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Symptoms and Signs – Differential Diagnosis of Horner's syndrome
Brain stem/cervical spinal cord: tumour (glioma), infarction,
Cervical sympathetic chain: Pancoast tumour (lung apex)
Internal carotid artery: dissection, occlusion
syringomyelia/bulbia
Tl root: brachia! plexus lesion, neurofibromatosis


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Symptoms and Signs – Differential Diagnosis of Howell-Jolly bodies
Hypergammaglobulinaemia
Hyposplenism: sickle cell disease, coeliac disease/dermatitis herpetiformis,
Iron deficiency
Leukaemia
Megaloblastic anaemia
Post-splenectomy
ulcerative colitis, tropical sprue, amyloidosis, essential thrombocythaemia




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Symptoms and Signs – Differential Diagnosis of Hepatosplenomegaly
Worldwide: malaria, schistosomiasis, leishmaniasis
Portal hypertension (See Portal hypertension)
Other: amyloidosis, storage disorders, e.g. Gaucher's disease, infantile polycystic disease
Myeloproliferative disorders*
Megaloblastic anaemia (e.g. pernicious anaemia)
Lymphoproliferative disorders**
Infection: hepatitis B or C, EBV, CMV, leptospirosis, toxoplasmosis, tuberculosis, brucellosis


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Symptoms and Signs – Differential Diagnosis of Splitting of S2
Wide
Delayed activation of right ventricle
RBBB, left ventricular pacing, left ventricular preexcitation (WolffParkinson-
White syndrome)

Prolonged right ventricular ejection time
Pulmonary stenosis, pulmonary hypertension
Reduced Left ventricular ejection time
Mitral regurgitation, VSD

Wide fixed splitting
ASD

Reversed splitting
Delayed activation of left ventricle
LBBB, right ventricular pacing, right ventricular preexcitation
Prolonged left ventricular ejection time
Aortic stenosis, HOCM, hypertension, PDA


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ifferential Diagnosis of Single Second Heart Sound
Apparent: obesity, COPD, pericardialeffusion
Absent a2: severe aortic stenosis, severe aortic regurgitation
Absent p2: absent pulmonary valve, pulmonary atresia, pulmonary stenosis,
tetralogy of Fallot
Fusion of a2 and p2: Eisenmenger's syndrome



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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.