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​Symptoms and Signs – Differential Diagnosis of Viral Pneumonia
• Pulmonary emboli
• Other causes of atypical pneumonia: Mycoplasma, Chlamydia, Coxiella, legionnaires’ disease
• Bacterial pneumonia, which frequently complicates (i.e., can follow or be simultaneous with) viral (especially influenza) pneumonia
• Acute respiratory distress syndrome (ARDS)
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​Symptoms and Signs – Differential Diagnosis of Polycystic Ovary Syndrome (PCOS)
CAUSES OF AMENORRHEA
Primary (unusual in PCOS)
• Genetic disorder (Turner’s syndrome)
• Anatomic abnormality (e.g., imperforate hymen)
Secondary
• Pregnancy
• Functional (cause unknown; anorexia nervosa; stress, excessive exercise; hyperthyroidism, less commonly hypothyroidism; adrenal dysfunction, pituitary dysfunction; severe systemic illness; drugs such as oral contraceptives, estrogens, or dopamine
agonists)
• Abnormalities of the genital tract (uterine tumor, endometrial scarring, ovarian tumor)
CAUSES OF HIRSUTISM
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​Symptoms and Signs – Differential Diagnosis of Polycythemia Vera
• Stress polycythemia (Gaisböck’s syndrome, relative polycythemia): laboratory evaluation demonstrates normal RBC mass, arterial oxygen saturation, and erythropoietin level; plasma volume is decreased. Splenomegaly is not present on physical examination.
• Smoking: polycythemia is secondary to increased carboxyhemoglobin, resulting in left shift in the Hgb dissociation curve. Laboratory evaluation shows increased hematocrit (Hct), red blood cell (RBC) mass, erythropoietin level, and carboxyhemoglobin. Splenomegaly is not present on physical examination.
• Hypoxemia (secondary polycythemia): living for prolonged periods at high altitudes, pulmonary fibrosis, congenital cardiac lesions with right-to-left shunts. Laboratory evaluation shows decreased arterial oxygen saturation and elevated erythropoietin level. Splenomegaly is not present on physical examination.
• Hemoglobinopathies associated with high oxygen affinity: an abnormal oxyhemoglobin dissociation curve (P50) is present.
• Erythropoietin-producing disorders: renal cell carcinoma, hepatoma, cerebral hemangioma, uterine fibroids, polycystic kidneys. The erythropoietin level is elevated in these patients; the arterial oxygen saturation is normal. Splenomegaly may be present with metastatic neoplasms.
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​Symptoms and Signs – Differential Diagnosis of Polymorphous Light Eruption
• Lymphocytic infiltration (on histologic examination, marked papillary edema favors polymorphic light eruption)
• Reticular erythematous mucinosis (clinically, polymorphous light eruption resolves once exposure to sunlight has ceased, in contrast to the persistent lesions of reticular erythematous mucinosis)
• SLE (most cases of polymorphic light eruption are negative with immunofluorescence testing)
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Symptoms and Signs – Differential Diagnosis of Polymyositis
• Alcoholic myopathy
• Amyotrophic lateral sclerosis (ALS)
• Dermatomyositis
• Diseases associated with polymyositis (e.g., sarcoidosis, HIV infection)
• Drug-induced myopathies (e.g., HMG reductase inhibitors, gemfibrozil)
• Fibromyalgia
• Guillain-Barré syndrome
• Inclusion body myositis
• Muscular dystrophies
• Myasthenia gravis or Eaton-Lambert syndrome
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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.