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Symptoms and Signs of QRS complexes
Axis deviation: See Axis deviation
Bundle branch block: See Bundle branch blocks Low voltage QRS complexes
Incorrect standardization Obesity
COPD
Pericardia! effusion Myxoedema
Wide QRS complexes
Ventricular extrasystoles, ventricular tachycardia, complete AV block Bundle branch block: Left and Right
Left anterior hemiblock
Dominant Rwaves in V
Axis deviation: See Axis deviation
Bundle branch block: See Bundle branch blocks Low voltage QRS complexes
Incorrect standardization Obesity
COPD
Pericardia! effusion Myxoedema
Wide QRS complexes
Ventricular extrasystoles, ventricular tachycardia, complete AV block Bundle branch block: Left and Right
Left anterior hemiblock
Dominant Rwaves in V
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Symptoms and signs -Differential Diagnosis of Proptosis
Unilateral
Orbital tumour (e.g. optic nerve tumour, Hodgkin's lymphoma, etc.),
granuloma Orbital cellulitis
Bilateral
Caroticocavernous fistula
Cavernous sinus thrombosis
Thyrotoxicosis
Orbital abnormalities (craniostenoses: Crouzon or Apert syndrome)
Unilateral
Orbital tumour (e.g. optic nerve tumour, Hodgkin's lymphoma, etc.),
granuloma Orbital cellulitis
Bilateral
Caroticocavernous fistula
Cavernous sinus thrombosis
Thyrotoxicosis
Orbital abnormalities (craniostenoses: Crouzon or Apert syndrome)
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Symptoms and Signs Differential diagnosis - Priapism
Low flow:
After normal intercourse
After self-injection of alprostadil or papaverine for impotence 0(-Blocking agents, e.g. prazosin
Haematological diseases: sickle cell diseases, leukaemia Haemodialysis
High flow (rare):
Caused by an injury resulting in an aneurysm of the deep artery of the corpus
Cavernosum
Low flow:
After normal intercourse
After self-injection of alprostadil or papaverine for impotence 0(-Blocking agents, e.g. prazosin
Haematological diseases: sickle cell diseases, leukaemia Haemodialysis
High flow (rare):
Caused by an injury resulting in an aneurysm of the deep artery of the corpus
Cavernosum
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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 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 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
