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Symptoms and Signs – Differential Diagnosis of Diplopia
Monocular
Originates from cornea or lens, e.g. cataract
Binocular
Cranial nerve palsies (111, IV, VI)
Monocular
Originates from cornea or lens, e.g. cataract
Binocular
Cranial nerve palsies (111, IV, VI)
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Symptoms and Signs – Differential Diagnosis of Dysarthria
Defective co-ordination between the nerves: internuclear ophthalmoplegia
Extra-ocular muscle disease (dysthyroid eye disease, myasthenia gravis, ocular
myopathy, ocular myositis)
Orbital fracture
Defective co-ordination between the nerves: internuclear ophthalmoplegia
Extra-ocular muscle disease (dysthyroid eye disease, myasthenia gravis, ocular
myopathy, ocular myositis)
Orbital fracture
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Symptoms and Signs – Differential Diagnosis of Dehydration
GI loss: diarrhoea, vomiting
Polyuria (e.g. diabetes mellitus, diabetes insipidus, hypercalcaemia)
Pyrexia/excess sweating
Reduced Fluid intake: severe illness, anorexia, malnutrition
GI loss: diarrhoea, vomiting
Polyuria (e.g. diabetes mellitus, diabetes insipidus, hypercalcaemia)
Pyrexia/excess sweating
Reduced Fluid intake: severe illness, anorexia, malnutrition
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Symptoms and Signs – Differential Diagnosis of Corneal ulcer
(Infections may follow corneal abrasion, contact lens wear or topical steroids)
Acanthamoeba
Bacterial infection (Staphylococcus aureus/epidermidis, Pseudomonas, Streptococcus pneumoniae, Haemophilus, coliforms)
Fungal
Viral (herpes simplex, herpes zoster)
(Infections may follow corneal abrasion, contact lens wear or topical steroids)
Acanthamoeba
Bacterial infection (Staphylococcus aureus/epidermidis, Pseudomonas, Streptococcus pneumoniae, Haemophilus, coliforms)
Fungal
Viral (herpes simplex, herpes zoster)
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Symptoms and Signs – Differential Diagnosis of Cottonwool spots
Diabetes (pre-proliferative retinopathy)
Haematological disorders: anaemia, leukaemia, hyperviscosity states
HIV retinopathy
Hypertensive retinopathy
Papilloedema
Retinal vein occlusion
SLE, polyarteritis nodosa, dermatomyositis
Diabetes (pre-proliferative retinopathy)
Haematological disorders: anaemia, leukaemia, hyperviscosity states
HIV retinopathy
Hypertensive retinopathy
Papilloedema
Retinal vein occlusion
SLE, polyarteritis nodosa, dermatomyositis
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Symptoms and Signs – Differential Diagnosis of Raised Cortisol
ACTH, e.g. bronchial carcinoids, ectopic CRH)
Alcoholism
Cushing's syndrome (pituitary adenoma, adrenal adenoma/carcinoma, ectopic
Depression
Exogenous glucocorticoids
Increased Cortisol-binding globulin (CBG): oestrogen, pregnancy
Stress, acute/chronic illness
ACTH, e.g. bronchial carcinoids, ectopic CRH)
Alcoholism
Cushing's syndrome (pituitary adenoma, adrenal adenoma/carcinoma, ectopic
Depression
Exogenous glucocorticoids
Increased Cortisol-binding globulin (CBG): oestrogen, pregnancy
Stress, acute/chronic illness
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Symptoms and Signs – Differential Diagnosis of Crackles
Fine crackles
Pulmonary fibrosis (See Lung function tests, for the causes)
Pulmonary oedema
Crackles continued
Coarse crackles
Bronchiectasis
Consolidation (pneumonia)
COPD
Fine crackles
Pulmonary fibrosis (See Lung function tests, for the causes)
Pulmonary oedema
Crackles continued
Coarse crackles
Bronchiectasis
Consolidation (pneumonia)
COPD
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Symptoms and Signs – Differential Diagnosis of Cough
ACE inhibitors
Asthma, COPD, pulmonary emboli, infection (pneumonia, TB, fungal),
bronchiectasis, malignancy, interstitial lung disease, sarcoidosis,
Gastro-oesophageal reflux disease
Heart failure
pneumoconiosis
Post-nasal drip
Psychogenic
Upper respiratory tract infection
ACE inhibitors
Asthma, COPD, pulmonary emboli, infection (pneumonia, TB, fungal),
bronchiectasis, malignancy, interstitial lung disease, sarcoidosis,
Gastro-oesophageal reflux disease
Heart failure
pneumoconiosis
Post-nasal drip
Psychogenic
Upper respiratory tract infection
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Symptoms and Signs – Differential Diagnosis of Cramp
Drugs: 13-agonists, Angiotensin II receptor blockers, cisplatin, vincristine
Extracellular volume/salt depletion (diuretics, excessive sweating, fluid removal during haemodialysis)
Flat feet, hypermobility syndrome, inappropriate leg positioning, prolonged sitting
Hypokalaemia
Hypomagnesaemia
Hypothyroidism
Idiopathic
Muscle ischaemia, myopathy, motor neurone disease
Drugs: 13-agonists, Angiotensin II receptor blockers, cisplatin, vincristine
Extracellular volume/salt depletion (diuretics, excessive sweating, fluid removal during haemodialysis)
Flat feet, hypermobility syndrome, inappropriate leg positioning, prolonged sitting
Hypokalaemia
Hypomagnesaemia
Hypothyroidism
Idiopathic
Muscle ischaemia, myopathy, motor neurone disease
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Pathology - Pancreatic head adenocarcinoma
These patients usually have "painless jaundice" and may have some of the risk factors linked to pancreatitis, such as excessive alcohol use and tobacco use.
Tumors located in the head of the pancreas can exert pressure on the pancreatic part of the common bile duct (CBD), leading to a blockage in the flow of bile and resulting in the enlargement of the CBD and the biliary ducts within the liver. Consequently, there is a higher level of conjugated bilirubin in the bloodstream. It should be emphasized that only conjugated bilirubin may be identified in the urine, and this usually leads to darkening as a result of the urobilin pigment. Jaundice commonly manifests when bilirubin levels exceed 3g/dL. Another consequence of the obstruction is reduced bile flow in the colon, resulting in feces that float because of the higher fat content. The presence of pale "acholic" stools is due to a reduced level of stercobilin, a by-product of bilirubin, which is responsible for the typical brown color of stools. The overall prognosis is typically unfavorable, although, in certain circumstances, it may be possible to perform a surgical removal of the tumor using the Whipple technique (pancreaticoduodenectomy).
These patients usually have "painless jaundice" and may have some of the risk factors linked to pancreatitis, such as excessive alcohol use and tobacco use.
Tumors located in the head of the pancreas can exert pressure on the pancreatic part of the common bile duct (CBD), leading to a blockage in the flow of bile and resulting in the enlargement of the CBD and the biliary ducts within the liver. Consequently, there is a higher level of conjugated bilirubin in the bloodstream. It should be emphasized that only conjugated bilirubin may be identified in the urine, and this usually leads to darkening as a result of the urobilin pigment. Jaundice commonly manifests when bilirubin levels exceed 3g/dL. Another consequence of the obstruction is reduced bile flow in the colon, resulting in feces that float because of the higher fat content. The presence of pale "acholic" stools is due to a reduced level of stercobilin, a by-product of bilirubin, which is responsible for the typical brown color of stools. The overall prognosis is typically unfavorable, although, in certain circumstances, it may be possible to perform a surgical removal of the tumor using the Whipple technique (pancreaticoduodenectomy).
