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Symptoms and Signs – Differential Diagnosis of Hirsutism
Target organ hypersensitivity
Ovaries: PCOS, androgen-secreting ovarian tumours (e.g. arrhenoblastoma which is a Sertoli-Leydig cell tumour)
Familial, racial (common in some Mediterranean and Indian subcontinent populations)
Drugs: ciclosporin, androgens, minoxidil, phenytoin
Adrenals: Congenital adrenal hyperplasia, androgen-secreting adrenal tumours, Cushing's syndrome


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Symptoms and Signs – Differential Diagnosis of Hoarse voice
Singer's nodules
Recurrent laryngeal nerve injury: tumours (base of skull, neck, e.g. thyroid, mediastinum, e.g. lung cancer), surgery (thyroid, parathyroid, carotid endarterectomy)
Laryngitis: Acute (associated with viral upper respiratory tract infection, acute vocal strain), Chronic (associated with chronic vocal cord strain, alcohol, smoking, GORD, postnasal drip, chemical fumes)
Laryngeal trauma (e.g. intubation)
Laryngeal carcinoma
Hysterical aphonia
Hypothyroidism


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Symptoms and Signs – Differential Diagnosis of Raised Homocysteine
Disease: hypothyroidism, renal failure, breast/ovarian cancer
Drugs: methotrexate, theophylline, phenytoin
Genetic: Cystathionine beta 1-synthetase deficiency, MTHFR polymorphism
Lifestyle: aging, smoking, increase coffee consumption
Vitamin deficiency: B6 , B12, folate


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Symptoms and Signs – Differential Diagnosis of Horner's syndrome
Brain stem/cervical spinal cord: tumour (glioma), infarction,
Cervical sympathetic chain: Pancoast tumour (lung apex)
Internal carotid artery: dissection, occlusion
syringomyelia/bulbia
Tl root: brachia! plexus lesion, neurofibromatosis


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Symptoms and Signs – Differential Diagnosis of Howell-Jolly bodies
Hypergammaglobulinaemia
Hyposplenism: sickle cell disease, coeliac disease/dermatitis herpetiformis,
Iron deficiency
Leukaemia
Megaloblastic anaemia
Post-splenectomy
ulcerative colitis, tropical sprue, amyloidosis, essential thrombocythaemia




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Symptoms and Signs – Differential Diagnosis of Hepatosplenomegaly
Worldwide: malaria, schistosomiasis, leishmaniasis
Portal hypertension (See Portal hypertension)
Other: amyloidosis, storage disorders, e.g. Gaucher's disease, infantile polycystic disease
Myeloproliferative disorders*
Megaloblastic anaemia (e.g. pernicious anaemia)
Lymphoproliferative disorders**
Infection: hepatitis B or C, EBV, CMV, leptospirosis, toxoplasmosis, tuberculosis, brucellosis


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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.