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Symptoms and Signs – Differential Diagnosis of 'a' waves (Cannon waves)
Regular: nodal rhythm, paroxysmal nodal tachycardia, partial heart block with
very long PR interval
Irregular: complete heart block, multiple ectopic beats
Regular: nodal rhythm, paroxysmal nodal tachycardia, partial heart block with
very long PR interval
Irregular: complete heart block, multiple ectopic beats
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Symptoms and Signs – Differential Diagnosis of Raised Jugular venous pressure
Right heart failure
Tricuspid regurgitation
Pericardial effusion, constrictive pericarditis
Fluid overload
Obstruction of superior vena cava
Right heart failure
Tricuspid regurgitation
Pericardial effusion, constrictive pericarditis
Fluid overload
Obstruction of superior vena cava
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Symptoms and Signs – Differential Diagnosis of Jugular foramen syndrome (involving cranial nerves IX, X and XI)
Infection from the middle ear spreading into the posterior fossa
Jugular vein thrombosis
Meningiomata
Metastases
Neurofibroma of IXth, Xth or Xllth nerves
Other tumours: cerebellopontine angle tumours, cholesteatomas, glomus
Paget's disease
Trauma: fracture at base of skull
tumour, carotid body tumour
Infection from the middle ear spreading into the posterior fossa
Jugular vein thrombosis
Meningiomata
Metastases
Neurofibroma of IXth, Xth or Xllth nerves
Other tumours: cerebellopontine angle tumours, cholesteatomas, glomus
Paget's disease
Trauma: fracture at base of skull
tumour, carotid body tumour
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Symptoms and Signs – Differential Diagnosis of Jaundice
Pre-hepatic
Haemolysis (See Anaemia, haemolytic), ineffective erythropoiesis,
Reduced glucuronidation (Gilbert's syndrome, Crigler-Najjar syndrome)
Hepatocellular
Alcoholic hepatitis
Autoimmune hepatitis
Cirrhosis, hepatic metastases, hepatic abscess
Drugs (paracetamol, anti-TB drugs, statins, sodium valproate, halothane), toxins, herbal medications
Dubin-Johnson syndrome, Rotor syndrome
Septicaemia
Viral: A, B, C; (other infections: CMV, EBV, toxoplasmosis, leptospirosis, Q fever)
Wilson's disease, haemochromatosis, cr1-antitrypsin deficiency, Budd-Chiari syndrome
Obstructive
Benign stricture (following invasive procedures)
Carcinoma of head of pancreas/ampulla of Vater/bile duct
Drugs: (antibiotics, OCPs, chlorpromazine, sulphonylureas, gold)
Gallstones (in the common bile duct)
Lymphadenopathy at the porta hepatic
Parasites, e.g. schistosomiasis/fasciola, pancreatitis, AIDS cholangiopathy
Primary sclerosing cholangitis, primary biliary cirrhosis
Pre-hepatic
Haemolysis (See Anaemia, haemolytic), ineffective erythropoiesis,
Reduced glucuronidation (Gilbert's syndrome, Crigler-Najjar syndrome)
Hepatocellular
Alcoholic hepatitis
Autoimmune hepatitis
Cirrhosis, hepatic metastases, hepatic abscess
Drugs (paracetamol, anti-TB drugs, statins, sodium valproate, halothane), toxins, herbal medications
Dubin-Johnson syndrome, Rotor syndrome
Septicaemia
Viral: A, B, C; (other infections: CMV, EBV, toxoplasmosis, leptospirosis, Q fever)
Wilson's disease, haemochromatosis, cr1-antitrypsin deficiency, Budd-Chiari syndrome
Obstructive
Benign stricture (following invasive procedures)
Carcinoma of head of pancreas/ampulla of Vater/bile duct
Drugs: (antibiotics, OCPs, chlorpromazine, sulphonylureas, gold)
Gallstones (in the common bile duct)
Lymphadenopathy at the porta hepatic
Parasites, e.g. schistosomiasis/fasciola, pancreatitis, AIDS cholangiopathy
Primary sclerosing cholangitis, primary biliary cirrhosis
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Symptoms and Signs – Differential Diagnosis of Jaccoud's arthropathy
