Symptoms and Signs – Differential Diagnosis of Dysmenorrhoea
Primary
No organic cause found
​
Secondary
Fibroids
Adenomyosis
Endometriosis
Pelvic inflammatory disease
Ovarian tumours

​Symptoms and Signs – Differential Diagnosis of  Deafness
Conductive
Eardrum: perforation, cholesteatoma (chronic otitis media)
Middle ear effusion (secondary to infection or malignancy)
Otosclerosis, ossicular abnormality
Wax in the canal

Sensorineural
Congenital: maternal rubella, eclampsia, perinatal hypoxia
Degenerative: presbyacusis
Genetic: e.g. Alpert syndrome, Waardenburg syndrome, DIDMOAD
Infection: measles, mumps, meningitis, syphilis (rare}
 Meniere's disease, Paget's disease of bone
Toxic: aminoglycosides, cytotoxic drugs, frusemide
Trauma: noise, head injury, surgery
Tumour: acoustic neuroma

​Symptoms and Signs – Differential Diagnosis of Raised CRP
Infection
Inflammation
Malignancy

​Symptoms and Signs – Differential Diagnosis of  Dactylitis
Psoriatic arthritis
Gonococcal arthritis
Sickle cell (bone marrow infarction}
Sarcoid (bone cysts}

​Symptoms and Signs – Differential Diagnosis of Cyanosis 
Cyanosis
Central
Reduced  Oxygen transfer due to lung disease: fibrosing alveolitis, severe pneumonia,
COPD, massive pulmonary embolism
R ---> L shunt (cyanotic congenital heart disease)
Methaemoglobinaemia, sulfhaemoglobinaemia
Acute: asthma, pneumothorax, inhaled foreign body, left ventricular failure

Peripheral
All causes of central cyanosis
Cold exposure
Raynaud's phenomenon
Arterial occlusion
Reduced Cardiac output e.g. shock, left ventricular failure

​Symptoms and Signs – Differential Diagnosis of Normal cells, increased protein (cytoalbuminaemic dissociation) in CSF
Spinal block (tumour, epidural abscess)
Tumour
Guillain-Barre syndrome

​Symptoms and Signs – Differential Diagnosis of Cryoglobulinaemia
Type I: Multiple myeloma, Waldenstrom's macroglobulinaemia
Type II: Chronic HCV infection, EBV, HBV
Type Ill: Inflammatory/autoimmune disorders (e.g. SLE, leukocytoclastic
vasculitis), lymphoproliferative malignancies, HCV

​Symptoms and Signs – Differential Diagnosis of Cranial nerve lesions
Ill
Vascular:
Aneurysm: posterior communicating artery, basilar (in the brainstem), in the
cavernous sinus
Infarction in the brainstem
Infarction in the nerve trunk ('medical' causes) diabetes, hypertension, SLE,
polyarteritis nodosa, giant cell arteritis
Thrombosis: in the cavernous sinus
Inflammation/infiltration of the basal meninges: TB, sarcoid, lymphoma,
carcinoma, syphilis
Tumour: brainstem, cavernous sinus, superior orbital fissure/orbit tumour/
granuloma
Tentorial herniation ('coning')
Brainstem CVA/demyelination/tumour
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
lnfective/carcinomatous meningitis
Orbital tumour
Nerve trunk infarction

IV
Head trauma

V
Sensory: trigeminal neuralgia, herpes zoster, nasopharyngeal carcinoma
Cerebellopontine angle tumour (acoustic neuroma, meningioma)
Brainstem CVA/tumour/demyelination
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
Neoplastic infiltration of skull base
Petrositis (Gradenigo's syndrome)

VI
Damage to the nerve's blood supply (vasa nervosum): diabetes mellitus,
hypertension
False localizing sign of increased intracranial pressure
Brainstem CVA/demyelination/tumour, Wernicke-Korsakoff syndrome
Cavernous sinus lesions
Cerebellopontine angle tumour
lnfective/carcinomatous meningitis
Petrositis (Gradenigo's syndrome)
Orbital tumour

Multiple palsies
Trauma
Basal meningeal infiltration: carcinoma, TB, sarcoid, lymphoma,
leukaemia
Brainstem lesions (CVA, tumour)
Guillain-Barre syndrome
Mononeuritis multiplex
Arnold-Chiari malformation
Paget's disease
CSF