Lymphology Association of North America (LANA) Practice Exam

A patient exhibits bilateral, symmetrical edema and has a positive Stemmer's sign. What is NOT a plausible contributor to the patient’s edema/lymphedema?

1. Venous insufficiency

2. Acute deep venous thrombosis

3. Congestive heart failure

4. Arterial insufficiency

The correct answer is: Acute deep venous thrombosis

In the context of bilateral, symmetrical edema accompanied by a positive Stemmer's sign, it's important to recognize the nature of the conditions typically associated with lymphedema. A positive Stemmer's sign indicates that there is a problem with lymphatic drainage, which is characteristic of lymphedema rather than other fluid retention issues. Congestive heart failure, venous insufficiency, and arterial insufficiency can contribute to edema, but they primarily cause bilateral swelling of a different character. However, acute deep venous thrombosis generally leads to unilateral edema due to obstruction of venous return in one limb; thus, it does not typically present as bilateral swelling. The presence of bilateral, symmetrical edema suggests a systemic issue rather than localized obstruction, making the scenario of acute deep venous thrombosis less plausible in this case. In summary, the characteristics of the patient's edema, especially the bilateral nature and positive Stemmer's sign, indicate that acute deep venous thrombosis is less likely to be a contributing factor to the edema.