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Symptoms and Signs – Differential Diagnosis of reduced Urea
Increased GFR (pregnancy}
Low-protein diet, starvation, liver failure SIADH
Drugs: sodium valproate
Increased GFR (pregnancy}
Low-protein diet, starvation, liver failure SIADH
Drugs: sodium valproate
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Symptoms and Signs – Differential Diagnosis of Tongue Furring
Smokers
Mouth breathers
Drugs, e.g. antibiotics
Dehydration
GI diseases
Smokers
Mouth breathers
Drugs, e.g. antibiotics
Dehydration
GI diseases
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Symptoms and Signs – Differential Diagnosis of Thyroid function tests
Normal T4, T3 and TSH: Euthyroid
Normal T4 and T3, reduced TSH: Sub-clinical hyperthyroidism, same causes as overt
hyperthyroidism
Normal T4 and T3, Raised TSH: Subclinical hypothyroidism, same causes as overt
hypothyroidism
Reduced T4 and T3, raised TSH: Primary hypothyroidism (See Hypothyroidism}
Reduced T4 and T3, reduced or normal TSH: Secondary hypothyroidism (See Hypopituitarism},
sick euthyroid syndrome (systemic illness, esp. hospitalized patients}
Raised T4 and T3, reduced TSH: Primary hyperthyroidism (See Hyperthyroidism}
Raised T4 and T3, normal or Raised j TSH: Secondary hyperthyroidism (pituitary TSHoma},
resistance to thyroid hormone
Raised T4 and T3, normal TSH: i Serum thyroxine-binding globulin
Familial dysalbuminaemic hyperthyroxinaemia Anti-T4 antibodies
Normal T4, T3 and TSH: Euthyroid
Normal T4 and T3, reduced TSH: Sub-clinical hyperthyroidism, same causes as overt
hyperthyroidism
Normal T4 and T3, Raised TSH: Subclinical hypothyroidism, same causes as overt
hypothyroidism
Reduced T4 and T3, raised TSH: Primary hypothyroidism (See Hypothyroidism}
Reduced T4 and T3, reduced or normal TSH: Secondary hypothyroidism (See Hypopituitarism},
sick euthyroid syndrome (systemic illness, esp. hospitalized patients}
Raised T4 and T3, reduced TSH: Primary hyperthyroidism (See Hyperthyroidism}
Raised T4 and T3, normal or Raised j TSH: Secondary hyperthyroidism (pituitary TSHoma},
resistance to thyroid hormone
Raised T4 and T3, normal TSH: i Serum thyroxine-binding globulin
Familial dysalbuminaemic hyperthyroxinaemia Anti-T4 antibodies
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Symptoms and Signs – Differential Diagnosis of Sore tongue
Ulcers: infection (herpes simplex), inflammatory (Bechet’s disease), malignancy Glossitis (iron/folate/vitamin B/riboflavin deficiency, candidiasis) Sore physiologically normal tongue
Psychogenic
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Symptoms and Signs – Differential Diagnosis of Tongue Ulceration
Aphthous ulcer
Dental trauma
Tumour
Syphilis
Aphthous ulcer
Dental trauma
Tumour
Syphilis
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Symptoms and Signs – Differential Diagnosis of Tracheal deviation
Collapse
Tension pneumothorax
Large pleural effusion
Collapse
Tension pneumothorax
Large pleural effusion
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Symptoms and Signs – Differential Diagnosis of Tremor
Essential tremor: (postural tremor of hands/head, e.g. when holding a glass/ writing, positive family history, 1with alcohol or J3-blockers)
Physiological tremor: (made worse by hyperthyroidism, anxiety, alcohol, drugs, e.g. J3-agonist bronchodilators, valproate, lithium, antidepressants)
Tremor at rest: Parkinson's disease and other akinetic-rigid syndromes Action tremor: cerebellar sign (See Cerebellar signs)
Essential tremor: (postural tremor of hands/head, e.g. when holding a glass/ writing, positive family history, 1with alcohol or J3-blockers)
Physiological tremor: (made worse by hyperthyroidism, anxiety, alcohol, drugs, e.g. J3-agonist bronchodilators, valproate, lithium, antidepressants)
Tremor at rest: Parkinson's disease and other akinetic-rigid syndromes Action tremor: cerebellar sign (See Cerebellar signs)
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Symptoms and Signs – Differential Diagnosis of Tricuspid regurgitation
Congenital: Ebstein's anomaly (malpositioned tricuspid valve), cleft tricuspid valve in ostium primum ASD
Infective endocarditis (common in IV drug users)
Rheumatic heart disease (associated with tricuspid stenosis or other vavular
disease)
Carcinoid syndrome, cirrhosis (long-standing), Drugs: fenfluramine,
methysergide, endomyocardial fibrosis (may be associated with
hypereosinophilia)
Functional: consequence of right ventricular dilatation (e.g. in pulmonary
hypertension, myocardial infarction), valve prolapse (e.g. in Marfan's
syndrome)
Iatrogenic: radiotherapy
Congenital: Ebstein's anomaly (malpositioned tricuspid valve), cleft tricuspid valve in ostium primum ASD
Infective endocarditis (common in IV drug users)
Rheumatic heart disease (associated with tricuspid stenosis or other vavular
disease)
Carcinoid syndrome, cirrhosis (long-standing), Drugs: fenfluramine,
methysergide, endomyocardial fibrosis (may be associated with
hypereosinophilia)
Functional: consequence of right ventricular dilatation (e.g. in pulmonary
hypertension, myocardial infarction), valve prolapse (e.g. in Marfan's
syndrome)
Iatrogenic: radiotherapy
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Symptoms and Signs – Differential Diagnosis of Raised Troponin T,
Myocardial infarction
May also be elevated in: unstable angina, chronic renal failure
Myocardial infarction
May also be elevated in: unstable angina, chronic renal failure
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Symptoms and Signs – Differential Diagnosis of Tumour markers, T
a-Fetoprotein: hepatoma, germ-cell tumour, pregnancy, hepatitis, cirrhosis,
open neural tube defects
CA 125: ovarian cancer, other malignancies (breast, endometrial, lung,
pancreas). Benign conditions (endometriosis, fibroids, pelvic inflammatory
disease, peritonitis, cirrhosis)
CA 15-3: breast cancer, benign breast disease
CA 19-9: pancreatic cancer, colorectal cancer, cholestasis
CEA: colorectal cancer, medullary thyroid carcinoma, cirrhosis, pancreatitis,
smoking
HCG: pregnancy, germ cell tumours, hydatidiform mole, choriocarcinoma PLAP: seminoma, smoking, pregnancy, ovarian carcinoma
PSA: prostate cancer, benign prostatic hyperplasia, prostatitis, digital rectal
examination, (PSA also Twith age and size of the gland)
a-Fetoprotein: hepatoma, germ-cell tumour, pregnancy, hepatitis, cirrhosis,
open neural tube defects
CA 125: ovarian cancer, other malignancies (breast, endometrial, lung,
pancreas). Benign conditions (endometriosis, fibroids, pelvic inflammatory
disease, peritonitis, cirrhosis)
CA 15-3: breast cancer, benign breast disease
CA 19-9: pancreatic cancer, colorectal cancer, cholestasis
CEA: colorectal cancer, medullary thyroid carcinoma, cirrhosis, pancreatitis,
smoking
HCG: pregnancy, germ cell tumours, hydatidiform mole, choriocarcinoma PLAP: seminoma, smoking, pregnancy, ovarian carcinoma
PSA: prostate cancer, benign prostatic hyperplasia, prostatitis, digital rectal
examination, (PSA also Twith age and size of the gland)
