- Published on
Symptoms and Signs – Differential Diagnosis of Amenorrhoea
Non-pathological: pregnancy, lactation, menopause, drugs (e.g. Depo-Provera)
Hypothalamus: starvation, anorexia, excessive exercise, weight loss, GnRH
deficiency (isolated or part of Kallmann's syndrome)
Pituitary: hypopituitarism, hyperprolactinaemia
Ovaries: PCOS, premature ovarian failure, damage to ovaries (infection e.g.
mumps, autoimmune, surgery, radiotherapy), ovarian dysgensis (e.g. Turner's
syndrome)
Uterus/vagina: absent uterus, imperforate hymen, transverse vaginal septum
Asherman's syndrome: scarring of endometrial lining 2° to infection and
instrumentation, e.g. D&C
Thyroid: hypo/hyperthyroidism
Adrenals: adrenal tumours, Cushing's syndrome
Note: The causes in italics present only with primary amenorrhoea.
Non-pathological: pregnancy, lactation, menopause, drugs (e.g. Depo-Provera)
Hypothalamus: starvation, anorexia, excessive exercise, weight loss, GnRH
deficiency (isolated or part of Kallmann's syndrome)
Pituitary: hypopituitarism, hyperprolactinaemia
Ovaries: PCOS, premature ovarian failure, damage to ovaries (infection e.g.
mumps, autoimmune, surgery, radiotherapy), ovarian dysgensis (e.g. Turner's
syndrome)
Uterus/vagina: absent uterus, imperforate hymen, transverse vaginal septum
Asherman's syndrome: scarring of endometrial lining 2° to infection and
instrumentation, e.g. D&C
Thyroid: hypo/hyperthyroidism
Adrenals: adrenal tumours, Cushing's syndrome
Note: The causes in italics present only with primary amenorrhoea.
- Published on
Symptoms and Signs – Differential Diagnosis of Amnesia
Acute/transient
In the presence of other cognitive deficits: acute confusional state (See Delirium)
Temporal lobe epilepsy
Transient global amnesia (may be associated with migraine)
Trauma (head injury)
Acute/transient
In the presence of other cognitive deficits: acute confusional state (See Delirium)
Temporal lobe epilepsy
Transient global amnesia (may be associated with migraine)
Trauma (head injury)
- Published on
Symptoms and Signs – Differential Diagnosis of Migraine
Chronic/persistent
In the presence of other cognitive deficits
Infection: herpes simplex encephalitis
Inflammation: limbic encephalitis (may be paraneoplastic), sarcoidosis
Medial temporal lobe lesions (bilateral)
Toxic metabolic: thiamine deficiency (Korsakoff's psychosis in alcoholism, hyperemesis gravidarum)
Transient ischaemic attack (TIA), tumours (rare)
Tumours: midline (in the region of the third ventricle)
Vascular: posterior cerebral artery occlusion (bilateral)
Chronic/persistent
In the presence of other cognitive deficits
Infection: herpes simplex encephalitis
Inflammation: limbic encephalitis (may be paraneoplastic), sarcoidosis
Medial temporal lobe lesions (bilateral)
Toxic metabolic: thiamine deficiency (Korsakoff's psychosis in alcoholism, hyperemesis gravidarum)
Transient ischaemic attack (TIA), tumours (rare)
Tumours: midline (in the region of the third ventricle)
Vascular: posterior cerebral artery occlusion (bilateral)
- Published on
Symptoms and Signs – Differential Diagnosis of Alopecia
Non-scarring
Traction, trichotillomania
Telogen effluvium: transitory j in number of hairs in resting phase of the hair growth cycle, associated with stress, (e.g. surgery, febrile illness, childbirth, etc.)
Nutritional deficiency (iron, zinc, biotin, caloric deficiency)
Endocrine diseases (hypopituitarism, hypo/hyperthyroidism, diabetes mellitus)
Drugs (cytotoxics, ciclosporin, OCPs, anticoagulants, antithyroid drugs, vitamin A/ retinoids)
Cutaneous diseases (e.g. psoriasis, eczema)
Congenital
Alopecia areata
Aging (male/female pattern baldness)
Scarring
Infection: pyogenic infection, TB (lupus vulgaris), syphilis, viral (varicella, herpes simplex), fungal (e.g. ringworm), protozoa! (Leishmaniasis), leprosy
Inflammatory disease: SLE, scleroderma, sarcoidosis
Skin disease: lichen planus, cicatricial pemphigoid, necrobiosis lipoidica, folliculitis decalvans
Trauma/burns
Non-scarring
Traction, trichotillomania
Telogen effluvium: transitory j in number of hairs in resting phase of the hair growth cycle, associated with stress, (e.g. surgery, febrile illness, childbirth, etc.)
