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Symptoms and Signs – Differential Diagnosis of Hyperparathyroidism
1° hyperparathyroidism
Parathyroid adenoma or hyperplasia (may be associated with MEN syndromes)
and rarely carcinoma
2° hyperparathyroidism
l Calcium (e.g. due to vitamin D deficiency or resistance or chronic renal failure)
3° hyperparathyroidism
Autonomous parathyroid hyperplasia secondary to long-standing 2°
Hyperparathyroidism


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Symptoms and Signs – Differential Diagnosis of Hyperphosphataemia
Renal failure
Hypo & Pseudohypoparathyroidism (PTH: Phosphate Trashing Hormone!)
Rhabdomyolysis
Tumour lysis syndrome
Acromegaly
Excessive phosphate intake/administration
Vitamin D intoxication



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Symptoms and Signs – Differential Diagnosis of Hyperpigmentation
Radiation
Post-inflammatory, e.g. after erythroderma
Photosensitive rashes See Photodistributed rash
Others: chronic renal failure, chronic·wasting (TB, carcinoma), disseminated malignant melanomatosis
Liver disease: haemochromatosis, primary biliary cirrhosis
Endocrine: Addison's disease, Nelson's syndrome, ectopic ACTH, pregnancy
Drugs: amiodarone, busulfan, chlorpromazine, phenothiazines



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Symptoms and Signs – Differential Diagnosis of Hyperaldosteronism
1° hyperaldosteronism: adenoma (Conn's syndrome), bilateral adrenal
hyperplasia, glucocorticoid-remediable aldosteronism
2° hyperaldosteronism: j Renin: renin-secreting tumour, renal artery stenosis,
cirrhosis, cardiac failure, diuretics, Bartter's syndrome



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Symptoms and Signs – Differential Diagnosis of Hyperbilirubinaemia
Conjugated:, hepatocellular and obstructive
Reduced glucuronidation (Gilbert's syndrome, Crigler-:Najjar syndrome)
Unconjugated: haemolysis (See Anaemia, haemolytic}, ineffective erythropoiesis,


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Symptoms and Signs – Differential Diagnosis of Hypercalcaemia
Drugs: Lithium, thiazides
Endocrine diseases: hyperthyroidism, phaeochromocytoma, acromegaly, Addison's disease
Excess vitamin D: self-administered, sarcoid, TB
Familial hypocalciuric hypercalcaemia
Hypercalcaemia
Hypercalcaemia can also occur in diuretic phase of acute renal failure
Hypercalciuria
Hyperparathyroidism: primary and tertiary
Idiopathic hypercalciuria
Immobility
Increased Ca2+ intake
Increased Ca2+ intake ('milk alkali syndrome')
Malignancy: multiple myeloma, bone metastasis: (prostate, kidney, thyroid, breast, lung), bronchial squamous cell carcinoma, lymphoma
Other causes
Renal tubular acidosis
X-linked hypercalciuria (Dent's disease)


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Symptoms and Signs – Differential Diagnosis of Hypergammaglobulinaemia
Polyclonal
Chronic liver disease, primary biliary cirrhosis, autoimune hepatitis
Chronic inflammatory/connective tissue disease (e.g. Sj6gren's syndrome,
sarcoidosis, SLE, rheumatoid arthritis, dermatomyositis), inflammatory bowel
disease
Chronic infection (e.g. bronchiectasis), TB, brucellosis, leishmaniasis, leprosy, HIV
Infection



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Symptoms and Signs – Differential Diagnosis of Hyperglycaemia
Diabetes
Endocrine: Cushing's syndrome, acromegaly, phaeochromocytomas, glucagonomas, somatostatinomas
Pancreatectomy, chronic pancreatitis, haemochromatosis
Primary (type 1 & 2)
Secondary:
Steroids
Steroids
Stress, e.g. acute/severe illness


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Symptoms and Signs – Differential Diagnosis of Hyperhidrosis
Acute: any acute febrile illness, myocardial infarction, hypoglycaemia, hypotension
Chronic infection: TB, brucellosis
Endocrine: thyrotoxicosis, acromegaly, phaeochromocytoma
Malignancy: lymphoma
Medications: opiates, drugs with cholinergic properties, sympathomimetics


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Symptoms and Signs – Differential Diagnosis of Hiccups
Benign
Gastric distension: over eating, carbonated beverages, aerophagia, gastric
insufflation during endoscopy
Excessive alcohol ingestion and tobacco use; sudden changes in ambient or GI
temperature, sudden excitement

Phrenic nerve irritation
Neck masses (e.g. goitres), mediastinal masses
Diaphragmatic abnormalities:, e.g. gastro-oesophageal reflux, hiatus hernia,
intra-operative manipulation
Subdiaphragmatic:, e.g. subphrenic abscess

Vagus nerve irritation
Irritation of the recurrent laryngeal nerve by pharyngitis, laryngitis, tumours of
the neck
Irritation of the auricular branch of the vagus by foreign bodies touching the
tympanic membrane

Toxic/metabolic
Uraemia, alcohol intoxication, general anaesthetic
CNS disorders
Vascular, infective or structural lesions releasing the normal inhibition of the
hiccup reflex

Psychogenic
Anxiety, malingering



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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.