Lymphadenopathy Quiz

Lymphadenopathy = Enlargement of 1 or more lymph nodes Supraclavicular fossa = A region where lymph node palpability is not normal Nephertiti Efeovbokhan, MD = One of the authors of The Patient History: An Evidence-Based Approach to Differential Diagnosis, 2e Palpability = Ability to feel or touch something, such as lymph nodes

Fever, headache, sore throat, fatigue = Complained symptoms Rhinorrhea, cough = Symptoms denied by the man Multiple swollen lymph glands in the front of his neck = Noticed by the man Sore lymph glands, symptoms not improving = Man's concerns

Establish a presumptive diagnosis using open-ended questions = Initial step in the diagnosis process More focused history taking = Follow-up to open-ended questions Classify lymphadenopathy = Categorization of the lymph node enlargement Distinguish benign causes of lymphadenopathy from more serious ones = Differentiation for further evaluation

<p>Neck and groin regions = Normal palpability Supraclavicular fossa, axilla, epitrochlear, or popliteal regions = Generally not palpable Multiple swollen lymph glands in the front of his neck = Region affected by the man in the case scenario Enlargement of 1 or more lymph nodes = Definition of lymphadenopathy</p> Signup and view all the answers

<p>CINEMA DIVITT = Congenital, infectious, neoplastic, endocrine, metabolic, allergic, degenerative, inflammatory/immunologic, vascular, idiopathic or iatrogenic, traumatic, toxic MIAMI = Malignancies, infections, autoimmune disorders, miscellaneous and unusual conditions, and iatrogenic causes Congenital syphilis, upper respiratory infections, bacterial and viral infections, fungi, parasites, rickettsiae, and neoplastic conditions = Differential diagnosis for lymphadenopathy Actinomycosis, brucellosis, cat-scratch disease, chancroid, and others = Specific bacterial causes of lymphadenopathy</p> Signup and view all the answers

<p>Adenovirus = Viral causes Cytomegalovirus = Viral causes Epstein-Barr virus = Viral causes Hepatitis B and C, herpes simplex, human immunodeficiency virus = Viral causes</p> Signup and view all the answers

<p>Chagas disease, filariasis, kala-azar, leishmaniasis, toxoplasmosis, and trypanosomiasis = Parasitic causes Toxoplasmosis = Parasitic causes Kala-azar = Parasitic causes Leishmaniasis = Parasitic causes</p> Signup and view all the answers

<p>0.8%-1% = Neoplastic causes Less than 1% = Neoplastic causes Over two-thirds = Neoplastic causes 63% = Neoplastic causes</p> Signup and view all the answers

<p>Bacterial or mycobacterial infections = Tuberculosis, upper respiratory infections Metastatic cancer = Breast cancer, lung cancer, melanoma Autoimmune disorders = Connective tissue diseases Medication-associated serum sickness = Specific symptoms like joint pain, mouth ulcers, rashes after sun exposure, dry mouth, or dry eyes</p> Signup and view all the answers

<p>Swollen, hard, tender, or draining lymph glands = Physical symptoms of lymphadenopathy Fevers, rashes, fatigue, unintentional weight loss = Associated symptoms of lymphadenopathy Genital herpes, sporotrichosis, herpes zoster, mumps = Specific symptoms associated with lymphadenopathy Changes over time and factors that make it better or worse = Modifying symptoms of lymphadenopathy</p> Signup and view all the answers

<p>Patient's medical history and thorough physical examination = Initial steps in the diagnostic approach for lymphadenopathy Diagnostic algorithms and alarm symptoms suggestive of malignancy = Additional tools in the diagnostic approach for lymphadenopathy Time course and modifying symptoms = Important factors to consider in the diagnostic approach for lymphadenopathy Emotional impact on patients and their families = Psychosocial aspect to consider in the diagnostic approach for lymphadenopathy</p> Signup and view all the answers

<p>Consideration of conditions that mimic lymph node swelling = Important cautionary step in evaluating lymphadenopathy Repeated evaluation, patient education, and shared decision making = Steps to take for nonspecific lymphadenopathy that persists or progresses Addressing the emotional impact and providing reassurance = Supportive measures for patients and their families Prognosis and observation in primary care settings = Reassurance and observation for specific patient demographics</p> Signup and view all the answers

<p>Lymphoma = Can cause lymphadenopathy Adrenal insufficiency = Can lead to lymphadenopathy Allergic factors = Can contribute to lymphadenopathy Cat-scratch disease = Infectious cause of lymphadenopathy</p> Signup and view all the answers

<p>Breast = Can cause metastatic solid tumors and lymphadenopathy Head and neck = Can lead to metastatic solid tumors and lymphadenopathy Ovary = Can contribute to metastatic solid tumors and lymphadenopathy Stomach = Can result in metastatic solid tumors and lymphadenopathy</p> Signup and view all the answers

<p>Hyperthyroidism = Can cause lymphadenopathy Multiple endocrine neoplasia = Can lead to lymphadenopathy Lipid storage diseases = Can contribute to lymphadenopathy Severe hypertriglyceridemia = Can result in lymphadenopathy</p> Signup and view all the answers

<p>Traumatic causes = Can contribute to lymphadenopathy Vascular factors = Can lead to lymphadenopathy Degenerative factors = Can cause lymphadenopathy Inflammatory/immunologic factors = Can result in lymphadenopathy</p> Signup and view all the answers

<p>Age over 50 = Increases the risk of malignancy and lymphadenopathy Leukemia = Can lead to increased risk of malignancy and lymphadenopathy Esophagus cancer = Can result in increased risk of malignancy and lymphadenopathy Melanoma = Can cause increased risk of malignancy and lymphadenopathy</p> Signup and view all the answers

