- Published on
Symptoms and Signs – Differential Diagnosis of Urinary tract obstruction
In the lumen: stones, tumour, blood clots, sloughed renal papillae (NSAIDs, diabetes mellitus, sickle cell)
In the wall: stricture (ureteridurethral), defective peristalsis, neuropathic bladder Pressure from the outside: prostatidpelvic mass, retroperitoneal fibrosis, phimosis
In the lumen: stones, tumour, blood clots, sloughed renal papillae (NSAIDs, diabetes mellitus, sickle cell)
In the wall: stricture (ureteridurethral), defective peristalsis, neuropathic bladder Pressure from the outside: prostatidpelvic mass, retroperitoneal fibrosis, phimosis
- Published on
Symptoms and Signs – Differential Diagnosis of Urine microscopy
Bacteria
Urinary tract infection
Asymptomatic bacteriuria
Contamination
Casts Epithelial cell casts: acute glomerulonephritis, acute tubular necrosis
Fatty casts: moderate/heavy proteinuria
Granular casts, finely granulated: concentrated urine, diuretics (loop), exercise,
fever
Granular casts, densely granulated: glomerulonephritis, interstitial nephritis,
diabetic nephropathy, amyloidosis
Hyaline casts: same as finely granulated granular casts
Red cell casts: glomerulonephritis, vasculitis, malignant hypertension
Waxy casts: advanced renal failure
White cell casts: pyelonephritis, proliferative glomerulonephritis
Cells
White cells: UTI (pyelonephritis, cystitis, urethritis), pyuria without bacteriuria: culture inhibited by antibacterial agent or wrong growth condition for fastidious organisms, TB, renal/bladder calculi, glomerulonephritis, interstitial nephritis, analgesic nephropathy, chemical cystitis
Red cell
Tumour cells: Genitourinary malignancy e.g. bladder cancer, infiltration of renal
parenchyma e.g. lymphoma
Crystals
Calcium oxalate (dumbbell-shaped, envelope-shaped, needle-shaped) Calcium phosphate
Cystine (hexagonal shape)
Magnesium ammonium phosphate (coffin-lid-shaped)
Uric acid (rhombic plates, rosettes)
Bacteria
Urinary tract infection
Asymptomatic bacteriuria
Contamination
Casts Epithelial cell casts: acute glomerulonephritis, acute tubular necrosis
Fatty casts: moderate/heavy proteinuria
Granular casts, finely granulated: concentrated urine, diuretics (loop), exercise,
fever
Granular casts, densely granulated: glomerulonephritis, interstitial nephritis,
diabetic nephropathy, amyloidosis
Hyaline casts: same as finely granulated granular casts
Red cell casts: glomerulonephritis, vasculitis, malignant hypertension
Waxy casts: advanced renal failure
White cell casts: pyelonephritis, proliferative glomerulonephritis
Cells
White cells: UTI (pyelonephritis, cystitis, urethritis), pyuria without bacteriuria: culture inhibited by antibacterial agent or wrong growth condition for fastidious organisms, TB, renal/bladder calculi, glomerulonephritis, interstitial nephritis, analgesic nephropathy, chemical cystitis
Red cell
Tumour cells: Genitourinary malignancy e.g. bladder cancer, infiltration of renal
parenchyma e.g. lymphoma
Crystals
Calcium oxalate (dumbbell-shaped, envelope-shaped, needle-shaped) Calcium phosphate
Cystine (hexagonal shape)
Magnesium ammonium phosphate (coffin-lid-shaped)
Uric acid (rhombic plates, rosettes)
- Published on
Symptoms and Signs – Differential Diagnosis of Uveitis
Inflammatory/Connective tissue diseases: Seronegative spondylarthropathies: (reactive arthritis, enteropathic (inflammatory bowel disease), ankylosing spondylitis, psoriatic arthritis), sarcoidosis, Bechet's desease, juvenile chronic
arthritis
Infection: CMV, toxoplasmosis, post-operative infection, fungal, herpetic, TB,
syphilis, Toxocara
