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Symptoms and Signs – Differential Diagnosis of Proteinuria
Amyloidosis
Diabetes mellitus
Hypertension
Infection (UTI)
Inflammation (SLE, glomerulonephritis)
Multiple myeloma
Other: fever, exercise, CCF, orthostatic proteinuria, contamination (semen,
Pregnancy
vaginal discharge)
Amyloidosis
Diabetes mellitus
Hypertension
Infection (UTI)
Inflammation (SLE, glomerulonephritis)
Multiple myeloma
Other: fever, exercise, CCF, orthostatic proteinuria, contamination (semen,
Pregnancy
vaginal discharge)
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Symptoms and Signs – Differential diagnosis of Raised Prothrombin Time
Warfarin/vitamin K deficiency Liver disease
DIC
Heparin
Note: PT monitors the extrinsic pathway i.e. deficiency or inhibition of
coagulation factors: VII, X, V, 11, fibrinogen
Warfarin/vitamin K deficiency Liver disease
DIC
Heparin
Note: PT monitors the extrinsic pathway i.e. deficiency or inhibition of
coagulation factors: VII, X, V, 11, fibrinogen
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Symptoms and Signs – Differential Diagnosis of Proximal muscle weakness
Toxic/metabolic: steroids, Cushing's syndrome, thyrotoxicosis, hypothyroidism, osteomalacia
Inflammatory: dermatomyositis, polymyositis, polymyalgia rheumatica lnfecti_on: staphylococcal myositis, parasites (trichinosis, cysticercosis), viral
(influenza, coxsackie, echo)
Inherited: muscular dystrophies, metabolic myopathies (e.g. glycogen storage
diseases e.g. McArdle's syndrome), mitochondrial myopathies, familial periodic paralysis (associated with hypo/hyperkalaemia)
Toxic/metabolic: steroids, Cushing's syndrome, thyrotoxicosis, hypothyroidism, osteomalacia
Inflammatory: dermatomyositis, polymyositis, polymyalgia rheumatica lnfecti_on: staphylococcal myositis, parasites (trichinosis, cysticercosis), viral
(influenza, coxsackie, echo)
Inherited: muscular dystrophies, metabolic myopathies (e.g. glycogen storage
diseases e.g. McArdle's syndrome), mitochondrial myopathies, familial periodic paralysis (associated with hypo/hyperkalaemia)
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Symptoms and Signs – Differential Diagnosis of Pruritus
Cutaneous diseases
Eczema, allergic reactions
Lichen planus
Scabies
Herpes simplex, herpes zoster, parasites Dermatitis herpetiformis
Blistering disorders
Psoriasis (occasionally)
Nodular prurigo (following insect bites)
Systemic diseases
Metabolic: liver failure, chronic renal failure
Endocrine: hyperthyroidism, hypothyroidism, diabetes mellitus Haematological: polycythaemia, iron deficiency anaemia, Hodgkin's lymphoma Psychological: parasitophobia, anxiety
Tropical infection: filariasis, hookworm
Drugs: alkaloids
Cutaneous diseases
Eczema, allergic reactions
Lichen planus
Scabies
Herpes simplex, herpes zoster, parasites Dermatitis herpetiformis
Blistering disorders
Psoriasis (occasionally)
Nodular prurigo (following insect bites)
Systemic diseases
Metabolic: liver failure, chronic renal failure
Endocrine: hyperthyroidism, hypothyroidism, diabetes mellitus Haematological: polycythaemia, iron deficiency anaemia, Hodgkin's lymphoma Psychological: parasitophobia, anxiety
Tropical infection: filariasis, hookworm
Drugs: alkaloids
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Symptoms and Signs- Differential Diagnosis of Pruritus ani
Incontinence, diarrhoea, poor hygiene
Infection: Enterobius vermicularis (threadworm}, fungal (candidiasis, tinea cruris),
scabies
Anal disease: haemorrhoids, fissure, fistula, wart
Skin disease: contact dermatitis, eczema, psoriasis, lichen sclerosis Other: anxiety, tight pants
Incontinence, diarrhoea, poor hygiene
Infection: Enterobius vermicularis (threadworm}, fungal (candidiasis, tinea cruris),
