv hsv uri hepatitis |
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what are fungal causes of enlarged LN?
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histoplasmosis
coccidiodomycosis aspergillosis |
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any bug that ends in osis is a __ cause?
-bacterial -fungal -viral |
fungal
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what are malignant causes of LN enlargement.
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lymphoma
hodgkins non hodgkins leukemia acute lymphocytic leukemia CLL lymphosarcoma |
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what are autoimmune causes of LN enlargement?
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SLE
RA |
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inflammation of what other structures can cause enlarged LN?
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throiditis
mumps parotitis stenson's duct stone |
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what medications cause LN enlargement?
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dilantin
tegretol quinidine |
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what are some congenital causes of enlarged LN?
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brachial cleft cyst
thyroglossal duct cyst |
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what will the s/s found on PE ?
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tenderness
warmth pain |
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is a fixed or mobile LN more concerning?
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fixed, firm, and painless is most concerning
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what should your first investigation be?
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complete H & P
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what should you be looking for in your PE?
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sites of infection, OM, dental abcess, skin infection, uti, scratches by animals
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what are some lab tests you could run if you choose to not just do watchful waiting?
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cbc with diff
throat culture mono spot ppd cxr rpr hiv hep panel |
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what are tests to run if you suspect toxoplasmosis?
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cmv, bartonella, rf, ana, contrast CT
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if the node enlargement is worrisome or does not resolve after 4 weeks of watchful waiting what is the test of choice?
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excisional biopsy
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why would FNA not be good enough?
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may not yield enough tissue for diagnosis
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if a LN is under 1 cm in size what is the chance of CA?
what if the LN is 1-2.2 cm in size? what if the LN is >2.25 cm in size? |
<1.0 no chance of CA
1-2.2 cm-8% chance of CA >2.5 cm-38% of CA |
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if a pt >40 y.o. has an enlarged supraclavicular LN what is the probability of malignancy?
50% 75 % 90% |
90%
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if a pt with an enlarged supraclavicular LN is under age 40 what is the chance of malignancy?
-25% -40% -75% |
25%
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if you suspect a bacterial etiology to an enlarged LN what is the abx of choice in the tx?
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zithromax
keflex bactrim |
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if you are uncertain about the etiology of the LN enlargement who should you consult?
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oncology
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