<aside> 💡 Detection of lymph nodes should lead to an examination of the area drained by the enlarged nodes.

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During palpation of lymph nodes consider the following features: Site Size - abnormal nodes are greater than 1cm in size Consistency- hard (carcinoma), rubbery (lymphoma) Tenderness- in infection or acute inflammation Fixation- mobile if non-malignant Overlying skin- if tethered more likely to be a malignancy

• General appearance
• Vital Signs
• Hands/Arms
• Face
• Bony Tenderness: with patient sitting up tap over spine, check sternum, clavicle and shoulders by pushing them towards each other (infiltration due to myeloma, lymphoma, carcinoma)
• Abdomen
• Legs
• CVS: systolic flow murmur and cardiac failure with anemia. venous disease in legs.
• Resp: Chest infections or effusions
• CNS: evidence of peripheral neuropathy with B12 deficiency
• Fundoscopy