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Symptoms and Signs – Differential Diagnosis of Jugular foramen syndrome (involving cranial nerves IX, X and XI)
Infection from the middle ear spreading into the posterior fossa
Jugular vein thrombosis
Meningiomata
Metastases
Neurofibroma of IXth, Xth or Xllth nerves
Other tumours: cerebellopontine angle tumours, cholesteatomas, glomus
Paget's disease
Trauma: fracture at base of skull
tumour, carotid body tumour
Infection from the middle ear spreading into the posterior fossa
Jugular vein thrombosis
Meningiomata
Metastases
Neurofibroma of IXth, Xth or Xllth nerves
Other tumours: cerebellopontine angle tumours, cholesteatomas, glomus
Paget's disease
Trauma: fracture at base of skull
tumour, carotid body tumour
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Symptoms and Signs – Differential Diagnosis of Raised Jugular venous pressure
Right heart failure
Tricuspid regurgitation
Pericardial effusion, constrictive pericarditis
Fluid overload
Obstruction of superior vena cava
Right heart failure
Tricuspid regurgitation
Pericardial effusion, constrictive pericarditis
Fluid overload
Obstruction of superior vena cava
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Symptoms and Signs – Differential Diagnosis of 'a' waves (Cannon waves)
Regular: nodal rhythm, paroxysmal nodal tachycardia, partial heart block with
very long PR interval
Irregular: complete heart block, multiple ectopic beats
Regular: nodal rhythm, paroxysmal nodal tachycardia, partial heart block with
very long PR interval
Irregular: complete heart block, multiple ectopic beats
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Symptoms and Signs – Differential Diagnosis of Ketonuria
Carcinoma
Congenital anomaly
Cystic kidney
Diabetes
Glycogen storage diseases
Hydronephrosis, pyonephrosis
Hypertrophy (following contralateral nephretomy)
Increased Metabolic requirements: fever, pregnancy, thyrotoxicosis
Kidney, enlarged
Perirenal haematoma
Starvation
Carcinoma
Congenital anomaly
Cystic kidney
Diabetes
Glycogen storage diseases
Hydronephrosis, pyonephrosis
Hypertrophy (following contralateral nephretomy)
Increased Metabolic requirements: fever, pregnancy, thyrotoxicosis
Kidney, enlarged
Perirenal haematoma
Starvation
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Symptoms and Signs – Differential Diagnosis of Knee, swelling
Kussmaul's breathing 61
Septic arthritis (staphylococci, gonococci, Gram -ve bacilli, TB, Lyme disease)
Trauma, haemarthrosis (in haemophiliacs)
Gout/pseudogout
Rheumatoid arthritis, osteoarthritis
Seronegative arthritides (reactive arthritis, enteropathic arthritis (IBD, Whipple's
disease), ankylosing spondylitis, psoriatic arthritis)
Systemic: SLE, Sjogren's syndrome, sarcoidosis, Behc;et's disease, vasculitides
Malignancy
Localized swellings:
Anterior: pre-patellar bursa
lnfrapatellar bursa
Osgood-Schlatter disease
Lateral/medial: lateral/medial meniscus cyst
Exostosis
Posterior:
Semimembranous bursa
Baker's cyst
Popliteal aneurysm
Kussmaul's breathing 61
Septic arthritis (staphylococci, gonococci, Gram -ve bacilli, TB, Lyme disease)
Trauma, haemarthrosis (in haemophiliacs)
Gout/pseudogout
Rheumatoid arthritis, osteoarthritis
Seronegative arthritides (reactive arthritis, enteropathic arthritis (IBD, Whipple's
disease), ankylosing spondylitis, psoriatic arthritis)
Systemic: SLE, Sjogren's syndrome, sarcoidosis, Behc;et's disease, vasculitides
Malignancy
Localized swellings:
Anterior: pre-patellar bursa
lnfrapatellar bursa
Osgood-Schlatter disease
Lateral/medial: lateral/medial meniscus cyst
Exostosis
Posterior:
Semimembranous bursa
Baker's cyst
Popliteal aneurysm
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Symptoms and Signs – Differential Diagnosis of Koebner phenomenon
Lichen planus
Molluscum contagiosum
Psoriasis
Vitiligo
Warts
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Symptoms and Signs – Differential Diagnosis of Kussmaul's breathing
Constrictive pericarditis
Metabolic acidosis, e.g. diabetic ketoacidosis, uraemia, etc.
Pericardia! effusion
Restrictive cardiomyopathy
Constrictive pericarditis
Metabolic acidosis, e.g. diabetic ketoacidosis, uraemia, etc.
Pericardia! effusion
Restrictive cardiomyopathy
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Symptoms and Signs – Differential Diagnosis of Hypothyroidism
Primary
Congenital: athyreosis, dyshormogenesis, iodide deficiency
Acquired:
Autoimmune (Hashimoto's thyroiditis}
Iatrogenic (surgery, radio-iodine, drugs, e.g. amiodarone, Lithium,
thionamides)
Iodide deficiency/excess
Secondary
Hypothalamidpituitary disease
Primary
Congenital: athyreosis, dyshormogenesis, iodide deficiency
Acquired:
Autoimmune (Hashimoto's thyroiditis}
Iatrogenic (surgery, radio-iodine, drugs, e.g. amiodarone, Lithium,
thionamides)
Iodide deficiency/excess
Secondary
Hypothalamidpituitary disease
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Symptoms and Signs – Differential Diagnosis of Impotence
Psychological (patients may have morning erections)
Neurological: autonomic neuropathy (e.g. diabetes mellitus, uraemia), nerve damage after bladder neck/prostate surgery, multiple sclerosis Vascular disease (e.g. atherosclerosis)
Endocrine disorders: hypogonadism/androgen deficiency, hyperthyroidism, prolactinomas, acromegaly
Drugs: alcohol, antidepressants, beta -blockers, cannabis, diuretics (spirinolactone), major tranquilizers
Psychological (patients may have morning erections)
Neurological: autonomic neuropathy (e.g. diabetes mellitus, uraemia), nerve damage after bladder neck/prostate surgery, multiple sclerosis Vascular disease (e.g. atherosclerosis)
Endocrine disorders: hypogonadism/androgen deficiency, hyperthyroidism, prolactinomas, acromegaly
Drugs: alcohol, antidepressants, beta -blockers, cannabis, diuretics (spirinolactone), major tranquilizers
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Symptoms and Signs – Differential Diagnosis of Infertility
Female
Uterine cavity abnormalities (e.g. fibroids, endometriosis)
Obstructed fallopian tubes (e.g. post- infection/inflammation/surgery: adhesions)
Chromosome abnormalities
Antiphospholipid syndrome
Anovulation (1 °/2° hypogonadism)
(Note: semen analysis (sperm density, motility etc.) should be performed to exclude male factor infertility.)
Female
Uterine cavity abnormalities (e.g. fibroids, endometriosis)
Obstructed fallopian tubes (e.g. post- infection/inflammation/surgery: adhesions)
Chromosome abnormalities
Antiphospholipid syndrome
Anovulation (1 °/2° hypogonadism)
(Note: semen analysis (sperm density, motility etc.) should be performed to exclude male factor infertility.)
