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CHAPTER FIVE. Lymphedema

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Lymphatic flow in the lower extremity is

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a. Deep to superficial.

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b. Superficial to deep.

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c. Anterior to posterior.

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d. Posterior to anterior.

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Which of the following mechanisms is not effective in assisting lymphatic flow?

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a. Diaphragmatic breathing

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b. Positive pressure gradient within the lymphatic system

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c. Muscle contractions

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d. Smooth muscle in the walls of the collecting vessels

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Which of the following characteristics are associated with Stage III lymphedema?

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a. Hard non-pitting edema and presence of skin folds

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b. Mild fibrosis and pitting edema

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c. Normal joint range of motion and strength

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d. Negative Stemmer test and loss of skin mobility

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JB, a 62-year-old retired postal worker, presents with the following symptoms: heaviness and aching in both lower extremities, hemosiderin stains on the lower 1/3 of the legs, bilateral edema from the dorsum of the foot to below the knee, positive Stemmer sign bilaterally, mild to moderate fibrosis in the lower leg, and 3+ distal pulses. Medical history is negative for diabetes. What is the most likely diagnosis for this patient?

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a. Kidney insufficiency

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b. Cardiac insufficiency

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c. Primary lymphedema

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d. CVI with secondary lymphedema

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The most effective intervention for Stage II lymphedema is

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a. Education, garments, and MLD.

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b. Diuretics, garment, and exercise.

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c. MLD, compression therapy, and exercise.

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d. Education, compression pump, and diuretics.

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