Discuss the workup of the cervical lymphadenopathy.
The initial step is to direct a complete and deliberate physical examination to decide its exact location, consistency, size, obsession, and delicacy joined by a complete presentation history and an audit of the patient's indications. This would help determine the type of treatment and whether there is a need for further tests (Gow & Minkes, 2016).
What tests would you do first and why?
Further, tests would be carried out to determine the exact nature and extent of the lymphadenopathy. If it were malignant, the tests would be to determine the extent to which it has spread in order to determine the course of treatment. If otherwise, the tests would be to determine the exact nature in order to develop a course of treatment (Weerakkody, 2016).
What are your differential diagnoses?
The differential diagnoses, in this case, would be for benign reactive lymphadenopathy, sexually transmitted illness, and skin infections.
How would you explain the problem to your patient and why are the tests necessary?
When it comes to having any form of lymphadenopathy, there is a fear of malignancy despite statistics that such a risk is low. The most encouraged way to break the news is to be gentle but factual. The physician should explain that the tests are just precautionary; however, he should prepare the patient of the likelihood of malignancy by explaining that it is medically possible to do deal with it (Gow & Minkes, 2016).
How would your recommendations differ to an adult, pediatric, and geriatric patient?
For the pediatric cases, most of them result from infections rather those serious malignancies. The recommendation would be for treatment of the infection and further tests later if the lymphadenopathy persists (WL, 2016). In older adults, there is a need to check for a history of malignancy. Therefore, the recommendation would be for malignant father biopsy with continuous checkup of recurrence. There is a high likelihood that such conditions would be malignant in a geriatric patient the recommendation would be for the patient to have a biopsy and if there is a history of malignancy to take chemoprevention drugs.
References
Gow, K. & Minkes, R. (2016). Pediatric Lymph Node Disorders Workup: Approach Considerations, Laboratory Studies, Imaging Studies. Emedicine.medscape.com. Retrieved 27 July 2016, from http://emedicine.medscape.com/article/937855-workup#showall
Weerakkody, Y. (2016). Differential diagnosis of adult cervical lymphanopathy | Radiology Reference Article | Radiopaedia.org. Radiopaedia.org. Retrieved 27 July 2016, from http://radiopaedia.org/articles/differential-diagnosis-of-adult-cervical-lymphanopathy
WL, L. (2016). Childhood cervical lymphadenopathy. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 27 July 2016, from http://www.ncbi.nlm.nih.gov/pubmed/14722499
