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Symptoms and Signs – Differential Diagnosis of Nystagmus
Physiological: at the extreme lateral gaze
Pendular {to-and-fro movements have equal velocity): congenital
Jerky (slow-phase and fast phase are present):
Acute labyrinthitis, other inner ear (labyrinth/vestibular nerve) diseases, e.g.
Meniere's disease, benign positional vertigo (otoconial debris in semicircular
canals), vestibular neuronitis, acoustic neuroma
Brainstem/vestibular nuclei: vascular (CVA), inflammation (multiple sclerosis,
tumour), toxic (alcoholism)
Cerebellar disease (See Cerebellar signs)
Drugs (e.g. phenytoin)
Nystagmus is also seen in internuclear ophthalmoplegia (l adduction on the side
of lesion, nystagmus of the contralateral abducting eye)


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Symptoms and Signs – Differential Diagnosis of Nipple discharge
Blood-stained: intraductal carcinoma, intraductal papilloma, Paget's disease of the nipple
Milky: late pregnancy, lactation, puberty, hyperprolactinaemia
purulent: mastitis, breast abscess, TB (rare)
Yellow/green: duct ectasia, fibrocystic disease


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Symptoms and Signs – Differential Diagnosis of Night sweats
Symptoms and Signs – Differential Diagnosis of Infections: chronic infections, e.g. TB, subacute bacterial infections (e.g. endocarditis, osteomyelitis), others: HIV, histoplasmosis
Malignancy, e.g. lymphoma, solid tumours
Medications: GnRH agonists, antidepressants
Menopause



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Symptoms and Signs – Differential Diagnosis of Neck Swelling
Midline
Hard: bony tumour or plasmacytoma
Lymph nodes
Manubrium swelling:
Pulsatile: eroding aortic aneurysm
Rare: sublingual dermoid cyst, pharyngeal pouch, plunging ranula, subhyoid bursa, laryngeal/tracheal/oesophageal carcinoma
Soft: lipoma
Thyroglossal cyst
Thyroid gland swelling

Anterior triangle

Branchial cyst
Carotid body aneurysm
Carotid body tumour
Lymph nodes, cold abscess (TB)
Salivary gland {submandibular/parotid) swelling
Sternomastoid tumour

Posterior triangle
Cystic hygroma
Lymph nodes, cold abscess {TB)
Subclavian artery aneurysm
Tumour of clavicle


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Symptoms and Signs – Differential Diagnosis of Neck pain
Degenerative: cervical spondylosis, diffuse idiopathic skeletal hyperostosis
Infection: osteomyelitis (e.g. TB), discitis, general systemic infection (cervical myalgia)
Inflammatory: rheumatoid arthritis, spondylarthropathy, polymyalgia rheumatica
Malignancy: primary and secondary bone tumours, myeloma
Metabolic/endocrine: osteoporosis, osteomalacia, Paget's disease of bone, thyroiditis, haemorrhagic thyroid cyst
Neurological: disc prolapse, meningism (meningitis, subarachnoid haemorrhage), vertebral/carotid artery dissection, brachia! plexus lesions (trauma, thoracic outlet syndrome)
Postural, cold exposure
Referred pain: temporomandibular/acromioclavicular joint, shoulder, pharynx, heart/vessels, lung, diaphragm
Trauma: acute flexion-extension injury, fracture, dislocation


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Symptoms and Signs – Differential Diagnosis of Eczema
Allergic rhinitis: seasonal/perennial
Infection: viral (acute/chronic), sinusitis
Inflammation: polyps (e.g. cystic fibrosis), Wegener's granulomatosis, sarcoidosis, midline granuloma
Lichen planus
Nasal discharge
Rarely: TB, fungal, syphilis, AIDS
Trauma
Trauma: foreign body, fracture of anterior fossa (CSF leak)
Tumours (nasopharyngeal, maxillary sinus)
Vasomotor rhinitis


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Symptoms and Signs – Differential Diagnosis of Myoglobinuria
Drugs/toxins: fibrates, statins, alcohol, CO
lschaemia, immobility, coma
Metabolic: hypokalaemia, hypophosphataemia
Myositis
Others: malignant hyperthermia, neuroleptic malignant syndrome, inherited muscle disorders
Rigorous exercise, seizures
Trauma, surgery

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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.