Ocular disease: e.g. sympathetic ophthalmitis, intraocular tumours
Inflammatory/Connective tissue diseases: Seronegative spondylarthropathies: (reactive arthritis, enteropathic (inflammatory bowel disease), ankylosing spondylitis, psoriatic arthritis), sarcoidosis, Bechet's desease, juvenile chronic
arthritis
Infection: CMV, toxoplasmosis, post-operative infection, fungal, herpetic, TB,
syphilis, Toxocara
Ocular disease: e.g. sympathetic ophthalmitis, intraocular tumours
- Published on
Symptoms and Signs – Differential Diagnosis of increased Urea
Impaired glomerular filtration rate (GFR}
High protein diet, GI haemorrhage, catabolic states Dehydration
Drugs: steroids, tetracycline
Impaired glomerular filtration rate (GFR}
High protein diet, GI haemorrhage, catabolic states Dehydration
Drugs: steroids, tetracycline
- Published on
Symptoms and Signs – Differential Diagnosis of reduced Urea
Increased GFR (pregnancy}
Low-protein diet, starvation, liver failure SIADH
Drugs: sodium valproate
Increased GFR (pregnancy}
Low-protein diet, starvation, liver failure SIADH
Drugs: sodium valproate
- Published on
Symptoms and Signs – Differential Diagnosis of Tongue Furring
Smokers
Mouth breathers
Drugs, e.g. antibiotics
Dehydration
GI diseases
Smokers
Mouth breathers
Drugs, e.g. antibiotics
Dehydration
GI diseases
- Published on
Symptoms and Signs – Differential Diagnosis of Thyroid function tests
Normal T4, T3 and TSH: Euthyroid
Normal T4 and T3, reduced TSH: Sub-clinical hyperthyroidism, same causes as overt
hyperthyroidism
Normal T4 and T3, Raised TSH: Subclinical hypothyroidism, same causes as overt
hypothyroidism
Reduced T4 and T3, raised TSH: Primary hypothyroidism (See Hypothyroidism}
Reduced T4 and T3, reduced or normal TSH: Secondary hypothyroidism (See Hypopituitarism},
sick euthyroid syndrome (systemic illness, esp. hospitalized patients}
Raised T4 and T3, reduced TSH: Primary hyperthyroidism (See Hyperthyroidism}
Raised T4 and T3, normal or Raised j TSH: Secondary hyperthyroidism (pituitary TSHoma},
resistance to thyroid hormone
Raised T4 and T3, normal TSH: i Serum thyroxine-binding globulin
Familial dysalbuminaemic hyperthyroxinaemia Anti-T4 antibodies
Normal T4, T3 and TSH: Euthyroid
Normal T4 and T3, reduced TSH: Sub-clinical hyperthyroidism, same causes as overt
hyperthyroidism
Normal T4 and T3, Raised TSH: Subclinical hypothyroidism, same causes as overt
hypothyroidism
Reduced T4 and T3, raised TSH: Primary hypothyroidism (See Hypothyroidism}
Reduced T4 and T3, reduced or normal TSH: Secondary hypothyroidism (See Hypopituitarism},
sick euthyroid syndrome (systemic illness, esp. hospitalized patients}
Raised T4 and T3, reduced TSH: Primary hyperthyroidism (See Hyperthyroidism}
Raised T4 and T3, normal or Raised j TSH: Secondary hyperthyroidism (pituitary TSHoma},
resistance to thyroid hormone
Raised T4 and T3, normal TSH: i Serum thyroxine-binding globulin
Familial dysalbuminaemic hyperthyroxinaemia Anti-T4 antibodies
- Published on
Symptoms and Signs – Differential Diagnosis of Sore tongue
Ulcers: infection (herpes simplex), inflammatory (Bechet’s disease), malignancy Glossitis (iron/folate/vitamin B/riboflavin deficiency, candidiasis) Sore physiologically normal tongue
Psychogenic
- Published on
Symptoms and Signs – Differential Diagnosis of Tongue Ulceration
Aphthous ulcer
Dental trauma
Tumour
Syphilis
Aphthous ulcer
Dental trauma
Tumour
Syphilis
- Published on
Symptoms and Signs – Differential Diagnosis of Tracheal deviation
Collapse
Tension pneumothorax
Large pleural effusion
Collapse
Tension pneumothorax
Large pleural effusion
