DDx 2 Lower Leg Swelling & Lymph (Quiz 4)

what are the S&S of a DVT?

unilateral tight/painful calf that is worse when walking, swollen leg, can be asymptomatic

what may be some history components for someone with a DVT?

long flights, bed rest, oral birth control, smoking, cancer, post surgery

what exams will be positive with a DVT?

homans and moses 

what labs will be positive with a DVT?

D-Dimer 

how is a DVT diagnosed?

dopler ultrasound or ascending contrast venography (gold standard)

what is the treatment for a DVT?

anticoagulants and elevation

what are the S&S of cellulitis?

spreading patches on the skin, fever, chills, malaise, lymphadenopathy

what do labs reveal with a aptient that has cellulitis?

leukocytosis or neutrophilia 

what is the treatment for cellulitis?

antibiotics (oral dicloxacillin or cephalexin)

what are the S&S of venous insuffciency?

itchy/achy legs with prolonged standing, edema relieved with elevation, chronic leg swelling, pitting edema

what may history reveal with a patient that havs venous insuffciency?

leg trauma, phlebitis, DVT, obesity, diet high in salt

what is the imaging for venous insufficieny?

duplex ultrasonography for eval

what are S&S of primary varicosities?

dull/achy/heavy or feeling of fatigue LE with standing 

what are the S&S of reflex sympathetic dystrophy (CRPS-1)?

persistent pain or swelling after trauma, pain localized to arm or leg, color and temp changes, limited ROM

what is stage one diagnosis of reflex sympathetic dystrophy (CRPS-1)?

sharp pain, burning in area

what is stage two diagnosis of reflex sympathetic dystrophy (CRPS-1)?

mottled, atrophic cold skin

what is stage three diagnosis of reflex sympathetic dystrophy (CRPS-1)?

throbbing pain with dystrophic changes obvious 

what is the treatment for reflex sympathetic dystrophy (CRPS-1)?

CMT, PT, elevation, sympathetic blockers

what are the S&S of congestive heart failure?

bilateral leg edema, dyspena with exertion or lying supine at night — orthopnea

what will exam reveal with CHF?

rales, cardiomegalym dilation of upper-lobe veins

what will x-ray. reveal with CHF?

hazy vessels, cardiomegaly, interstitial pulmonary edema

what does ECG reveal with CHF?

arrhythmias or hypertrophy

what are the S&S of non-hodgkin lymphoma?

painless lymphadenopathy, fever, night sweats, 10% body weight loss in B cell type

what will labs reveal with non-hodgkin lympoma?

increased serum lactate dehydrogenase

how is non-hodgkin lymphoma diagnosed?

tissue / lymph node biopsy 

what is the treatment for indolent non-hodgkin lymphoma?

rituximab with or without chem

what is the treatment for aggressive non-hodgkin lymphoma?

predisone R-CHOP immunotherapy

what are S&S of hodgkin lymphoma?

itching, lymphadenopathy, night sweats, fever, painless mass in neck

how is hodgkin lymphoma diagnosed?

serum chemistry, PET/CT scans, bone marrow and lymph node biopsies. reed-sternberg cells will be present 

what is the treatment for hodgkin lymphoma?

ABVD, chemo, stem cell transplant

what are the signs and symptoms of chronic lymphocytic leukemia?

fatigue, lymphadenopathy, splenomegaly, hepatomegaly, 50-70 years old

what will labs show with chronic lymphocytic leukemia?

WBC > 20,000, B-cell CD19 and T-Cell CD5 present

what is the treatment for chronic lymphocytic leukemia?

chemo or ibrutinib 

what are the S&S of lymphogranuloma venereum in males?

inguinal buboes 1-4 weeks after exposure

what are the S&S of lymphogranuloma venereum in females?

lymph drainage to perirectal glands

what is the cause of lymphogranuloma venereum?

STI of C.trachomatis

what labs are positive with lymphogranuloma venereum?

positive complement fixation test 

what is the treatment for lymphogranuloma venereum?

doxycycline, erthomycin, azithromycin

what population is cat-scratch disease common in?

kids with cat scratches or bites

what are the S&S of cat-scratch disease?

papulae or ulcer, fever, headache, malaise, regional lymh nodes tender, enlarged and suppurative

what needs to be tested for with cat-scratch disease?

bartonella henselae 

what are possible complications of cat-scratch disease?

encephalopathy, endocarditis, angiomatosis