scabies
Anal disease: haemorrhoids, fissure, fistula, wart
Skin disease: contact dermatitis, eczema, psoriasis, lichen sclerosis Other: anxiety, tight pants
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Symptoms and Signs – Differential Diagnosis of Ptosis
Third nerve palsy
Homer's syndrome
Myopathy:
Myasthenia gravis Myotonic dystrophy Ocular myopathy
Congenital Syphilis
Third nerve palsy
Homer's syndrome
Myopathy:
Myasthenia gravis Myotonic dystrophy Ocular myopathy
Congenital Syphilis
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Symptoms and Signs – Differential Diagnosis of Pseudohermaphrodite Female
Excess androgens:
Increase Exposure during the embryonic period: androgen from adrenal/ovarian tumour or luteoma of pregnancy, congenital adrenal hyperplasia (CAH), intake of androgens or androgenic progestogens taken by the mother
Increase Synthesis in the adrenals: CAH
Male
Leydig cell hypoplasia
Luteinizing hormone (LH) or LH-receptor mutation (autosomal recessive) Testosterone synthesis defects (autosomal recessive)
5-alpha reductase deficiency (autosomal recessive)
Androgen insensitivity: spectrum varies from partial (Reifenstein's syndrome) -,
complete (testicular feminization syndrome)
Excess androgens:
Increase Exposure during the embryonic period: androgen from adrenal/ovarian tumour or luteoma of pregnancy, congenital adrenal hyperplasia (CAH), intake of androgens or androgenic progestogens taken by the mother
Increase Synthesis in the adrenals: CAH
Male
Leydig cell hypoplasia
Luteinizing hormone (LH) or LH-receptor mutation (autosomal recessive) Testosterone synthesis defects (autosomal recessive)
5-alpha reductase deficiency (autosomal recessive)
Androgen insensitivity: spectrum varies from partial (Reifenstein's syndrome) -,
complete (testicular feminization syndrome)
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Symptoms and Signs – Differential Diagnosis of Unequal/delayed pulses
Atherosclerosis, thromboembolic disease
Aortic dissection
Aortic aneurysm
Arteritis: Large vessel vasculitis (Takayasu's arteritis, giant cell arteritis, secondary
syphilis)
Subclavian steal syndrome Supravalvular aortic stenosis
Atherosclerosis, thromboembolic disease
Aortic dissection
Aortic aneurysm
Arteritis: Large vessel vasculitis (Takayasu's arteritis, giant cell arteritis, secondary
syphilis)
Subclavian steal syndrome Supravalvular aortic stenosis
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Symptoms and Signs – Differential Diagnosis of bounding pulse
Peripheral vasodilatation_: CO2 retention (e.g. COPD), sepsis, liver failure, thyrotoxicosis
Increased Stroke volume: aortic regurgitation, patent ductus arteriosus, large AV fistulas, thyrotoxicosis, severe anaemia, exercise
Peripheral vasodilatation_: CO2 retention (e.g. COPD), sepsis, liver failure, thyrotoxicosis
Increased Stroke volume: aortic regurgitation, patent ductus arteriosus, large AV fistulas, thyrotoxicosis, severe anaemia, exercise
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Symptoms and Signs – Differential Diagnosis of Pulmonary hypertension
Primary
Secondary:
Left heart disease (mitral valve disease, LVF, left atrial myxoma/thrombosis) Chronic lung disease (COPD)
Recurrent pulmonary emboli
Increased Pulmonary blood flow (VSD, ASD, patent ductus arteriosus)
Connective tissue disease (e.g. SLE, scleroderma) Drugs: fenfluramine (appetite suppressant)
HIV
Primary
Secondary:
Left heart disease (mitral valve disease, LVF, left atrial myxoma/thrombosis) Chronic lung disease (COPD)
Recurrent pulmonary emboli
Increased Pulmonary blood flow (VSD, ASD, patent ductus arteriosus)
Connective tissue disease (e.g. SLE, scleroderma) Drugs: fenfluramine (appetite suppressant)
HIV