Bronchial carcinoma
Hypocomplementaemic urticarial vasculitis
Rheumatic fever
SLE
Bronchial carcinoma
Hypocomplementaemic urticarial vasculitis
Rheumatic fever
SLE
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Symptoms and Signs – Differential Diagnosis of Hypothyroidism
Primary
Congenital: athyreosis, dyshormogenesis, iodide deficiency
Acquired:
Autoimmune (Hashimoto's thyroiditis}
Iatrogenic (surgery, radio-iodine, drugs, e.g. amiodarone, Lithium,
thionamides)
Iodide deficiency/excess
Secondary
Hypothalamidpituitary disease
Primary
Congenital: athyreosis, dyshormogenesis, iodide deficiency
Acquired:
Autoimmune (Hashimoto's thyroiditis}
Iatrogenic (surgery, radio-iodine, drugs, e.g. amiodarone, Lithium,
thionamides)
Iodide deficiency/excess
Secondary
Hypothalamidpituitary disease
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Symptoms and Signs – Differential Diagnosis of Impotence
Psychological (patients may have morning erections)
Neurological: autonomic neuropathy (e.g. diabetes mellitus, uraemia), nerve damage after bladder neck/prostate surgery, multiple sclerosis Vascular disease (e.g. atherosclerosis)
Endocrine disorders: hypogonadism/androgen deficiency, hyperthyroidism, prolactinomas, acromegaly
Drugs: alcohol, antidepressants, beta -blockers, cannabis, diuretics (spirinolactone), major tranquilizers
Psychological (patients may have morning erections)
Neurological: autonomic neuropathy (e.g. diabetes mellitus, uraemia), nerve damage after bladder neck/prostate surgery, multiple sclerosis Vascular disease (e.g. atherosclerosis)
Endocrine disorders: hypogonadism/androgen deficiency, hyperthyroidism, prolactinomas, acromegaly
Drugs: alcohol, antidepressants, beta -blockers, cannabis, diuretics (spirinolactone), major tranquilizers
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Symptoms and Signs – Differential Diagnosis of Infertility
Female
Uterine cavity abnormalities (e.g. fibroids, endometriosis)
Obstructed fallopian tubes (e.g. post- infection/inflammation/surgery: adhesions)
Chromosome abnormalities
Antiphospholipid syndrome
Anovulation (1 °/2° hypogonadism)
(Note: semen analysis (sperm density, motility etc.) should be performed to exclude male factor infertility.)
Female
Uterine cavity abnormalities (e.g. fibroids, endometriosis)
Obstructed fallopian tubes (e.g. post- infection/inflammation/surgery: adhesions)
Chromosome abnormalities
Antiphospholipid syndrome
Anovulation (1 °/2° hypogonadism)
(Note: semen analysis (sperm density, motility etc.) should be performed to exclude male factor infertility.)
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Symptoms and Signs – Differential Diagnosis of Insomnia
Self-limiting: stress, travel etc.
Psychological: depression, mania, anxiety
nocturia, asthma, alcoholism, apnoea, tinnitus, dystonia
Medical: drugs, withdrawal of antidepressants/hypnotics, caffeine, pain, pruritus,
Self-limiting: stress, travel etc.
Psychological: depression, mania, anxiety
nocturia, asthma, alcoholism, apnoea, tinnitus, dystonia
Medical: drugs, withdrawal of antidepressants/hypnotics, caffeine, pain, pruritus,
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Symptoms and Signs –Differential Diagnosis of Raised lntracranial pressure
Vascular: haemorrhage (extradural, subdural, subarachnoid, intracerebral)
Tumours
Trauma: head injury
Infection: meningitis/encephalitis, abscess
Benign intracranial hypertension, hydrocephalus, cerebral oedema
Vascular: haemorrhage (extradural, subdural, subarachnoid, intracerebral)
Tumours
Trauma: head injury
Infection: meningitis/encephalitis, abscess
Benign intracranial hypertension, hydrocephalus, cerebral oedema
