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62 Cards in this Set
- Front
- Back
Sinus hyperplasia is frequently a normal finding in which nodes (2)?
|
Mesenteric
Axillary |
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What cells is a primary follicle composed of?
|
Virgin B cells
|
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What cells is the interfollicular zone comprised of?
|
T cells
|
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Lymphadenopathy in which nodes is almost always due to malignancy (2)?
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Supraclavicular
Retroperitoneal |
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Occurence and extent of lymphadenopathy is greater in whom?
Children OR adults |
Children
|
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Biopsied LNs from infectious mono. can look like what other conditions (3)?
|
Non-Hodgkin's lymphoma
Waldenstrom's macroglubilinemia Lymphocyte-predominant Hodgkin's |
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What pts. often have epitrochlear, axillary, and inguinal lymphadenopathy?
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Manual laborers
Repeated, minor injuries to extremities cause repeated small infections NOTE: the nodes are usually non-tender |
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What anti-epileptic drug is associated w/ lymphadenopathy?
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Dilantin
|
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How do NON-neoplastic nodes typically appear on exam?
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Enlarged
Flat Relatively soft |
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How do neoplastic nodes typically appear on exam?
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Enlarged
Irregular Rubbery hard |
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How do infected nodes typically appear on exam?
|
Enlarged
Variable hardness Tenderness Redness Heat Pain NOTE: Hodgkin's may occasionally present w/ tender LNs |
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A LN larger than ____ should be considered enlarged
|
1 cm
|
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Rubella has a tendency to affect which LNs?
|
Posterior auricular
|
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Toxoplasmosis has a tendency to affect which LNs?
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Posterior cervical
|
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Intra-thoracic/abdominal carcinomas usually affect which LNs?
|
Supraclavicular
Scalene |
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Sarcoidosis usually affects which LNs?
|
HILAR
Supraclavicular Scalene |
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Hodgkin's disease has a tendency to affect which LNs?
|
Mediastinal
|
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Subacute necrotizing lymphadenitis has a tendency to affect which LNs?
|
Posterior cervical
|
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What is sinus histiocytosis?
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Benign disorder of young adults
Painless, massive cervical lymphadenopathy (bilateral) Histiocytic infiltration in the sinuses of the LN |
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Secondary syphilis has a tendency to affect which LNs?
|
Epitrochlear
(bliaterl) |
|
What are the charactertistics of Castleman's disease?
(w/ regards to lymphadenopathy) |
Large, solitary mediastinal mass
Atypical hyperplasia, w/ burned out germinal centers Marked capillary proliferation |
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Which important veneral disease does NOT produce lymphadenopathy?
|
Gonorrhea
|
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Which lymphatic disease often mimics appendicitis?
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Acute mesenteric lymphadenitis
|
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Pts. w/ marked enlargement of the retroperitoneal LNs often present w/ what?
|
Backache
(assoc. w/ other findings weight loss, sweats, etc.) |
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Where are the epitrochlear LNs located?
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In the "elbow pit"
|
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Why is a LN biopsy NOT indicated in CLL?
|
Peripheral blood and marrow findings are diagnostic
|
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Increased what in peripheral blood is diagnostic of infectious mono?
|
Atypical lymphocytes
|
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What is the white pulp composed of (2)?
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Secondary lymph follicles
Periarterial lymphatic sheaths |
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What is the red pulp composed of?
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Splenic cords and sinuses
|
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What cell type are the marginal zones of the spleen rich in?
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Monocytes
|
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Flow of venous drainage from the spleen
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Sinuses --> pulp veins --> trabecular veins --> splenic hilar veins
|
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What are splenic cords?
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Extravascular collections of hematopoietic cells (mostly red)
|
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Where does arterial blood flow of the spleen empty into?
|
Splenic cords
|
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Lymphatic drainage of the spleen
|
Confined to the white pulp
Lymphatics coalesce to form trabecular lymphatic vessels Run adjacent to trabecular arteries |
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What LNs does lymphatic drainage of the spleen drain into?
|
Splenic hilar nodes
Celiac nodes |
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Where are the marginal zones located in the spleen?
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At the junction of the white and red pulp
|
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% of cardiac output that is blood flow to the spleen
|
5%
|
|
What is chronic passive congestion?
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Splenomegaly due to an increase in portal vein pressure
NOTE: splenomegaly is due to expansion of the RED pulp |
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Degree of splenic sequestration for RBCs, granulocytes, platelets
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RBCs - 1%
Granulocytes - 20% Platelets - 30% |
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With enlargement of the spleen, how much red cell pooling can occur?
|
25%
|
|
With enlargement of the spleen, how much platelet pooling can occur?
|
Up to 90%
|
|
What type of organisms is the spleen specialized for removing?
|
Encapsulated organisms
|
|
What is normal spleen size and weight?
|
4 x 8 x 12 cm
<= 200 grams |
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Normal size spleen is usually no longer palpabe after what age?
|
3 - 4 years old
|
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What is primary splenic hyperplasia?
|
Splenomegaly in which a specific underlying disorder is not found
|
|
Most common causes of splenomegaly in the Western hemisphere (2)
|
Hematologic disorders
Congestive splenomegaly |
|
7 clinical manifestations of splenomegaly
|
LUQ pain, discomfort, fullness
Left supraclavicular pain Early satiety Weight loss Excess sweating Manifestations of cytopenias Hematemesis from varices |
|
LUQ pain is not common in absence of what?
|
Splenic infarction
|
|
Left supraclavicular pain in splenomegaly is due to what?
|
Irritation to the left diaphragm
|
|
What is Felty's syndrome?
|
Syndrome of Rheumatoid arthritis, splenomegaly, and neutropenia
|
|
Organisms that can cause the "infectious mono symptom complex"
|
EBV
CMV Toxoplasmosis |
|
What do Rouleau formations indicate?
|
Hypergammaglobulinemia
(can be either poly- or monoclonal) |
|
Type of gammaglobulin assoc. w/ Waldenstrom's macroglobulinemia
|
Monoclonal IgM
|
|
Hallmarks of an increased rate of RBC destruction (5)
|
Poikilocytosis
Anisocytosis Schistocytosis Polychromatophilia Nucleated RBCs |
|
Splenomegaly is more often seen in what pts. w/ ALL
Children or adults |
Children
NOTE: splenomegaly is DISTINCTLY UNUSUAL in adults w/ acute leukemia |
|
What is the most common cause of stomatocytosis?
|
Heavy alcohol intake
|
|
Charactertistic blood findings in the thalassemias
|
Target cells
Hypochromic microcytes Basophilic stippling |
|
How is diagnosis of hereditary pyropoikilocytosis confirmed?
|
Demonstrating increased fragility to heat
|
|
Most common cause of Autoimmune hemolytic anemia
|
Drugs
|
|
Charactertistic finding on the smear in AIHA
|
Autoagglutination of RBCs
|
|
Most common underlying disease process in congestive splenomegaly
|
Intrinsic liver disease
|
|
Splenectomy is often indicated in this condition
(even if spleen is NOT enlarged) |
Autoimmune thrombocytopenia
|