Body Systems: Lymphatic System

Question 1

lymphodema

Answer 1

abnormal collection of lymph usually in the extremities

Question 2

lymphoedema ss

Answer 2

• swelling of extremity and gross distension
• no pain

Question 3

lymphoedema etiology

Answer 3

• inflammatory or mechanical
• if untreated, connective tissues loses elasticity nd edema becomes permanent
• lymphatic circulation may be compromised by infection, neoplasm, thrombosis
• allergic reactions, trauma, surgery may be implicated
• tight clothing tat constrict vessels can cause temporary lymphoedema
• women who had mastectomies my experience lymphedema in the adjacent arm
• stagnant interstitiel fluids are breeding ground for infection and toxins

Question 4

lymphoedema prognosis

Answer 4

• varies and depends on cause
• surgical intervention usually has positive outcome
• not life threatening but carries danger of uncontrolled infection

Question 5

lymphoedema diagnosis

Answer 5

• painless swelling suggest lympoedema
  -,lymphangiography, radioactive isotope studies

Question 6

lymphoedema treatment

Answer 6

• remove construction
• reduce swelling via elastic bandages or stockings
• affected limbs elevated above heart to encourage drainage
• diuretics reduce fluid volume
• surgery to relive mechanical obstruction
• antibiotics if infection

Question 7

lymphoedema prevention

Answer 7

• many cases are not preventable
• avoid tight clothing

Question 8

lymphangitis

Answer 8

inflammation if lymph vessels

Question 9

lymphangitis ss

Answer 9

• red streak at site of entry of infective organism that extends to regional lymph node
• swollen and tender lymph node
• cellulitis in surrounding tissue
• general infection involving fever, chills, malaise

Question 10

lymphangitis etiology

Answer 10

• bacterial invasion into lymph vessels at site of local trauma or ulceration
• occasionally entry side undetectable
• bacteria travel to regional lymph node and stimulate inflammation

Question 11

lymphangitis prognosis

Answer 11

• varies depending on amount of tissue involved and nature of causative organism
• surgical intervention usually positive outcome

Question 12

lymphangitis diagnosis

Answer 12

• visual inspection of area
• blood tests indicating leukocytosis
• cultures of infected tissue

Question 13

lymphangitis treatment

Answer 13

• systemic antibiotics
• elevate unrest affected area
• apply warm and wet dressings
• surgical drainage of purulent material

Question 14

lymphangitis prevention

Answer 14

• cannot be prevented
• good hand washing prevents infection

Question 15

lymphoma

Answer 15

• malignant neoplasms arising form uncontrolled proliferation of cellular components of lymph systems
• dysfunctional cells may be B, T cells or both
• neoplastic lymphocytes are migratory and not only found in lymph structure, but also bloodstream, bone marrow, non-lymph organs
• treatment determined by cell type and stage
• 2 categories: Hodgkin’s disease and non-Hodgekin’s lymphoma
• both types of lymphoma are staged using Ann armour Cotswolds staging system considering the neoplastic involvement of lymph structures, extra nodal tumour sites, presences or absence of systemic symptoms

Question 16

lymphoma staging

Answer 16

stage 1: single lymph structure or region involved
stage 2: two or more lymphs structures involved with involvement being on these same side of the diaphragm
stage 3: lymph region of both sides of the diaphragm are involved
stage 4: widespread involvement of extra nodal tissue above and below the diaphragm

• each stage either an A or a B indicating whet any of the B symptoms are absent (A) or present (B)
• B symptoms: unexplained weight loss of more than 10% of body eight in 6 months, persistent or recurrent fevers above 38C, recurrent drenching night sweats

Question 17

Hodgkin’s disease

Answer 17

cancer of bodies lymphatic system involving cell proliferation and interference with normal functioning by collecting in masses in various parts of the body

Question 18

Hodgkin’s disease ss

Answer 18

• painless enlargement of lymph nodes in neck or mediastinum
• fatigue
• alcohol induced pain
• pruritus (itching)
• B symptoms as disease progresses

Question 19

Hodgkin’s disease etiology

Answer 19

• represents 15% of all lymphomas
• peak incidents: 20s, over 50
• risk factors: previous malignancy, chemotherapy, radiation, family, history, immunosuppression
• tumours arise in tissues of lymph nodes and spread to other lymph nodes, spleen, liver, bone marrow

