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​Symptoms and  Signs – Differential Diagnosis of  Labyrinthitis
• Acute labyrinthine ischemia (vascular insufficiency)
• Benign positional vertigo
• Cholesteatoma
• Drug induced
• Eighth nerve tumor
• Head trauma
• Labyrinthine fistula
• Meniere’s disease
• Other forms of labyrinthitis (bacterial and syphilitic)
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​Symptoms and Signs – Differential Diagnosis of  Lactose Intolerance
• Bowel neoplasm
• Celiac disease
• Cystic fibrosis
• Diverticular disease
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Laxative abuse
• Nontropical and tropical sprue
• Pancreatic insufficiency
• Parasitic disease (e.g., giardiasis)
• Viral or bacterial infections
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​Symptoms and Signs – Differential Diagnosis of Laryngeal Cancer
• Allergic and nonallergic rhinosinusitis
• Gastroesophageal reflux
• Laryngeal papilloma
• Laryngitis
• Tracheomalacia
• Vocal cord paralysis secondary to a neurologic condition or secondary to entrapment of the recurrent laryngeal nerve caused by mediastinal compression
• Voice abuse leading to hoarseness
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​Symptoms and Signs – Differential Diagnosis of Laryngitis
YOUNG CHILDREN WITH SIGNS OF AIRWAY
OBSTRUCTION
• Supraglottitis (epiglottitis)
• Laryngotracheobronchitis
• Tracheitis
• Foreign body aspiration
ADULTS WITH PERSISTENT HOARSENESS
• Allergic and nonallergic rhinosinusitis
• Gastroesophageal reflux
• Voice abuse leading to hoarseness
• Laryngeal papilloma
• Laryngeal carcinoma
• Vocal cord paralysis secondary to a neurologic condition or
secondary to entrapment of the recurrent laryngeal nerve caused
by mediastinal compression
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​Symptoms and Signs – Differential Diagnosis of  Left Axis Deviation
• Endocardial cushion defects and other congenital heart disease
• Left anterior fascicular block (hemiblock)
• Left bundle branch block
• Left ventricular hypertrophy (LVH)
• Mechanical shifts causing a horizontal heart, high diaphragm, pregnancy, ascites
• Normal variation
• Some forms of ventricular tachycardia
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​Symptoms and Signs – Differential Diagnosis of  Left Bundle Branch Block
• Ischemic heart disease
• Electrolyte abnormalities (e.g., hyperkalemia)
• Cardiomyopathy
• Idiopathic
• Left ventricular hypertrophy (LVH)
• Pulmonary embolism
• Cardiac trauma
• Bacterial endocarditis
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​Symptoms and Signs – Differential Diagnosis of Nocturnal Leg Cramps 
• Alcohol use
• Amyotrophic lateral sclerosis (ALS)
• Baker’s cyst
• Contractures
• Deep venous thrombosis (DVT)
• Diabetic neuropathy
• Electrolyte abnormalities (hypokalemia, hyponatremia, hypocalcemia, hyperkalemia, hypophosphatemia)
• Heat cramps
• Hemodialysis
• Hyperthyroidism
• Hypoglycemia
• Medications
• Peripheral nerve injury
• Peripheral vascular insufficiency
• Respiratory alkalosis
• Uremia
• Vitamin B12 deficiency
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