<p>Endocrine conditions = May have varying prevalence in causing lymphadenopathy Metabolic causes = May have varying prevalence in causing lymphadenopathy Infectious causes = May have varying prevalence in causing lymphadenopathy Toxic causes = May have varying prevalence in causing lymphadenopathy</p> Signup and view all the answers

<p>Open-ended questions = Can help in obtaining information about lymphadenopathy Structured interview framework = Can assist in obtaining information about lymphadenopathy Visual aid = Can help in understanding and discussing lymphadenopathy symptoms Thorough history review = Can assist in gathering information about lymphadenopathy</p> Signup and view all the answers

<p>Onset = Can be gathered through an interview for lymphadenopathy Duration = Can be gathered through an interview for lymphadenopathy Location = Can be gathered through an interview for lymphadenopathy Triggers = Can be gathered through an interview for lymphadenopathy</p> Signup and view all the answers

<p>Cuts = Can lead to secondary infections and lymphadenopathy Bites = Can result in secondary infections and lymphadenopathy Abrasions = Can cause secondary infections and lymphadenopathy Burns = Can contribute to secondary infections and lymphadenopathy</p> Signup and view all the answers

<p>Gaucher's disease = Can contribute to lymphadenopathy Niemann-Pick disease = Can lead to lymphadenopathy Fabry's disease = Can result in lymphadenopathy Tangier's disease = Can cause lymphadenopathy</p> Signup and view all the answers

<p>Reviewing patient's history = Crucial for diagnosing the cause of lymphadenopathy Conducting a thorough interview = Crucial for diagnosing the cause of lymphadenopathy Gathering information on symptoms = Crucial for diagnosing the cause of lymphadenopathy Obtaining information on exposures = Crucial for diagnosing the cause of lymphadenopathy</p> Signup and view all the answers

<p>Certain prescribed medications = Can cause lymphadenopathy Chemicals = Can lead to lymphadenopathy Lung cancer = Can contribute to lymphadenopathy Prostate cancer = Can result in lymphadenopathy</p> Signup and view all the answers

<p>Metastatic cancer of the mediastinum, esophagus, or thorax = Right supraclavicular lymphadenopathy Breast cancer = Lymphadenopathy Sarcoidosis = Lymphadenopathy HIV infection = Lymphadenopathy</p> Signup and view all the answers

<p>Persistence or growth over several weeks or months = Alarm symptom Systemic inflammation/infection = Alarm symptom &quot;Hard&quot; lymph node = Alarm symptom Malaise, fatigue, fever, unintentional weight loss, and night sweats = Linked to lymphadenopathy</p> Signup and view all the answers

<p>Cat-scratch disease = Infectious disease associated with lymphadenopathy Toxoplasmosis = Infectious disease associated with lymphadenopathy Tuberculosis = Infectious disease associated with lymphadenopathy Lyme disease = Infectious disease associated with lymphadenopathy</p> Signup and view all the answers

<p>Unprotected sexual intercourse = Potential cause of lymphadenopathy Injection drug use = Potential cause of lymphadenopathy Consumption of unpasteurized milk or cheese = Potential cause of lymphadenopathy Hunting and eating wild animals = Potential cause of lymphadenopathy</p> Signup and view all the answers

<p>Cancer history = Influence on subsequent diagnostic decision making Recent travel = Influence on subsequent diagnostic decision making Family history of head and neck cancer = Influence on subsequent diagnostic decision making Exposure to undercooked meats = Influence on subsequent diagnostic decision making</p> Signup and view all the answers

<p>Cancer = 1%-4% Local infections for which antimicrobial therapy may be beneficial = 10%-30% Systemic infection = &lt;1% Severe autoimmune disease = &lt;1%</p> Signup and view all the answers

<p>Fatigue = Linked to lymphadenopathy Fever = Linked to lymphadenopathy Night sweats = Linked to lymphadenopathy Unintentional weight loss = Linked to lymphadenopathy</p> Signup and view all the answers

<p>Systemic infection = Associated with lymphadenopathy Autoimmune connective tissue disease = Associated with lymphadenopathy Medications = Associated with lymphadenopathy Radiation exposure = Associated with lymphadenopathy</p> Signup and view all the answers

<p>TB skin test = Impact on identifying potential causes of lymphadenopathy Exposure to infectious diseases = Impact on identifying potential causes of lymphadenopathy Changes in moles and skin lesions = Impact on identifying potential causes of lymphadenopathy Tick bites in Lyme disease-endemic areas = Impact on identifying potential causes of lymphadenopathy</p> Signup and view all the answers

<p>Autoimmune diseases = Associated with lymphadenopathy Severe autoimmune disease = Associated with lymphadenopathy Lymphoma = Associated with lymphadenopathy Tuberculosis = Associated with lymphadenopathy</p> Signup and view all the answers

<p>Alcohol and tobacco use = Impact on identifying potential causes of lymphadenopathy Exposure to undercooked meats = Impact on identifying potential causes of lymphadenopathy Tick bites = Impact on identifying potential causes of lymphadenopathy Risky behaviors = Impact on identifying potential causes of lymphadenopathy</p> Signup and view all the answers

<p>Persistence or growth over several weeks or months = Linked to lymphadenopathy Systemic inflammation/infection = Linked to lymphadenopathy &quot;Hard&quot; lymph node = Linked to lymphadenopathy Malaise = Linked to lymphadenopathy</p> Signup and view all the answers