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A 28 year old male presents with fatigue/loss of appetite/weakness. He has also noticed several pound weight loss

of the past few months without intentionally dieting. His medical history is unremarkable, he doesn't take any medications, he has no toxic habits, works full time, and lives by himself.

Exam:

Vitals: Temp 98.4

HR: 104

RR: 16

BP: 108/76

General: He is no acute distress, calm and appropriate.

CV: RRR, no murmurs/rubs/gallops

Pulm: CTAB

Abdomen: S/NT/ND, ++hepatosplenomegaly

HEENT: Sclera slightly pale, no jaundice, he has palpable cervical/pre-post auricular lymph nodes

Lymph: No edema, palpable axillary and inguinal lymph nodes bilaterally

Discussion: What other history would you like to know about this young man?

What is your differential diagnosis for this otherwise healthy man with diffuse lyphadenopathy?

What testing/lab work would you order?

How would you counsel him right now when he is in your office? Would you tell him what was on your mind? Would you tell him why you were ordering lab work? How abstract or definitive would you be?

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