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Symptoms and Signs – Differential Diagnosis of Pulsus Paradoxicus
Cardiac tamponade, constrictive pericarditis
Asthma (severe)
Cardiac tamponade, constrictive pericarditis
Asthma (severe)
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Symptoms and Signs – Differential Diagnosis of Purpura
Senile
Steroids (iatrogenic, Cushing's syndrome)
Infection: meningococcal septicaemia/DIC, infective endocarditis
Platelet disorders: quantitative (thrombocytopenia), qualitative (von Willebrand's
disease), coagulopathy (haemophilia, liver disease, anticoagulants) Vasculitis: e.g:
1°: Henoch-Schiinlein purpura, polyarteritis nodosa, Churg-Strauss, Wegener's granulomatosis, cryoglobulinaemia
2°: SLE, rheumatoid arthritis
Collagen diseases: scurvy, Ehlers-Danlos syndrome
Others: emboli (e.g. cholesterol), hereditary haemorrhagic telangiectasia,
Amyloidosis
Senile
Steroids (iatrogenic, Cushing's syndrome)
Infection: meningococcal septicaemia/DIC, infective endocarditis
Platelet disorders: quantitative (thrombocytopenia), qualitative (von Willebrand's
disease), coagulopathy (haemophilia, liver disease, anticoagulants) Vasculitis: e.g:
1°: Henoch-Schiinlein purpura, polyarteritis nodosa, Churg-Strauss, Wegener's granulomatosis, cryoglobulinaemia
2°: SLE, rheumatoid arthritis
Collagen diseases: scurvy, Ehlers-Danlos syndrome
Others: emboli (e.g. cholesterol), hereditary haemorrhagic telangiectasia,
Amyloidosis
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Symptoms and Signs – Differential Diagnosis of Pyoderma gangrenosum
Inflammatory bowel disease, autoimmune hepatitis
Rheumatoid arthritis, seronegative arthritides
Haematological: leukaemia, myeloma, polycythaemia rubra vera Wegener's granulomatosis
Idiopathic (50%)
Inflammatory bowel disease, autoimmune hepatitis
Rheumatoid arthritis, seronegative arthritides
Haematological: leukaemia, myeloma, polycythaemia rubra vera Wegener's granulomatosis
Idiopathic (50%)
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Symptoms and Signs – Differential Diagnosis of Sterile Pyuria
TB, inadequately treated UTI, UTI with fastidious culture requirement Bladder: tumour, chemical cystitis (e.g. cytotoxics)
Calculi
Renal papillary necrosis (e.g. analgesic excess), interstitial nephritis, polycystic
kidney disease Prostatitis
Appendicitis
TB, inadequately treated UTI, UTI with fastidious culture requirement Bladder: tumour, chemical cystitis (e.g. cytotoxics)
Calculi
Renal papillary necrosis (e.g. analgesic excess), interstitial nephritis, polycystic
kidney disease Prostatitis
Appendicitis
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Symptoms and Signs – Differential Diagnosis of Pyrexia of unknown origin (PUO}
Infection: abscesses (subphrenic, liver, pelvis)
Bacterial: infective endocarditis, osteomyelitis, UTI, biliary infection TB, brucellosis, viral infections (HIV, CMV, EBV), malaria
lnflammation/CTD: rheumatoid arthritis, SLE, sarcoidosis, vasculitides, polymyalgia rheumatica
Malignancy: lymphomas, leukaemia, renal cell carcinoma, hepatocellular carcinoma, pancreatic carcinoma
Drugs: e.g. sulphonamides, isoniazid, aspirin
Familial Mediterranean fever (FMF), familial periodic fever (FPF)
Infection: abscesses (subphrenic, liver, pelvis)
Bacterial: infective endocarditis, osteomyelitis, UTI, biliary infection TB, brucellosis, viral infections (HIV, CMV, EBV), malaria
lnflammation/CTD: rheumatoid arthritis, SLE, sarcoidosis, vasculitides, polymyalgia rheumatica
Malignancy: lymphomas, leukaemia, renal cell carcinoma, hepatocellular carcinoma, pancreatic carcinoma
Drugs: e.g. sulphonamides, isoniazid, aspirin
Familial Mediterranean fever (FMF), familial periodic fever (FPF)
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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 Q Waves
Normal
If
Normal
If
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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 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)
