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Symptoms and Signs – Differential Diagnosis of Normal Pressure Hydrocephalus
• Alzheimer’s disease with extrapyramidal features
• Cognitive impairment in the setting of Parkinson’s disease or Parkinson’s plus syndromes
• Diffuse Lewy body disease
• Frontotemporal dementia
• Cervical spondylosis with cord compromise in setting of degenerative dementia
• Multifactorial gait disorder
• Multi-infarct dementia
• Alzheimer’s disease with extrapyramidal features
• Cognitive impairment in the setting of Parkinson’s disease or Parkinson’s plus syndromes
• Diffuse Lewy body disease
• Frontotemporal dementia
• Cervical spondylosis with cord compromise in setting of degenerative dementia
• Multifactorial gait disorder
• Multi-infarct dementia
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Symptoms and Signs – Differential Diagnosis of Hydronephrosis
• Congenital abnormality of urinary tract
• Medication effects
• Neoplastic disease
• Neurologic disease
• Prostatic hypertrophy
• Trauma
• Urinary reflux
• Urinary stones
• Urinary tract infection (UTI)
• Congenital abnormality of urinary tract
• Medication effects
• Neoplastic disease
• Neurologic disease
• Prostatic hypertrophy
• Trauma
• Urinary reflux
• Urinary stones
• Urinary tract infection (UTI)
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Symptoms and Signs – Differential Diagnosis of Hyperaldosteronism
• Diuretic use
• Hypokalemia from vomiting, diarrhea
• Other endocrine neoplasm (pheochromocytoma, deoxycorticosterone-producing tumor, renin-secreting tumor)
• Renovascular hypertension
• Diuretic use
• Hypokalemia from vomiting, diarrhea
• Other endocrine neoplasm (pheochromocytoma, deoxycorticosterone-producing tumor, renin-secreting tumor)
• Renovascular hypertension
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Symptoms and Signs – Differential Diagnosis of Hyperamylasemia
• Acute cholecystitis
• Acute ethanol ingestion
• Appendicitis
• Bulimia, anorexia nervosa
• Burns
• Carcinomatosis of lung, esophagus, ovary
• Diabetic ketoacidosis (DKA)
• Drugs (morphine)
• Intestinal infarction
• Intestinal obstruction
• Macroamylasemia
• Mumps
• Pancreatic abscess
• Pancreatic neoplasm
• Pancreatic pseudocyst
• Pancreatitis (acute or chronic)
• Perforated peptic ulcer
• Peritonitis
• Post endoscopic retrograde cholangiopancreatography (ERCP)
• Prostate tumors
• Renal insufficiency
• Ruptured ectopic pregnancy
• Salivary gland inflammation
• Acute cholecystitis
• Acute ethanol ingestion
• Appendicitis
• Bulimia, anorexia nervosa
• Burns
• Carcinomatosis of lung, esophagus, ovary
• Diabetic ketoacidosis (DKA)
• Drugs (morphine)
• Intestinal infarction
• Intestinal obstruction
• Macroamylasemia
• Mumps
• Pancreatic abscess
• Pancreatic neoplasm
• Pancreatic pseudocyst
• Pancreatitis (acute or chronic)
• Perforated peptic ulcer
• Peritonitis
• Post endoscopic retrograde cholangiopancreatography (ERCP)
• Prostate tumors
• Renal insufficiency
• Ruptured ectopic pregnancy
• Salivary gland inflammation
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Symptoms and Signs – Differential Diagnosis of Hyperbilirubinemia (Conjugated Bilirubin)
• Advanced neoplastic states
• Biliary obstruction
• Drug-induced cholestasis
• Hepatocellular disease
• Hereditary disorders (Dubin-Johnson syndrome, Rotor’s syndrome)
• Advanced neoplastic states
• Biliary obstruction
• Drug-induced cholestasis
• Hepatocellular disease
• Hereditary disorders (Dubin-Johnson syndrome, Rotor’s syndrome)
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Symptoms and Signs – Differential Diagnosis of Total Hyperbilirubinemia
• Drugs (steroids, diphenylhydantoin, phenothiazines, penicillin, erythromycin, clindamycin, captopril, amphotericin B, sulfonamides, azathioprine, isoniazid, 5-aminosalicylic acid,
• Hemolysis
• Hepatic congestion resulting from congestive heart failure (CHF)
• Hereditary disorders (Gilbert’s disease, Dubin-Johnson syndrome)
• Liver disease (hepatitis, cirrhosis, cholangitis, neoplasm, biliary obstruction, infectious mononucleosis)
• Pulmonary embolism or infarct
allopurinol, methyldopa, indomethacin, halothane, oral contraceptives, procainamide, tolbutamide, labetalol)
• Drugs (steroids, diphenylhydantoin, phenothiazines, penicillin, erythromycin, clindamycin, captopril, amphotericin B, sulfonamides, azathioprine, isoniazid, 5-aminosalicylic acid,
• Hemolysis
• Hepatic congestion resulting from congestive heart failure (CHF)
• Hereditary disorders (Gilbert’s disease, Dubin-Johnson syndrome)
• Liver disease (hepatitis, cirrhosis, cholangitis, neoplasm, biliary obstruction, infectious mononucleosis)
• Pulmonary embolism or infarct
allopurinol, methyldopa, indomethacin, halothane, oral contraceptives, procainamide, tolbutamide, labetalol)
