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Symptoms and Signs – Differential Diagnosis of Ataxia
Cerebellar ataxia
Vascular: infarction, haemorrhage
Infection: varicella, cerebellar abscess, TB, toxoplasmosis, cysticercosis
Inflammation: multiple sclerosis, vasculitis
Trauma
Tumour: cerebellar haemangioblastoma, astrocytoma, metastases, paraneoplastic
Toxidmetabolic: alcohol, phenytoin, myxoedema
Congenital: cerebellar hypoplasia, Dandy-Walker syndrome, Arnold-Chiari malformation
Degenerative: multiple system atrophy
Hereditary ataxias: autosomal recessive (e.g. Friedreich's ataxia, ataxia telangiectasia), autosomal dominant (e.g. spinocerebellar ataxia)
Storage diseases, e.g. Niemann-Pick disease, Tay-Sachs disease, ceroid lipofuscinosis, metachromatic leukodystrophy, sialidosis and numerous
other genetidmetabolic causes, e.g. Refsum disease, Wilson's disease, etc.
Sensory ataxia
Subacute combined degeneration of the cord (See B12 deficiency), syphilis (tabes
dorsalis), cervical myelopathy, diabetic pseudotabes
Cerebellar ataxia
Vascular: infarction, haemorrhage
Infection: varicella, cerebellar abscess, TB, toxoplasmosis, cysticercosis
Inflammation: multiple sclerosis, vasculitis
Trauma
Tumour: cerebellar haemangioblastoma, astrocytoma, metastases, paraneoplastic
Toxidmetabolic: alcohol, phenytoin, myxoedema
Congenital: cerebellar hypoplasia, Dandy-Walker syndrome, Arnold-Chiari malformation
Degenerative: multiple system atrophy
Hereditary ataxias: autosomal recessive (e.g. Friedreich's ataxia, ataxia telangiectasia), autosomal dominant (e.g. spinocerebellar ataxia)
Storage diseases, e.g. Niemann-Pick disease, Tay-Sachs disease, ceroid lipofuscinosis, metachromatic leukodystrophy, sialidosis and numerous
other genetidmetabolic causes, e.g. Refsum disease, Wilson's disease, etc.
Sensory ataxia
Subacute combined degeneration of the cord (See B12 deficiency), syphilis (tabes
dorsalis), cervical myelopathy, diabetic pseudotabes
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Symptoms and Signs – Differential Diagnosis of Asterixis
CO2 retention
Liver failure
CO2 retention
Liver failure
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Symptoms and Signs – Differential Diagnosis of Ascites
Exudate
Budd-Chiari syndrome (hepatic vein obstruction), portal vein thrombosis
Chylous ascites (obstruction of lymphatics, e.g. surgery, lymphoma)
Infection: e.g. TB, pyogenic
Malignancy (abdominal, pelvic, peritoneal mesothelioma)
Myxoedema (hypothyroidism)
Pancreatitis
Transudate
Rare: Meigs' syndrome (ovarian fibroma, ascites, pleural effusion), ovarian
Nephrotic syndrome
Hyperstimulation
Cirrohsis
Cardiac failure, constrictive pericarditis
Exudate
Budd-Chiari syndrome (hepatic vein obstruction), portal vein thrombosis
Chylous ascites (obstruction of lymphatics, e.g. surgery, lymphoma)
Infection: e.g. TB, pyogenic
Malignancy (abdominal, pelvic, peritoneal mesothelioma)
Myxoedema (hypothyroidism)
Pancreatitis
Transudate
Rare: Meigs' syndrome (ovarian fibroma, ascites, pleural effusion), ovarian
Nephrotic syndrome
Hyperstimulation
Cirrohsis
Cardiac failure, constrictive pericarditis
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Symptoms and Signs – Differential Diagnosis of Arterial blood gases
Hypoxia, normal or low PaCO2 (respiratory failure: type 1)
Asthma
COPD
Pulmonary embolism
Pulmonary oedema
Pneumonia
Pulmonary fibrosis
Right to Left shunt
ARDS
Hypoxia, high PaCO2 (respiratory failure: type 2)
CNS:
Organic disease involving respiratory centre (vascular, infection, inflammation,
trauma, tumour)
Drugs: opiates, benzodiazepines, barbiturates and other anaesthetic agents
Lungs:
Severe asthma, COPD, large airway obstruction, obstructive sleep apnoea
Neuromuscular:
Motor neurones: Guillain-Barre syndrome, motor neurone disease,
poliomyelitis, acute porphyria
Neuromuscular junction/muscle: myasthenia gravis, muscular dystrophies
muscle relaxants, diaphragmatic paralysis
Chest wall:
Severe kyphoscoliosis, severe obesity, traumatic 'flail chest'
