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Symptoms and Signs – Differential Diagnosis of Clubbing
Congenital
Acquired
Cardiovascular
Atrial myxoma
Congenital cyanotic heart disease
Infective endocarditis
Respiratory
Cancer: bronchial, mesothelioma
Cryptogenic organizing pneumonia (rare)
Fibrosis (e.g. cryptogenic fibrosing alveolitis)
Suppurative lung disease (abscess, bronchiectasis, empyema)
Gastrointestinal
aneurysm, brachia! AV malformations
Cirrhosis
GI lymphoma, malabsorption e.g. coeliac disease
Inflammatory bowel disease
Others: Thyroid acropachy (thyrotoxicosis), unilateral clubbing: axillary artery
Congenital
Acquired
Cardiovascular
Atrial myxoma
Congenital cyanotic heart disease
Infective endocarditis
Respiratory
Cancer: bronchial, mesothelioma
Cryptogenic organizing pneumonia (rare)
Fibrosis (e.g. cryptogenic fibrosing alveolitis)
Suppurative lung disease (abscess, bronchiectasis, empyema)
Gastrointestinal
aneurysm, brachia! AV malformations
Cirrhosis
GI lymphoma, malabsorption e.g. coeliac disease
Inflammatory bowel disease
Others: Thyroid acropachy (thyrotoxicosis), unilateral clubbing: axillary artery
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Symptoms and Signs – Differential Diagnosis of Cold peripheries
Acute ischaemic limb (thromboembolism)
Drugs: Beta-blockers
Hypothyroidism
Raynaud's phenomenon (vasospasm)
Shock
Acute ischaemic limb (thromboembolism)
Drugs: Beta-blockers
Hypothyroidism
Raynaud's phenomenon (vasospasm)
Shock
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Symptoms and Signs – Differential Diagnosis of Charcot's joint
Syringomyelia
Syphilis (tabes dorsalis)
Others: yaws, progressive sensory neuropathy, Charcot-Marie-Tooth disease, neurofibromatosis (pressure on sensory nerve roots)
Leprosy
Diabetes mellitus
Syringomyelia
Syphilis (tabes dorsalis)
Others: yaws, progressive sensory neuropathy, Charcot-Marie-Tooth disease, neurofibromatosis (pressure on sensory nerve roots)
Leprosy
Diabetes mellitus
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Symptoms and Signs – Differential Diagnosis of Cheilitis (angular stomatitis)
Riboflavin deficiency
Overclosure of the mouth (e.g. without teeth or with dentures)
Lip-sucking
Iron deficiency anaemia
Contact dermatitis (e.g. lipsticks, pen-sucking)
Candidiasis
Riboflavin deficiency
Overclosure of the mouth (e.g. without teeth or with dentures)
Lip-sucking
Iron deficiency anaemia
Contact dermatitis (e.g. lipsticks, pen-sucking)
Candidiasis
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Symptoms and Signs – Differential Diagnosis of Cherry red spot
metachromatic leukodystrophy
Lysosomal storage diseases: sialidosis, Tay-Sachs disease, Niemann-Pick disease,
CO poisoning
Central retinal artery occlusion (thrombosis, embolus, spasm, giant cell arteritis)
metachromatic leukodystrophy
Lysosomal storage diseases: sialidosis, Tay-Sachs disease, Niemann-Pick disease,
CO poisoning
Central retinal artery occlusion (thrombosis, embolus, spasm, giant cell arteritis)
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Symptoms and Signs – Differential Diagnosis of Chest pain
Cardiac large vessels: angina pectoris, myocardial infarction, pericarditis, aortic
dissection, rupture of thoracic aortic aneurysm, bleeding into an atheroma
Respiratory: pulmonary embolism, pneumothorax, pneumonia, connective tissue
diseases (e.g. SLE)
Gastrointestinal: reflux oesophagitis, oesophageal spasm, hiatus hernia, peptic
ulcer, pancreatitis
Musculoskeletal: Teitze's syndrome (costochondritis), fractured rib, Bornholm's
disease (Coxackie B virus infection, rare)
Neurological: herpes zoster, nerve root compression
Pleuritic chest pain
Pulmonary embolism
Pneumothorax
Pneumonia
Pericarditis
Connective tissue disease
Malignancy involving pleura, pathology under the diaphragm
Cardiac large vessels: angina pectoris, myocardial infarction, pericarditis, aortic
dissection, rupture of thoracic aortic aneurysm, bleeding into an atheroma
Respiratory: pulmonary embolism, pneumothorax, pneumonia, connective tissue
diseases (e.g. SLE)
Gastrointestinal: reflux oesophagitis, oesophageal spasm, hiatus hernia, peptic
ulcer, pancreatitis
Musculoskeletal: Teitze's syndrome (costochondritis), fractured rib, Bornholm's
disease (Coxackie B virus infection, rare)
Neurological: herpes zoster, nerve root compression
Pleuritic chest pain
Pulmonary embolism
Pneumothorax
Pneumonia
Pericarditis
Connective tissue disease
Malignancy involving pleura, pathology under the diaphragm
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Symptoms and Signs – Differential Diagnosis of Bilateral hilar lymphadenopathy on Chest X-ray
-TB
-Sarcoidosis
-Others: bronchial carcinoma, metastatic tumours, recurrent chest infections,
-Lymphoma
-AIDS, berylliosis, silicosis
-TB
-Sarcoidosis
-Others: bronchial carcinoma, metastatic tumours, recurrent chest infections,
-Lymphoma
-AIDS, berylliosis, silicosis
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Symptoms and Signs – Differential Diagnosis of Cavitating lung lesions on Chest X- Ray
Tumour (particularly squamous cell carcinoma)
Infarct
Abscess
Tumour (particularly squamous cell carcinoma)
Infarct
Abscess
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Symptoms and Signs – Differential Diagnosis of Coin lesions on Chest X – Ray
Tumours: bronchial carcinoma, metastatic deposit, e.g. breast cancer, renal cell
carcinoma, hamartoma, adenoma, fibroma
Infection: pneumonia, TB, abscess, hydatid cyst
Infarction
Encysted pleual effusion
Rheumatoid nodule
Vasculitides (e.g. Wegener's granulomatosis)
AV malformation
Tumours: bronchial carcinoma, metastatic deposit, e.g. breast cancer, renal cell
carcinoma, hamartoma, adenoma, fibroma
Infection: pneumonia, TB, abscess, hydatid cyst
Infarction
Encysted pleual effusion
Rheumatoid nodule
Vasculitides (e.g. Wegener's granulomatosis)
AV malformation
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Symptoms and Signs – Differential Diagnosis of Airspace/alveolar shadows
Pus (consolidation)
Fluid (pulmonary oedema)
Cells (lymphangitis carcinomatosis, alveolar cell carcinoma)
Blood (pulmonary haemorrhage)
Pus (consolidation)
Fluid (pulmonary oedema)
Cells (lymphangitis carcinomatosis, alveolar cell carcinoma)
Blood (pulmonary haemorrhage)
