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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 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 Portal hypertension
Prehepatic: portal/splenic vein thrombosis
Hepatic: cirrhosis, granulomata, schistosomiasis
Posthepatic: Budd-Chiari syndrome (hepatic vein thrombosis), congestive cardiac
failure, constrictive pericarditis
Prehepatic: portal/splenic vein thrombosis
Hepatic: cirrhosis, granulomata, schistosomiasis
Posthepatic: Budd-Chiari syndrome (hepatic vein thrombosis), congestive cardiac
failure, constrictive pericarditis
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Symptoms and Signs – Differential Diagnosis of Long PR interval
First-degree atrioventricular (AV) block
First-degree atrioventricular (AV) block
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Symptoms and Signs – Differential Diagnosis of Short PR interval
Hypertrophic obstructive cardiomyopathy, Duchenne's muscular dystrophy
Lown-Ganong-Levine syndrome
Wolff-Parkinson-White sndrome
Hypertrophic obstructive cardiomyopathy, Duchenne's muscular dystrophy
Lown-Ganong-Levine syndrome
Wolff-Parkinson-White sndrome
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Symptoms and Signs – Differential Diagnosis of Polychromasia
Haemorrhage
Haemolysis, dyserythropoiesis
Haematinics (ferrous sulphate, B,2)
Haemorrhage
Haemolysis, dyserythropoiesis
Haematinics (ferrous sulphate, B,2)
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Symptoms and Signs – Differential Diagnosis of Pleural effusion
Exudate
Pulmonary infarction
Post-Ml
Pancreatitis (acute)
Malignancy: bronchial carcinoma, mesothelioma
Inflammation/connective tissue disease, e.g. SLE, sarcoidosis
Infection: TB, bacterial pneumonia
Transudate
Meigs' syndrome
Hypothyroidism
Hypoproteinaemia
Constrictive pericarditis
Cardiac failure
Exudate
Pulmonary infarction
Post-Ml
Pancreatitis (acute)
Malignancy: bronchial carcinoma, mesothelioma
Inflammation/connective tissue disease, e.g. SLE, sarcoidosis
Infection: TB, bacterial pneumonia
Transudate
Meigs' syndrome
Hypothyroidism
Hypoproteinaemia
Constrictive pericarditis
Cardiac failure
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Symptoms and Signs – Differential Diagnosis of Poikilocytosis
Thalassaemia
Myelofibrosis
Iron deficiency anaemia
Thalassaemia
Myelofibrosis
Iron deficiency anaemia
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Symptoms and Signs – Differential Diaignosis of Polyarthralgia
Infection: disseminated septic arthritis (e.g. staphylococcal, gonococcal}, viral
(e.g. enteroviruses, EBV, HIV, Hepatitis B, mumps, rubella}, rheumatic fever,
Lyme disease, TB
Gout/pseudogout
Rheumatoid arthritis, osteoarthritis (generalized)
Seronegative arthritis: (Reactive/Reiter's, Enteropathic (Whipple's, IBD),
Ankylosing spondylitis, Psoriatic arthritis)
Systemic diseases: SLE, sarcoid, Sjogren's, Beh~et's, primary vasculitides,
polymyalgia rheumatica
Polyuria 81
Other: haemochromatosis, sickle cell, malignancy (hypertrophic pulmonary
osteoa rth ro pathy)
Migratory polyarthralgia
Gonococcal arthritis
Rheumatic fever
Infection: disseminated septic arthritis (e.g. staphylococcal, gonococcal}, viral
(e.g. enteroviruses, EBV, HIV, Hepatitis B, mumps, rubella}, rheumatic fever,
Lyme disease, TB
Gout/pseudogout
Rheumatoid arthritis, osteoarthritis (generalized)
Seronegative arthritis: (Reactive/Reiter's, Enteropathic (Whipple's, IBD),
Ankylosing spondylitis, Psoriatic arthritis)
Systemic diseases: SLE, sarcoid, Sjogren's, Beh~et's, primary vasculitides,
polymyalgia rheumatica
Polyuria 81
Other: haemochromatosis, sickle cell, malignancy (hypertrophic pulmonary
osteoa rth ro pathy)
Migratory polyarthralgia
Gonococcal arthritis
Rheumatic fever
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Symptoms and Signs – Differential Diagnosis of Polycythaemia
Relative polycythaemia: dehydration (e.g. alcohol, diuretics), Gaisbock'ssyndrome
True polycythaemia:
1 °: Polycythaemia rubra vera
2°: Appropriate j in erythropoietin: chronic hypoxia, e.g. high altitude,
chronic lung disease, cyanotic heart disease. Inappropriate j in
erythropoietin, e.g. renal cell carcinoma/cysts, hepatoma, cerebellar
haemangioblastoma, fibroids
Relative polycythaemia: dehydration (e.g. alcohol, diuretics), Gaisbock'ssyndrome
True polycythaemia:
1 °: Polycythaemia rubra vera
2°: Appropriate j in erythropoietin: chronic hypoxia, e.g. high altitude,
chronic lung disease, cyanotic heart disease. Inappropriate j in
erythropoietin, e.g. renal cell carcinoma/cysts, hepatoma, cerebellar
haemangioblastoma, fibroids
