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​Symptoms and Signs – Differential Diagnosis of Tularemia
• Anthrax
• Atypical pneumonia
• Bacterial skin infections
• Cat-scratch disease
• Fungal infection: sporotrichosis
• Group A streptococcal pharyngitis
• Infectious mononucleosis
• Meningococcal infections
• Rickettsial infections
• Typhoid fever
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​Symptoms and Signs – Differential Diagnosis of Tumor Markers Elevation
Causes of elevated levels of tumor markers:
CARCINOEMBRYONIC ANTIGEN (CEA)
• Colonic cancer (higher levels if the tumor is more differentiated or is extensive or has spread to the liver)
• Lung or breast cancer; seminoma
• Cigarette smokers
• Cirrhosis, inflammatory bowel disease, rectal polyps, pancreatitis
• Advanced age
ALPHA-FETOPROTEIN
• Hepatocellular cancer: very high titers or a rising titer is strongly suggestive, but >10% of patients do not have an elevated level
• Hepatic regeneration (e.g., cirrhosis, alcoholic or viral hepatitis)
• Cancer of the stomach, colon, pancreas, or lung
• Teratocarcinoma or embryonal cell carcinoma (testis, ovary, extragonadal)
• Pregnancy
• Ataxia-telangiectasia
• Normal variant
PROSTATE-SPECIFIC ANTIGEN
• Prostate carcinoma (localized disease)
• Prostatic hyperplasia
• Prostatitis
• Prostatitic infarction
CANCER-ASSOCIATED ANTIGEN (CA19-9)*
• Pancreatic carcinoma (80% with advanced, well-differentiated cancer have an elevated level)
• Other gastrointestinal cancers: colon, stomach, bile duct
• Acute or chronic pancreatitis
• Chronic liver disease
• Biliary tract disease
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​Symptoms and Signs – Differential Diagnosis of Turner’s Syndrome
• Noonan’s syndrome, an autosomally dominant inherited disorder also characterized by loose nuchal skin, midface hypoplasia, canthal folds, and stenotic cardiac valvular defects and affecting males and females equally; also have normal chromosome constitutions
• Other conditions in the differential diagnosis of loose skin, whether or not associated with edema:
• Fetal hydantoin syndrome (loose nuchal skin, midface hypoplasia, distal digital hypoplasia)
• Disorders of chromosome constitution (trisomy 21, tetrasomy 12p mosaicism)
• Congenital lymphedema (Milroy’s edema)
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​Symptoms and Signs – Differential Diagnosis of Urethral Discharge and Dysuria
• Cystitis
• Herpes simplex virus
• Interstitial cystitis
• Meatal stenosis
• Nongonococcal urethritis
• Prostatitis
• Trauma (foreign body, masturbation, horseback or bike riding) Urethritis, Gonococcal
• Urethritis (gonococcal, chlamydial, trichomonal)
• Vaginitis (candidiasis, chemical)
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​Symptoms and Signs – Differential Diagnosis of Ulcerative Colitis
• Acute: Campylobacter, Yersinia, Salmonella, Shigella, Chlamydia, Escherichia coli, Clostridium difficile, gonococcal proctitis
• Bacterial infections
• Celiac sprue, collagenous colitis, irradiation enteritis, endometriosis, gay bowel syndrome
• Chronic: Whipple’s disease, TB, enterocolitis
• Crohn’s disease
• Diverticulitis
• Irritable bowel syndrome
• Ischemic bowel disease
• Neoplasm (intestinal lymphoma, carcinoma of colon)
• Protozoal and parasitic infections (amebiasis, giardiasis, cryptosporidiosis)
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​Symptoms and Signs – Differential Diagnosis of Acute Urinary Retention
• Abdominal or pelvic surgery
• Alcohol toxicity
• Anxiety
• CNS neoplasm (primary or metastatic)
• Encephalitis
• Lower urinary tract instrumentation
• Mechanical obstruction: urethral stone, foreign body, urethral stricture, benign prostatic hyperplasia (BPH), prostate carcinoma, prostatitis, trauma with hematoma formation)
• Medications (antihistamines, antidepressants, narcotics,
• Neurogenic bladder
• Neurologic disease (multiple sclerosis [MS], parkinsonism, tabes dorsalis, cerebrovascular accident [CVA])
• Postoperative pain
• Pregnancy
• Spina bifida occulta
• Spinal anesthesia
• Spinal cord injury
anticholinergics)
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​Symptoms and Signs – Differential Diagnosis of Uric Acid Stones
• Decreased urine output (dehydration, malabsorption, diarrhea, inadequate fluid intake)
• Excessive dietary purine
• Hemolytic anemia
• Hyperuricemia
• Medications (salicylates, allopurinol, probenecid)
• Myeloproliferative disorders
• Tumor lysis
• Urine pH < 5.5 (e.g., diarrhea, high animal protein diet)
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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.