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Lymphadenopathy

  • Common cause

    • benign reactive node, mono, drug reaction
  • Serious ddx

    • metastasis, lymphoma, HIV
  • Labs

    • CBC
    • throat swab, culture
    • biopsy if suspicious
    • consider STD panel
    • CT if suspect metastatic cancer
  • Peds ddx

    • ring worm, Kawasaki disease
    • infection: mono, benign reactive nodes, Kawasaki disease, TB, ringworm (occipital node), cellulitis, cat scratch, tularemia, plague
    • STDs: HIV, syphilis, lymphogranuloma venereum, granuloma inguinale
    • hemonc: lymphoma, leukemia, Hodgekins
    • metastatic cancer: GI cancer (left supraclavicular node), breast cancer (axillary node), genital cancer (inguinal node), ENT cancer (cervical, supraclavicular node)
    • inflammation: sarcoidosis, phenytoin, serum sickness, local reaction to vaccine, phenytoin allergy, autoimmune disease
    • other: hyperthyroidism, goiter, lipoma
  • HPI

    • onset
    • triggering event
    • location: generalized vs localized
    • severity
  • ROS

    • fever, weight loss, fatigue
    • rash, pruritus
    • ENT: runny nose, sneezing, sore throat
    • cardio: chest pain
    • pulm: cough, dyspnea
    • GI: nausea, vomiting, diarrhea, blood in stool
    • GU: genital ulcers
  • PMH

    • HIV, syphilis
    • lymphoma
    • cancer
  • SH

    • foreign travel
    • animal exposure
    • new partners
  • Meds

    • Phenytoin
    • recent injection
  • Allergies

  • Px

    • vitals
    • HEENT: conjunctivitis, oral lesions, thyroid
    • skin: rash
    • lymph node: size, mobility, tenderness, other nodes
    • cardio
    • pulm
    • abd
    • genital ulcers if inguinal lymphadenopathy

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    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.