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Symptoms and Signs – Differential Diagnosis of Insomnia
Self-limiting: stress, travel etc.
Psychological: depression, mania, anxiety
nocturia, asthma, alcoholism, apnoea, tinnitus, dystonia
Medical: drugs, withdrawal of antidepressants/hypnotics, caffeine, pain, pruritus,


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Symptoms and Signs –Differential Diagnosis of Raised lntracranial pressure
Vascular: haemorrhage (extradural, subdural, subarachnoid, intracerebral)
Tumours
Trauma: head injury
Infection: meningitis/encephalitis, abscess
Benign intracranial hypertension, hydrocephalus, cerebral oedema



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Symptoms and Signs – Differential Diagnosis of Hypotension
Septicaemia

Hypovolaemia:
Haemorrhage
GI loss
Renal loss (diuretic, diabetes mellitus, diabetes insipidus, post-obstructive
diuresis, acute renal failure
Cutaneous loss (exudative lesions, burns)
Adrenal insufficiency


Cardiovascular:
Any condition that reduced cardiac output, e.g. arrhythmias, reduced diastolic filling
(pericardial disease), myocardial disease, outflow obstruction

Postural hypotension
Volume depletion

Autonomic neuropathy:

Metabolic: diabetes mellitus, amyloidosis (rare}, drugs (tricyclics, L-dopa}

Inflammation: Guillain-Barre syndrome

Infection: HIV, syphilis

Tumours: paraneoplastic (e.g. small cell lung cancer}, hypothalamic

Degenerative: Parkinson's disease, multiple system atrophy, Shy-Drager
Syndrome

Familial dysautonomia (Riley-Day syndrome}

Drugs: Antihypertensives, diuretics, nitrates, antidepressants, sedatives

Leg vein insufficiency



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Symptoms and Signs – Differential Diagnosis of Hypophosphataemia
Redistribution into cells
Increased insulin e.g. recovery from diabetic ketoacidosis (treatment with insulin stimulates glycolysis and phosphate uptake by the cells), refeeding (e.g. in alcoholics)
Respiratory alkalosis (alkalosis stimulates glycolysis and phosphate uptake by the cells)
Hungry bone syndrome (following parathyroidectomy in patients with preexisting osteopenia): due to marked deposition of Ca2+ and phosphate in bone

Gastrointestinal
Phosphate binders, e.g. aluminum/magnesium-containing antacids
Diarrhoea (chronic)
Reduced Dietary intake

Renal
Hyperparathyroidism (1° & 2°):increased urinary excretion
Vitamin D deficiency/resistance (both by reduced GI absorption and by causing
hypocalcaemia and 2° hyperparathyroidism)
Hereditary hypophosphataemic rickets (X-linked, autosomal dominant), tumourinduced
osteomalacia
Osmotic diuresis, e.g. glycosuria
Fanconi syndrome



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Symptoms and Signs – Differential Diagnosis of Hypopyon
Trauma, surgery
Malignancy: necrosis of intraocular tumours/metastases (e.g. leukaemia,
lymphoma, retinoblastoma)
Inflammation: anterior uveitis (See Uveitis)
Infection: endophthalmitis, corneal ulcers



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Symptoms and Signs – Differential Diagnosis of Hypopituitarism
Vascular: pituitary apoplexy (infarction/haemorrhage), Sheehan's syndrome
Pituitary tumour
Pituitary surgery/radiation
Mutations: e.g. Pit-1, Prop-1
Infection: meningitis/encephalitis, syphilis (rare) Inflammation/infiltration: TB, sarcoidosis, lymphoma, abscess, histiocytosis X,
Hypothalamic: anorexia, severe exercise, starvation
haemochromatosis, lymphocytic hypophysitis


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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.