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Symptoms and Signs – Differential Diagnosis of Hyperbilirubinemia (Unconjugated Bilirubin)
• Liver disease (hepatitis, cirrhosis, neoplasm)
• Hereditary disorders (Gilbert’s disease, Crigler-Najjar syndrome)
• Hepatic congestion caused by congestive heart failure (CHF)
• Hemolysis
• Liver disease (hepatitis, cirrhosis, neoplasm)
• Hereditary disorders (Gilbert’s disease, Crigler-Najjar syndrome)
• Hepatic congestion caused by congestive heart failure (CHF)
• Hemolysis
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Symptoms and Signs – Differential Diagnosis of Hypercalcemia
• Vitamin D intoxication, milk-alkali syndrome: increased GI absorption
• Thiazides: increased renal absorption
• Solid tumors: breast, lung, pancreas, kidneys, ovary
• Parathyroid hyperplasia, adenoma
• Paget’s disease: increased bone resorption, seen only during periods of immobilization
• Other causes: familial hypocalciuric hypercalcemia, thyrotoxicosis, adrenal insufficiency, prolonged immobilization, vitamin A intoxication, recovery from acute renal failure, lithium administration, pheochromocytoma, disseminated systemic lupus erythematosus (SLE)
• Malignant disease: increased bone resorption via osteoclast activating factors, secretion of parathyroid hormone (PTH)–like substances, prostaglandin E2, direct erosion by tumor cells, transforming growth factors, colony-stimulating activity
• Hyperparathyroidism: increased bone resorption, GI absorption, and renal absorption; etiology:
• Hyperparathyroidism or renal failure with secondary hyperparathyroidism
• Hypercalcemia is common in the following neoplasms:
• Hematologic cancers: myeloma, lymphosarcoma, adult T-cell lymphoma, Burkitt’s lymphoma
• Granulomatous disorders: increased GI absorption (e.g., Sarcoidosis)
• Vitamin D intoxication, milk-alkali syndrome: increased GI absorption
• Thiazides: increased renal absorption
• Solid tumors: breast, lung, pancreas, kidneys, ovary
• Parathyroid hyperplasia, adenoma
• Paget’s disease: increased bone resorption, seen only during periods of immobilization
• Other causes: familial hypocalciuric hypercalcemia, thyrotoxicosis, adrenal insufficiency, prolonged immobilization, vitamin A intoxication, recovery from acute renal failure, lithium administration, pheochromocytoma, disseminated systemic lupus erythematosus (SLE)
• Malignant disease: increased bone resorption via osteoclast activating factors, secretion of parathyroid hormone (PTH)–like substances, prostaglandin E2, direct erosion by tumor cells, transforming growth factors, colony-stimulating activity
• Hyperparathyroidism: increased bone resorption, GI absorption, and renal absorption; etiology:
• Hyperparathyroidism or renal failure with secondary hyperparathyroidism
• Hypercalcemia is common in the following neoplasms:
• Hematologic cancers: myeloma, lymphosarcoma, adult T-cell lymphoma, Burkitt’s lymphoma
• Granulomatous disorders: increased GI absorption (e.g., Sarcoidosis)
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Symptoms and Signs – Differential Diagnosis of Malignancy Induced Hypercalcemia
• Multiple myeloma: 33% frequency, 10% of hypercalcemic cases
• Lymphoma: 4% of hypercalcemic cases
• Lung carcinoma: 6% frequency, 35% of hypercalcemic cases
• Genitourinary cancer: 6% of hypercalcemic cases
• Breast carcinoma: 10% frequency, 25% of hypercalcemic cases
• Multiple myeloma: 33% frequency, 10% of hypercalcemic cases
• Lymphoma: 4% of hypercalcemic cases
• Lung carcinoma: 6% frequency, 35% of hypercalcemic cases
• Genitourinary cancer: 6% of hypercalcemic cases
• Breast carcinoma: 10% frequency, 25% of hypercalcemic cases
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Symptoms and Signs – Differential Diagnosis of Persistent Hypercapnia
• Hypercapnia with normal lungs: CNS disturbances (cerebrovascular accident [CVA], parkinsonism, encephalitis), metabolic alkalosis, myxedema, primary alveolar hypoventilation, spinal cord lesions
• Diseases of the chest wall (e.g., kyphoscoliosis, ankylosing spondylitis)
• Neuromuscular disorders (e.g., myasthenia gravis, Guillain-Barré syndrome, amyotrophic lateral sclerosis [ALS], muscular dystrophy, poliomyelitis)
• Chronic obstructive pulmonary disease (COPD)
• Hypercapnia with normal lungs: CNS disturbances (cerebrovascular accident [CVA], parkinsonism, encephalitis), metabolic alkalosis, myxedema, primary alveolar hypoventilation, spinal cord lesions
• Diseases of the chest wall (e.g., kyphoscoliosis, ankylosing spondylitis)
• Neuromuscular disorders (e.g., myasthenia gravis, Guillain-Barré syndrome, amyotrophic lateral sclerosis [ALS], muscular dystrophy, poliomyelitis)
• Chronic obstructive pulmonary disease (COPD)
