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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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Symptoms and Signs – Differential Diagnosis of Hepatomegaly
Cancer: (2° deposits, hepatoma, liver cell adenoma)
Cirrhosis (early) usually alcoholic, primary biliary cirrhosis
Congestive cardiac failure
Budd-Chiari (hepatic vein thrombosis)
Polycystic liver disease
Infection: hepatitis A, B, C, EBV, CMV, toxoplasmosis, leptospirosis, abscess
(amoebic, pyogenic), hydatid cyst
Infiltration: fatty infiltration (alcohol), haemochromatosis, amyloidosis,
sarcoidosis, lymphoproliferative diseases
'Apparent hepatomegaly': lowered diaphragm (e.g. in COPD) or Reidle's lobe (an
extension of the right lobe)
Also see Hepatosplenomegaly


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Symptoms and Signs – Differential Diagnosis of Hemiparesis, hemiplegia
Vascular: CVA (infarction, haemorrhage, TIA)
Tumour
Trauma: extradural or subdural haemorrhage (a history of trauma may not be apparent in the latter)
Other causes of transient hemiplegia/paresis: epileptic seizures (Todd's paralysis), migraine
Metabolic: hypoglycaemia can cause transient hemiplegia
Inflammation: multiple sclerosis, cerebral vasculitis
Infection: brain abscess from local (e.g. middle ear, sinuses) or distant (e.g. lung) infections




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​Symptoms and Signs – Differential Diagnosis of Gynaecomastia
Chronic liver disease
Chronic renal failure
Drugs: spirinolactone, cimetidine, cyproterone acetate, chlorpromazine,
Hyperthyroidism
Hypogonadism
oestrogens, digoxin, drugs of abuse (heroin, marijuana)
Physiological: puberty, elderly
Pseudogynaecomastia: e.g. in obese men
testicular)
Tumours: ectopic hCG (e.g. hepatoma and lung), oestrogen-producing (e.g.

Unilateral
Breast carcinoma
Lipoma, lymphangioma, neurofibroma, haematoma, dermoid cyst
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​Symptoms and Signs – Differential Diagnosis of Goitre
Simple goitre {euthyroid): puberty, pregnancy
Hyperthyroidism: Graves' disease, toxic adenoma, toxic multinodular goitre with
one palpable nodule, thyroiditis
Hypothyroidism: Hashimoto's disease
Lithium, antithyroid drugs, iodine deficiency/excess, dyshormogenesis
Thyroid cyst
Thyroid carcinoma: papillary, follicular, anaplastic, medullary, lymphoma
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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.