Hypoxia, normal or low PaCO2 (respiratory failure: type 1)
Asthma
COPD
Pulmonary embolism
Pulmonary oedema
Pneumonia
Pulmonary fibrosis
Right to Left shunt
ARDS
Hypoxia, high PaCO2 (respiratory failure: type 2)
CNS:
Organic disease involving respiratory centre (vascular, infection, inflammation,
trauma, tumour)
Drugs: opiates, benzodiazepines, barbiturates and other anaesthetic agents
Lungs:
Severe asthma, COPD, large airway obstruction, obstructive sleep apnoea
Neuromuscular:
Motor neurones: Guillain-Barre syndrome, motor neurone disease,
poliomyelitis, acute porphyria
Neuromuscular junction/muscle: myasthenia gravis, muscular dystrophies
muscle relaxants, diaphragmatic paralysis
Chest wall:
Severe kyphoscoliosis, severe obesity, traumatic 'flail chest'
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Symptoms and Signs – Differential Diagnosis of Arm swelling
Axillary lymph node involvement: radiotherapy, surgical excision, malignancy,
Cellulitis
cervical rib)
Congenital lymphoedema (rare)
Deep venous thrombosis (DVT) (axillary vein: associated with excessive exercise,
filariasis
Trauma
Axillary lymph node involvement: radiotherapy, surgical excision, malignancy,
Cellulitis
cervical rib)
Congenital lymphoedema (rare)
Deep venous thrombosis (DVT) (axillary vein: associated with excessive exercise,
filariasis
Trauma
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Symptoms and Signs – Differential Diagnosis of Aortic stenosis
Calcification of a congenital bicuspid AV
Calcification/degeneration of a tricuspid AV in elderly
Stenosis secondary to rheumatic heart disease
Calcification of a congenital bicuspid AV
Calcification/degeneration of a tricuspid AV in elderly
Stenosis secondary to rheumatic heart disease
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Symptoms and Signs – Differential Diagnosis of Anorectal pain
Anal fissure
Haemorrhoids (strangulated, thrombosed)
Malignancy
Perianal abscess
Perianal haematoma
Proctalgia fugax
Solitary rectal ulcer
Trauma
Anal fissure
Haemorrhoids (strangulated, thrombosed)
Malignancy
Perianal abscess
Perianal haematoma
Proctalgia fugax
Solitary rectal ulcer
Trauma
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Symptoms and Signs – Differential Diagnosis of Anosmia
Congenital: Kallmann's syndrome (anosmia and GnRH deficiency), cleft palate
Nasal congestion (rhinitis), nasal polyps
Neurological: tumours on the floor of the anterior fossa (e.g. meningioma), head
trauma, neurodegenerative diseases
Congenital: Kallmann's syndrome (anosmia and GnRH deficiency), cleft palate
Nasal congestion (rhinitis), nasal polyps
Neurological: tumours on the floor of the anterior fossa (e.g. meningioma), head
trauma, neurodegenerative diseases
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Symptoms and Signs – Differential Diagnosis of Aortic regurgitation
Aorta and valve ring dilatation: aortic dissection, aortitis (e.g. syphilis), arthritides (rheumatoid arthritis, seronegative arthritides, e.g. ankylosing spondylitis,
Others: Marfan's syndrome, pseudoxanthoma elasticum, Ehlers-Danlos syndrome, osteogenesis imperfecta, inflammatory bowel disease
Reiter's syndrome), HBP
Valve leaflet damage/abnormalities: infective endocarditis, rheumatic fever, trauma, bicuspid aortic valve
Aorta and valve ring dilatation: aortic dissection, aortitis (e.g. syphilis), arthritides (rheumatoid arthritis, seronegative arthritides, e.g. ankylosing spondylitis,
Others: Marfan's syndrome, pseudoxanthoma elasticum, Ehlers-Danlos syndrome, osteogenesis imperfecta, inflammatory bowel disease
Reiter's syndrome), HBP
Valve leaflet damage/abnormalities: infective endocarditis, rheumatic fever, trauma, bicuspid aortic valve
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Symptoms and Signs – Differential Diagnosis of Arachnodactyl
Ehler.s-Danlos syndrome
Homocysteinuria
Marfan's syndrome
Normal finding
Ehler.s-Danlos syndrome
Homocysteinuria
Marfan's syndrome
Normal finding