and answers
Which of the following is NOT part of the lymphatic system?
Tonsils
Thyroid
Thymus
Spleen - Answer-Thyroid
Which of the following statements is true for patients with breast edema?
All are true
Swimming is an excellent exercise for patients with breast edema.
Patients with breast edema should avoid shirts/tank tops with a built-in shelf.
Elastic taping may reduce edema by channeling fluid to the contralateral axilla. -
Answer-All are true
What term is used for lymph vessels which have a three-layer wall and bicuspid valves?
Collectors
Capillaries
Channels
Inner tubes - Answer-Collectors
What organ dysfunction causes myxedema?
Thyroid
Thymus
Liver
Kidney - Answer-Thyroid
Your current patient with left, lower-extremity lymphedema has received five sessions of
MLD and bandaging. Upon removal of the bandages, her leg is splotchy-red, very
warm, more swollen than the day before, and mildly painful. She feels unwell but
dismisses it as the flu. What is the MOST LIKELY cause for these symptoms and how
should you respond?
Cellulitis (erysipelas). Stop therapy and immediately inform the physician.
Dermatitis. Put hydrocortisone cream on the redness and bandage as usual.
Malignant lymphedema. Continue MLD and bandaging.
A deep vein thrombosis. Send the patient to the ER. - Answer-Cellulitis
When bandaging the LE of an obese patient with large medial thigh lobes, all of the
following regarding bandaging are true, EXCEPT:
The skin crease below the lobe needs to be padded to avoid maceration and skin break
down.
Using foam inserts will help to keep the bandages from sliding down.
Only long-stretch (Ace) bandages should be used instead of short-stretch bandages.
, Lifting the lobe with large figure-8 turns (steep bandaging angles) will help to keep the
bandages in place. - Answer-Only long stretch Ace bandages should be used instead of
short stretch bandages
During your MLD, which anastomoses pathway(s) should be used in a patient with
secondary, breast cancer-related, left upper-extremity lymphedema?
Bilateral axillo-inguinal
Right axillo-inguinal and inter-axillary
Inter-axillary only
Left axillo-inguinal and inter-axillary - Answer-Left axillo-inguinal and inter-axillary
During your MLD, which anastomoses pathway(s) should be used in a patient with
secondary, breast cancer-related, left upper-extremity lymphedema?
Bilateral axillo-inguinal
Right axillo-inguinal and inter-axillary
Inter-axillary only
Left axillo-inguinal and inter-axillary - Answer-Intermittent claudication which may
progress to pain at rest
A 60-year-old female was treated for left-sided breast cancer with mastectomy and
axillary-node dissection; she completed chemotherapy and radiation eight months ago.
She also has a history of right-sided breast cancer which was treated 14 years ago with
mastectomy and axillary node dissection. The patient presents with lymphedema only in
the LUE. As compared to her non-lymphedema side, the LUE is 3cm enlarged in the
forearm and 5.5 cm enlarged in the upper arm. The edema also includes her hand and
fingers and fluctuates greatly day to day. She has collateral veins and significant tissue
adhesions within the radiation field of her left chest wall and she reports mild pain of her
affected arm. Which of the following is most likely NOT a cause of her symptoms?
Cellulitis
Radiation fibrosis
Malignant lymphedema
Deep venous thrombosis - Answer-Cellulitis
Which of the following best describes the treatment for axillary web syndrome (AWS)?
Short-stretch bandaging with textured hi-density foam.
Specialized manual techniques with repeated stretching.
All are true.
Deep myofascial release combined with heat packs and ultra sound. - Answer-
Specialized manual techniques with repeated stretching.
Short-stretch bandages...
exert low resting pressure and low working pressure.
exert high resting pressure and high working pressure.
exert low resting pressure and high working pressure.
exert high resting pressure and low working pressure. - Answer-exert low resting
pressure and high working pressure.
, You are treating a patient with MLD who is undergoing axillary/breast radiation. Under
what conditions is MLD permissible within the radiation field?
Until signs of severe redness and wet desquamation appear.
Throughout the radiation treatment plan regardless of skin changes.
Until signs of inflammation (warmth, redness, and pain) appear, usually 2-3 weeks into
the radiation treatment plan.
MLD is always contraindicated in the radiation field. - Answer-Until signs of
inflammation (warmth, redness, and pain) appear, usually 2-3 weeks into the radiation
treatment plan.
How will hypoproteinemia, caused by liver disease or malnourishment, affect Starling's
equilibrium of fluid exchange?
It will decrease blood capillary pressure.
It will increase plasma colloid osmotic pressure COP(P).
It will reduce plasma colloid osmotic pressure COP(P).
It will increased blood capillary pressure. - Answer-It will reduce plasma colloid osmotic
pressure COP(P).
Which of the following best describes telangiectasia in an irradiated area?
Permanently-dilated lymph collectors
Dilation of the venous angle
Dilation of the thoracic duct
Permanently-dilated small blood vessels - Answer-Permanently-dilated small blood
vessels
A 40-year-old female presents with symmetrical, pitting edema that is greater distally
than proximally. The edema has progressed over the last 10 years. The patient had a
non cancer-related hysterectomy (no lymph nodes were removed) which coincided with
the onset of her edema. Her BMI was 39 at the onset of the edema and is currently 56.
Her mobility is vastly limited; it is especially difficult for her to get in and out of her car.
Your MLD sequence should include short neck, abdominal sequence, and which of the
following?
Bilateral axillary nodes only, then bilateral inguinal-axillary anastomoses.
Bilateral inguinal lymph nodes, but no anastomoses work to the axilla.
Bilateral axillo-inguinal anastomosis and inter-inguinal anastomoses.
Bilateral inguinal and axillary nodes and bilateral inguinal-axillary anastomoses. -
Answer-Bilateral inguinal and axillary nodes and bilateral inguinal-axillary anastomoses.
Which of the following is NOT a function of the lymphatic system?
Return of water and protein to the cardiovascular system.
Absorption of fat and fat-soluble vitamins.
Immunological function.
Return of water and protein to the interstitium. - Answer-Return of water and protein to
the interstitium.