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Symptoms and Signs – Differential Diagnosis of Hyperthyroidism
TSH-receptor mutations, McCune-Albright syndrome
Toxic multinodular goitre
Toxic adenoma
Thyroiditis (subacute/viral, post-partum)
Struma ovarii
Secondary hyperthyroidism (TSH)
Rarer causes
Graves' disease
Gestational thyrotoxicosis (raised hCG)
Follicular carcinoma of thyroid
Drugs: amiodarone, surreptitious thyroxine consumption (thyroiditis factitia)
Choreocarcinoma
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Symptoms and Signs – Differential Diagnosis of Hypertrichosis
Local
Lichen simplex
Melanocytic naevi
Spina bifida

Generalized
Anorexia nervosa
Malnutrition
Medication (minoxidil, ciclosporin, phenytoin),
Malignancy
Porphyria cutanea tarda

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Symptoms and Signs – Differential Diagnosis of Hyperuricaemia
Reduced Renal excretion
Psoriasis
Increase Synthesis: Lesch-Nyhan syndrome (HGPRT deficiency)
Increase Nucleic acid (purine) turnover: lymphoma, leukaemia, polycythaemia vera,
Increase Intake/production
Increase Dietary intake
Idiopathic
ethambutol, alcohol, pyrizinamide)
Drugs: ciclosporin, aspirin (low-dose), nicotinic acid, thiazides, loop diuretics,
Chronic renal disease, e.g. in diabetes mellitus, hypertension


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Symptoms and Signs – Differential Diagnosis of Hyperkalemia
ACE inhibitors
Addison's disease
Amiloride and other potassium-sparing diuretics
Pseudohyperkalaemia: haemolysis, leucocytosis, thrombocytosis
Released from cells: acidosis, rhabdomyolysis, suxamethonium
Renal failure
Renal tubular acidosis type 4


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Symptoms and Signs – Differential Diagnosis of Hyperkeratosis (palmoplantar)
2° syphilis
Congenital (tylosis, an autosomal dominant condition)
Friction (e.g. walking barefoot)
Keratoderma blenorrhagica (Reiter's syndrome)
Malignancy: gastric adenocarcinoma, bronchial carcinoma
Psoriasis
Toxidmetabolic: drug reaction, arsenic, vitamin A deficiency



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Symptoms and Signs – Differential Diagnosis of Hypernatraemia
Dehydration:
Reduced Fluid intake: elderly, confused or unconscious
Increased Fluid loss GI: diarrhoea vomiting
Renal: diabetes insipidus, osmotic diuresis (e.g. hyperglycaemia,
hypercalcaemia)
Skin: excessive sweating
Hyperosmolar non-ketotic coma
Excess Na+ administration (e.g. sodium bicarbonate)
Excess mineralocortcoids: hyperaldosteronism



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Symptoms and Signs – Differential Diagnosis of Hyperparathyroidism
1° hyperparathyroidism
Parathyroid adenoma or hyperplasia (may be associated with MEN syndromes)
and rarely carcinoma
2° hyperparathyroidism
l Calcium (e.g. due to vitamin D deficiency or resistance or chronic renal failure)
3° hyperparathyroidism
Autonomous parathyroid hyperplasia secondary to long-standing 2°
Hyperparathyroidism


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Symptoms and Signs – Differential Diagnosis of Hyperphosphataemia
Renal failure
Hypo & Pseudohypoparathyroidism (PTH: Phosphate Trashing Hormone!)
Rhabdomyolysis
Tumour lysis syndrome
Acromegaly
Excessive phosphate intake/administration
Vitamin D intoxication



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Symptoms and Signs – Differential Diagnosis of Hyperpigmentation
Radiation
Post-inflammatory, e.g. after erythroderma
Photosensitive rashes See Photodistributed rash
Others: chronic renal failure, chronic·wasting (TB, carcinoma), disseminated malignant melanomatosis
Liver disease: haemochromatosis, primary biliary cirrhosis
Endocrine: Addison's disease, Nelson's syndrome, ectopic ACTH, pregnancy
Drugs: amiodarone, busulfan, chlorpromazine, phenothiazines



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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.