Question 20

Hodgekin’s disease prognosis

Answer 20

• one of the most treatable forms of cancer, can be cured
• five year survival rate approaches 90%
• death can result form Hodgkin’s disease or secondary cancers
• B symptoms, low serum albumin and hemoglobin, male, over 45, anemia, leukocytosis indicate poor prognosis

Question 21

Hodgkin’s disease diagnosis

Answer 21

• node biopsy showing reed-sterner cell in lymphatic tissue, a large cell with 2 or more mirror image nuclei, each with a single nucleolus
• blood studies indicate mild, normochromic normocytic anemia, neutrophilic leukocytosis, lymphopenia, esinophils
• elevated ESR
• bone marrow biopsy
• CT scans of chest, abdomen, pelvis to determine extent
• liver,= and kidney function tests

Question 22

Hodgkin’s disease treatment

Answer 22

• stage 1,2: radiation therapy or combined chemoradiatherapy
• stage 3, 3B: combined chemoradiotheraoy
• stage 4: chemotherapy alone
• relapses: additional chemotherapy, bone marrow transplantation for multiple relapses

Question 23

Hodgkin’s disease prevention

Answer 23

none known

Question 24

non-Hodgkin’s lymphoma

Answer 24

heterogenous neoplasms of lymphoid cells

Question 25

non-Hodgkin's lymphoma ss

Answer 25

- painless lymphadenopathy - slow, indolent growth to rapid fatal progression - enlargement fo tonsils and adenoids - fatigue - pruritus - bone pain - GI symptoms - B symptoms

Question 26

non Hodgkin's lymphoma etiology

Answer 26

- peak: preadolescence, increasing age - risk factors: history malignancy, radiation, immunotherapy, chemotherapy, HIV, HTLV, EBV, hepatitis C, immunosuppression, connective tissue disorders - 3 categories: depends on how aggressive neoplasm is - indolent: 35-40% follicular lymphoma most common, small lymphocytic, mantle cell, marginal zone, can arise from B/T/NK - aggressive: 50% diffues and peripheral T cell most common - highly aggressive: 5%. burkitt's adult T cell

Question 27

non Hodgkin's lymphoma prognosis

Answer 27

- some can be cured - five year survival 53% - indolent: not curable with treatment generally - aggressive: curable but rapidly fatal if not treated

Question 28

non Hodgkin's lymphoma diagnosis

Answer 28

- physical examination - excision biopsy - bone marrow aspiration and biopsy - lab tests, blood tests, renal and liver function - chest radiography, CT of abdomen and pelvis - GI endoscopy - MRI if neurologic signs present

Question 29

non-Hodgkin's lymphoma treatment

Answer 29

- indolent: watchful waiting, chemotherapy, radiation though not curable - aggressive: chemotherapy with or without radiation therapy - relapses: high dose chemotherapy followed by bone marrow transplantation - periodic follow up

Question 30

non Hodgkin's lymphoma prevention

Answer 30

none known

Question 31

transfusion incompatibility reaction

Answer 31

blood or blood product transfusion has antibodies to recipients RBCs or recipient has antibodies to donors RBCs

Question 32

transfusion incompatibility reaction ss

Answer 32

- hypersensitivity can range form mild to fatal - haemolysis - agglutination - bacterial, allergic, circulatory overload transfusion reactions - chills and fever - tachycardia - serve: back pain, vomiting, diarrhea. hives rash, substernal tightness, dyspnea, hypertension, circulatory collapse, bleeding form puncture site, blood in urine, renal failure - most frequently associated with abcs: febrile and short lived, no hemolysis or allergy

Question 33

transfusion incompatibility reaction etiology

Answer 33

- ABO and RH incompatible blood as well as antigens the screening does not reveal cause an antigen antibody reaction - histamine and serotonin related from mast cells and platelets - disseminated intravascular coagulations usually triggers leading to coagulations problems

Question 34

transfusion incompatibility reaction prognosis

Answer 34

varies depending on amount of blood infused, cause, speed of intervention

Question 35

transfusion incompatibility reaction diagnosis

Answer 35

- chills, fever, gives, back pain, dyspnea during transfusion - analysis of blood and urine

Question 36

transfusion incompatibility reaction treatment

Answer 36

- stop blood transfusion - antihistamines - more aggressive treatment for anaphylaxis

Question 37

transfusion incompatibility reaction prevention

Answer 37

- prevention is best form of treatment - careful typing and crossmatching of blood products