LYMPHADENOPATHY & EDEMA

LYMPHADENOPATHY:


Its good to tell both significant and generalized lymphadenopathy

NO SIGNIFICANT AND GENERALISED LYMPHADENOPATHY .

If u say this examiners will be tempted to ask what is significant lymp??
ANS : SIGNIFICANT implies that the node enlargement is due to some pathology at present and not by chance or due t past pathology..

Measure ?? each lymph node has certain limit upto which it wil be normal .
INGUINAL – significant if more than 2.5 cm.
AXILLARY - >1.5 cm .
CERVICAL - >1 cm.
SUPRACLAVICULAR - >0.5 cm.

Others lymph nodes if palpable itself significant .
GENERALISED LYMPHADENOPATHY : involvement of two or more non contagious lymphnode.
The next question is what is PERSISTENT GENERALISED LYMPHADENPPATHY :

ANS: its s stage of hiv infection with presence of enlarged nodes >1cm in two or more extrainguinal sites for more than 3 months WITHOUT AN OBVIOUS CAUSE.


Cervical – palpated from back with head slightly flexed .
Anterior axillary & lateral – from front
Posterior axillary – from behind
Inguinal – supine position . palpate all the lymph nodes even If u cant find the findings , bcoz it’s the most easy for the examiner to see
whether u hav examined axillary nodes os not .



EDEMA :
Apparent increase in interstitial fluid volume which may expand several times before clinically visible .

PRESSURE TO DEMO PITTING EDEMA : 5 – 30 s.
Earliest site: behind medial malleolus – ambulant . at sacrum if bed ridden.

FAST edema - pit fills back within 40 s. (hypoalbuminaemia)
SLOW edema – takes more than 40 s to fill. (cardiac failure)