The document outlines a checklist for medical students at Majmaah University regarding lymph node examination and Body Mass Index (BMI) competencies. It includes initial examination steps, a guide for taking patient history, techniques for inspecting and palpating lymph nodes, as well as the interpretation of findings. Additionally, it provides the formula for calculating BMI and categorizes weight status based on BMI values.

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College of Medicine Majamaah University, KSA
Check list for the students: Lymph Node Examination and BMI
Competencies
1:Initial steps
A. Greet the patient & introduce yourself
B. Confirm the name & ID of patient.
C. Examine from the right side of patient
D. Explain the procedure and reassure: Take verbal consent
E. Hand hygiene with alcohol gel
F. Uncover the part to be examined
G. Position the patient siting , standing or lying down
H. Check the instrument and equipments required.
2: Brief history
History of present illness
Fever, Bleeding, Enlarged nodes, Swelling in extremities, Medication
Past and medical history
Infection: TB, HIV, Surgery, Transfusion ,Malignancy
Family history
Chronic illness, Malignancy, TB,…
I: Head and neck:
1: Submental
2: Submandibular
3: Preauricular
4: Post auricular
5: Occipital
6: Cervical
A: Anterior: Superficial and deep
B: posterior : Superficial and deep
7: Supraclavicular
II: Axillary group
1. Central /Anterior
2. Lateral
3. Pectoral/medial
Infraclavicular
4. Posterior/Subscapular
III: Inguinal group:
1: Horizontal
5. 2: Vertical
I: Inspection of the area

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Asymmetry or erythema
Swelling
Discharge
Ulceration, Scars, Pulsation…..
II: Palpation
1: Site: Assess the lymph node’s location in relation to other anatomical structures
2:Temperature: Of the site
3:Number AND Tenderness: Number of swelling and If tender on palpation.
4: Size: Assess the size of the lymph node.
5: Shape: Assess borders of Lymph node
Determine if they feel regular or irregular.
6: Consistency: Determine if lymph node feels soft/hard/ rubbery.
7: Mobility: Assess if the lymph node feels mobile / tethered to other local structures.
8: Fluctuant: Determine if fluid filled (is it trans-illuminable);
9: Pulsatility
10: Relation to underlying/overlying tissue : (tethered/ mobile)
Interpretation of lymph node findings
1: Normal: Lymph nodes are smooth and relatively soft.
2: Benign lymph nodes: typically less than 1cm, smooth, rounded, non-tender and mobile.
3: Reactive lymph nodes: typically smooth, rounded, tender, mobile & associated with infective symptoms
(e.g. fever).
4: Lymphadenopathy associated with hematological malignancy: widespread enlarged rubbery lymph
nodes.
5: Lymphadenopathy associated with metastatic cancer: regional groups draining the affected organ.
Lymph nodes typically feel hard, firm, and irregular and are often tethered to local structures.
5: Final steps: Professional & Ethical Attitude
Thank & cover the patient.
Polite, considerate towards the Simulator & Well organized presentation.

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Body Mass Index (BMI) / Quetelet Index
Height: in meter
Weight : kgs
Quetelet formula: BMI = kg/m2
Weight in Kgs divided by the Height in meters squared.
Interference
Category Normal range
Severe thinness <16
Moderate thinness 16-17
Mild thinness 17-18.5
Normal 18.5-25
Overweight 25-30
Obese I 30-35
Obese II 35-40
Obese III >40