CLT Contraindications & Precautions for Lymphatic Therapy 1 — Questions and Answers
Question 1: Which condition is considered an absolute contraindication for Manual Lymphatic Drainage (MLD)?
- Mild bilateral ankle edema
- Active deep vein thrombosis (DVT) (Correct answer)
- Healed surgical incision
- Controlled type 2 diabetes
Correct answer: Active deep vein thrombosis (DVT)
Active DVT is an absolute contraindication because MLD could dislodge the thrombus and cause a life-threatening pulmonary embolism.
Question 2: Which cardiac condition represents an absolute contraindication for lymphatic therapy?
- Controlled mild hypertension
- History of resolved myocardial infarction
- Decompensated congestive heart failure (Correct answer)
- Atrial fibrillation under medical management
Correct answer: Decompensated congestive heart failure
Decompensated CHF is an absolute contraindication because increasing lymphatic return overloads an already failing heart, risking acute decompensation.
Question 3: Active malignancy in or near the treatment area is classified as:
- A relative contraindication requiring physician clearance
- An absolute contraindication for MLD (Correct answer)
- A precaution requiring reduced treatment intensity only
- Not a contraindication if the patient is asymptomatic
Correct answer: An absolute contraindication for MLD
Active malignancy is an absolute contraindication because stimulating lymphatic flow could theoretically promote metastatic spread of cancer cells.
Question 4: A patient presents with acute cellulitis in the lymphedematous limb. The correct management is:
- Immediate aggressive MLD to flush the infection
- Compression bandaging only until antibiotics begin
- Defer all CDT until infection resolves with antibiotics (Correct answer)
- Gentle MLD combined with concurrent antibiotic treatment
Correct answer: Defer all CDT until infection resolves with antibiotics
Acute cellulitis requires antibiotics first; MLD and compression are deferred until the infection resolves because treatment could spread bacteria systemically.
Question 5: Renal failure is a contraindication for lymphatic therapy primarily because:
- MLD causes the kidneys to produce excess lymph
- Compression garments restrict renal blood vessels
- MLD stimulates excessive hormone release from the kidneys
- The kidneys may be unable to process the increased fluid mobilized during treatment (Correct answer)
Correct answer: The kidneys may be unable to process the increased fluid mobilized during treatment
In renal failure, the kidneys cannot adequately filter and excrete the increased fluid load mobilized by MLD, creating risk of dangerous fluid overload.
Question 6: A patient presents with acute inflammation following an insect sting on the forearm. The therapist should:
- Perform MLD distal to the sting to reduce distal edema
- Apply compression bandaging immediately to reduce swelling
- Avoid MLD on the affected limb until acute inflammation resolves (Correct answer)
- Perform MLD proximal to the sting site only
Correct answer: Avoid MLD on the affected limb until acute inflammation resolves
Acute inflammation is a local contraindication; MLD should be avoided in the area because it could spread inflammatory mediators and worsen the reaction.
Question 7: Which of the following is NOT an absolute contraindication for MLD?
- Active deep vein thrombosis
- Decompensated congestive heart failure
- Chronic Stage I lymphedema (Correct answer)
- Active malignancy in the treatment field
Correct answer: Chronic Stage I lymphedema
Chronic Stage I lymphedema is the primary indication for MLD treatment, not a contraindication; the other three are absolute contraindications.
CLT Contraindications & Precautions for Lymphatic Therapy 1
Which condition is considered an absolute contraindication for Manual Lymphatic Drainage (MLD)?