RETICULO-ENDOTHELIAL EXAMINATION

Question 1

How would you start any examination?

Answer 1

WIPER QQ
Wash hands
Introduce yourself
Ask permission
Expose the patient
Reposition the patient

Ask if they are in any pain or discomfort

Question 2

How exposed should the patient be for a reticulo-endothelial examination?

Answer 2

From the waist up

Question 3

How should the patient be positioned for the reticulo-endothelial examination?

Answer 3

Initially sat up

Question 4

What might you look for during general inspection of the patient in a reticulo-endothelial examination?

Answer 4

Patient may appear generally unwell and tired
Short of breath - anaemia
Signs of bleeding - thrombocytopenia
Any obvious lymph node swelling

Question 5

Having inspected the patient as part of a reticulo-endothelial examination, what should you do next?

Answer 5

Palpate the lymph nodes

Question 6

Which lymph nodes should you palpate as part of a reticulo-endothelial examination?

Answer 6

Submental nodes
Submandibular nodes
Anterior chain 
Posterior chain
Occipital nodes
Post and pre-auricular
Supra- and infra- clavicular
Axillary nodes
Inguinal nodes

Question 7

What might you notice about any of the lymph node groups during a reticulo-endothelial examination?

Answer 7

Enlarged nodes
Rubbery
Non-tender

Question 8

Having palpated the lymph nodes as part of the reticulo-endothelial examination, what would you do next?

Answer 8

Palpate the liver looking for hepatomegaly

Question 9

Having palpated the liver as part of the reticulo-endothelial examination, what would you do next?

Answer 9

Palpate the spleen looking for splenomegaly

Question 10

What test would you say you would do in an OSCE at the end of a reticulo-endothelial examination?

Answer 10

Blood tests and blood film, looking for blasts