What differentials are you considering?

Topic: Pediatric

Thomas is an 11-year-old who was brought into the clinic today by his father for a 10- pound weight loss over the past 2 weeks, and fatigue, pallor, and joint pain for the past seven days. His father also reports that for the past 6 days, Thomas has had fevers up to 102F. On exam, Thomas looks pale, thin, and mildly ill. You note enlarged anterior and posterior cervical nodes and enlarged inguinal nodes.

  1. What more should you know about Thomas?
  2. What differentials are you considering?
  3. What diagnostic tests/studies should you consider?
  4. What should you tell Thomas’s father about the tests you are ordering?