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Symptoms and Signs – Differential Diagnosis of Hyperprolactinaemia
Physiological: pregnancy, lactation, stress
Prolactinoma, rarely ectopic prolactin (lung, kidney tumours)
Reduced Dopamine transport to the anterior pituitary: pituitary tumour compressing
pituitary stalk (pseudoprolactinoma affect)
Drugs:
Depletion of central dopamine stores: reserpine, methyldopa
Dopamine receptor blockers: (chlorpromazine, haloperidol, sulpiride,
metoclopramide, domperidone)
Increased TRH secretion stimulates prolactin release (1° hypothyroidism)
Oestrogens: HRT/OCP, PCOS (oestrogen stimulates lactotrophs)
Chest wall injury (stimulation of the reflex pathway normally activated by
suckling in lactating women)
Others: liver failure, l dopamine synthesis/release from the hypothalamus
(tumour, inflammation, arteriovenous malformations)·
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Symptoms and Signs – Differential Diagnosis of Hypertension
Vascular: coarctation of aorta, renal artery stenosis
Renal disease: chronic glomerulonephritis, chronic pyelonephritis, cystic kidney disease, renal carcinoma
Pre-eclampsia
Essential (idiopathic)
Endocrine disease: Cushing's syndrome, Conn's disease, phaeochromocytomas, acromegaly, primary hyperparathyroidism
Drugs: oestrogen-containing OCPs, steroids
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Symptoms and Signs – Differential Diagnosis of Hyperthyroidism
TSH-receptor mutations, McCune-Albright syndrome
Toxic multinodular goitre
Toxic adenoma
Thyroiditis (subacute/viral, post-partum)
Struma ovarii
Secondary hyperthyroidism (TSH)
Rarer causes
Graves' disease
Gestational thyrotoxicosis (raised hCG)
Follicular carcinoma of thyroid
Drugs: amiodarone, surreptitious thyroxine consumption (thyroiditis factitia)
Choreocarcinoma
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Symptoms and Signs – Differential Diagnosis of Hypertrichosis
Local
Lichen simplex
Melanocytic naevi
Spina bifida

Generalized
Anorexia nervosa
Malnutrition
Medication (minoxidil, ciclosporin, phenytoin),
Malignancy
Porphyria cutanea tarda

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Symptoms and Signs – Differential Diagnosis of Hyperuricaemia
Reduced Renal excretion
Psoriasis
Increase Synthesis: Lesch-Nyhan syndrome (HGPRT deficiency)
Increase Nucleic acid (purine) turnover: lymphoma, leukaemia, polycythaemia vera,
Increase Intake/production
Increase Dietary intake
Idiopathic
ethambutol, alcohol, pyrizinamide)
Drugs: ciclosporin, aspirin (low-dose), nicotinic acid, thiazides, loop diuretics,
Chronic renal disease, e.g. in diabetes mellitus, hypertension


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Symptoms and Signs – Differential Diagnosis of Hyperkalemia
ACE inhibitors
Addison's disease
Amiloride and other potassium-sparing diuretics
Pseudohyperkalaemia: haemolysis, leucocytosis, thrombocytosis
Released from cells: acidosis, rhabdomyolysis, suxamethonium
Renal failure
Renal tubular acidosis type 4


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Symptoms and Signs – Differential Diagnosis of Hyperkeratosis (palmoplantar)
2° syphilis
Congenital (tylosis, an autosomal dominant condition)
Friction (e.g. walking barefoot)
Keratoderma blenorrhagica (Reiter's syndrome)
Malignancy: gastric adenocarcinoma, bronchial carcinoma
Psoriasis
Toxidmetabolic: drug reaction, arsenic, vitamin A deficiency



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Symptoms and Signs – Differential Diagnosis of Hypernatraemia
Dehydration:
Reduced Fluid intake: elderly, confused or unconscious
Increased Fluid loss GI: diarrhoea vomiting
Renal: diabetes insipidus, osmotic diuresis (e.g. hyperglycaemia,
hypercalcaemia)
Skin: excessive sweating
Hyperosmolar non-ketotic coma
Excess Na+ administration (e.g. sodium bicarbonate)
Excess mineralocortcoids: hyperaldosteronism



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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.