Lymphadenopathy and organomegaly: diagnostic approach — formative SAQs

SAQ 1 (10)

A well 5-year-old has a soft tender 2 cm cervical node on day 5 of a viral URI. Growth is normal. No supraclavicular nodes. Abdomen soft without organomegaly. ^{[1] [2]}

1. Give a one-sentence problem representation. (2)
2. List four classification axes you use at the bedside. (4) ^[2]
3. Outline your plan including safety-net features that would change management. (4) ^{[2] [3]}

Model answer

Problem representation. Acute localised tender cervical lymphadenopathy after URI in a well preschool child — most likely reactive. ^{[1] [2]}

Axes. Duration; distribution (localised vs generalised); character (soft/tender/mobile vs hard/fixed); systemic context (fever pattern, B symptoms, cytopenia clues, exposures). ^[2]

Plan. Observe with review; treat source if needed; avoid endless blind antibiotics; safety-net rapid growth, hardness/fixation, supraclavicular spread, bruising, breathing difficulty, night sweats, weight loss — then escalate imaging/labs/specialty. ^{[2] [3]}