Nutritional deficiency (iron, zinc, biotin, caloric deficiency)
Endocrine diseases (hypopituitarism, hypo/hyperthyroidism, diabetes mellitus)
Drugs (cytotoxics, ciclosporin, OCPs, anticoagulants, antithyroid drugs, vitamin A/ retinoids)
Cutaneous diseases (e.g. psoriasis, eczema)
Congenital
Alopecia areata
Aging (male/female pattern baldness)
Scarring
Infection: pyogenic infection, TB (lupus vulgaris), syphilis, viral (varicella, herpes simplex), fungal (e.g. ringworm), protozoa! (Leishmaniasis), leprosy
Inflammatory disease: SLE, scleroderma, sarcoidosis
Skin disease: lichen planus, cicatricial pemphigoid, necrobiosis lipoidica, folliculitis decalvans
Trauma/burns
- Published on
Symptoms and Signs – Differential Diagnosis of Loin pain
Infection: UTI (pyelonephritis), perinephric abscess/pyonephrosis Obstruction, e.g. renal stones
Pain from vertebral column
Polycystic kidney disease
Renal carcinoma
Renal vein thrombosis
Infection: UTI (pyelonephritis), perinephric abscess/pyonephrosis Obstruction, e.g. renal stones
Pain from vertebral column
Polycystic kidney disease
Renal carcinoma
Renal vein thrombosis
- Published on
Symptoms and Signs – Differential Diagnosis of Left upper quadrant (LUQ) Abdominal Pain
Central abdominal (periumbilical)
Colonic cancer (splenic flexure)
Gastrointestinal: intestinal obstruction, early appendicitis, gastroenteritis
Herpes zoster
Medical causes, e.g. diabetic ketoacidosis, uraemia
Pain from adjacent areas, e.g. epigastric, iliac fossae
Pain from adjacent areas: See epigastric (e.g. pancreatitis, peptic ulcer}, Left iliac Fossa pain , loin pain, cardiadpulmonary/pleural pathology, e.g. Ml, pericarditis, pneumonia, empyema, pulmonary infarction
Splenic rupture, splenic infarction (e.g. sickle cell disease), splenomegaly
Subphrenic abscess
Vascular: abdominal aortic aneurysm (leaking, ruptured), mesenteric ischaemia (thrombosis, embolism, vasculitis, e.g. polyarteritis nodosa)
Central abdominal (periumbilical)
Colonic cancer (splenic flexure)
Gastrointestinal: intestinal obstruction, early appendicitis, gastroenteritis
Herpes zoster
Medical causes, e.g. diabetic ketoacidosis, uraemia
Pain from adjacent areas, e.g. epigastric, iliac fossae
Pain from adjacent areas: See epigastric (e.g. pancreatitis, peptic ulcer}, Left iliac Fossa pain , loin pain, cardiadpulmonary/pleural pathology, e.g. Ml, pericarditis, pneumonia, empyema, pulmonary infarction
Splenic rupture, splenic infarction (e.g. sickle cell disease), splenomegaly
Subphrenic abscess
Vascular: abdominal aortic aneurysm (leaking, ruptured), mesenteric ischaemia (thrombosis, embolism, vasculitis, e.g. polyarteritis nodosa)
- Published on
Symptoms and Signs – Differential Diagnosis of Left iliac fossa (LIF) Abdominal Pain
constipation, irritable bowel syndrome
Gastrointestinal: diverticulitis, inflammatory bowel disease, colonic cancer,
Pain from adjacent areas:suprapubic, central abdominal, hip pathology,
psoas abscess, rectus sheath haematoma, left-sided lobar pneumonia
Renal pain
Reproductive pain
constipation, irritable bowel syndrome
Gastrointestinal: diverticulitis, inflammatory bowel disease, colonic cancer,
Pain from adjacent areas:suprapubic, central abdominal, hip pathology,
psoas abscess, rectus sheath haematoma, left-sided lobar pneumonia
Renal pain
Reproductive pain
- Published on
Symptoms and Signs – Differential Diagnosis of Right upper quadrant (RUQ) Abdominal Pain
Appendicitis, e.g. in a pregnant woman
Colonic cancer (hepatic flexure)
Gall bladder pathology: cholecystitis (usually related to gallstones, occasionally may be acalculous), biliary colic, cholangitis
Herpes zoster
Liver pathology: hepatitis, hepatomegaly (congestive, e.g. in congestive cardiac failure, Budd-Chiari syndrome), hepatic tumours, hepatidsubphrenic abscess
Pain from adjacent areas: See Epigastric (e.g. pancreatitis, peptic ulcer), RIF, Loin pain, pulmonary/pleural pathology, e.g. pneumonia, pulmonary infarction
Appendicitis, e.g. in a pregnant woman
Colonic cancer (hepatic flexure)
Gall bladder pathology: cholecystitis (usually related to gallstones, occasionally may be acalculous), biliary colic, cholangitis
Herpes zoster
Liver pathology: hepatitis, hepatomegaly (congestive, e.g. in congestive cardiac failure, Budd-Chiari syndrome), hepatic tumours, hepatidsubphrenic abscess
Pain from adjacent areas: See Epigastric (e.g. pancreatitis, peptic ulcer), RIF, Loin pain, pulmonary/pleural pathology, e.g. pneumonia, pulmonary infarction
- Published on
Symptoms and Signs – Differential Diagnosis of Epigastric Abdominal Pain
Acute gastritis
Functional disorders: non-ulcer dyspepsia, irritable bowel syndrome
Malignancy: gastric, pancreatic
Pain from adjacent areas: central abdominal pain, cardiadpulmonary/ pleural pathology, e.g. Ml, pericarditis, pneumonia
Pancreatitis
Peptic ulcer
Reflux oesophagitis
Acute gastritis
Functional disorders: non-ulcer dyspepsia, irritable bowel syndrome
Malignancy: gastric, pancreatic
Pain from adjacent areas: central abdominal pain, cardiadpulmonary/ pleural pathology, e.g. Ml, pericarditis, pneumonia
Pancreatitis
Peptic ulcer
Reflux oesophagitis
- Published on
Symptoms and Signs – Differential Diagnosis of Suprapubic Pain
Cystitis
Pain from adjacent areas
Urinary retention
Cystitis
Pain from adjacent areas
Urinary retention