Lymphedema

Question 1

Division of primary lymphedema

Answer 1

1. congenital
   - non-familial
   - familial (Milroy)
2. praecox (1-35yo)
   - non-familial
   - familial (Meig)
3. tarda >35 yo

Question 2

what is Milroy’s disease?

Answer 2

primary congenital familial lymphedema

Question 3

What is Meig’s disease?

Answer 3

primary familial lymphedema praecox

Question 4

anatomic classification of lymphedema?

Answer 4

1. distal hypoplastic (80%), 
in females, 
bilateral, 
starts at puberty
benign slow course
2. proximal hypoplastic (10%)
both genders
unilateral
at any age
fast progression
3. hyperplastic (10%)
both genders
bilateral
congenital
progressive

Question 5

what anatomic type of lymphedema is most common

Answer 5

distal hypoplastic

Question 6

Stemmer’s test

Answer 6

inability to pinch and lift a skinfold at the base of second toe
indicates lymphedema

Question 7

Klippel - Trewnany syndrome

Answer 7

slow flow AVF
capillary - lymphaticovenous malformation,
lymphedema, 
limb hyperthrophy,
splenic lymphatic cyst

Question 8

Lymphedema characteristics:

Answer 8

1. acral foot swelling (buffalo hump on the dorsum of the foot)
2. deep transverse digital sulci
3. hypoplastic toenails
4. squaring of toes
5. Concave toes with “ski - jump” nails

Question 9

Lymphedema staging

Answer 9

0 - occult, no swelling,
1 - completely relieved by elevation and pitting,
2 - not relieved by elevation
  a) pitting
  b) nonpitting
3 - elephantiasis