Published on
Symptoms and Signs – Differential Diagnosis of Splitting of S2
Wide
Delayed activation of right ventricle
RBBB, left ventricular pacing, left ventricular preexcitation (WolffParkinson-
White syndrome)

Prolonged right ventricular ejection time
Pulmonary stenosis, pulmonary hypertension
Reduced Left ventricular ejection time
Mitral regurgitation, VSD

Wide fixed splitting
ASD

Reversed splitting
Delayed activation of left ventricle
LBBB, right ventricular pacing, right ventricular preexcitation
Prolonged left ventricular ejection time
Aortic stenosis, HOCM, hypertension, PDA


Picture
Published on
ifferential Diagnosis of Single Second Heart Sound
Apparent: obesity, COPD, pericardialeffusion
Absent a2: severe aortic stenosis, severe aortic regurgitation
Absent p2: absent pulmonary valve, pulmonary atresia, pulmonary stenosis,
tetralogy of Fallot
Fusion of a2 and p2: Eisenmenger's syndrome



Picture
Published on

Symptoms and Signs – Differential Diagnosis of Hemianopia
Bitemporal
Superior temporal quadrants involved first
Pituitary adenoma, meningioma, carotid aneurysm
Nasopharyngeal carcinoma
Sphenoid sinus mucocele
Inferior temporal quadrants involved first
Craniopharyngioma
Third ventricular tumour

Homonymous
Involvement of:
Optic tract or
Optic radiation (in parietal or temporal lobes) or
Occipital cortex by: CVA (sudden): stroke/transient ischaemic attack (TIA)
Masses: gliomas, metastasis, abscess


Picture
Published on
Symptoms and Signs – Differential Diagnosis of Hemiparesis, hemiplegia
Vascular: CVA (infarction, haemorrhage, TIA)
Tumour
Trauma: extradural or subdural haemorrhage (a history of trauma may not be apparent in the latter)
Other causes of transient hemiplegia/paresis: epileptic seizures (Todd's paralysis), migraine
Metabolic: hypoglycaemia can cause transient hemiplegia
Inflammation: multiple sclerosis, cerebral vasculitis
Infection: brain abscess from local (e.g. middle ear, sinuses) or distant (e.g. lung) infections




Picture
Published on
Symptoms and Signs – Differential Diagnosis of Hepatomegaly
Cancer: (2° deposits, hepatoma, liver cell adenoma)
Cirrhosis (early) usually alcoholic, primary biliary cirrhosis
Congestive cardiac failure
Budd-Chiari (hepatic vein thrombosis)
Polycystic liver disease
Infection: hepatitis A, B, C, EBV, CMV, toxoplasmosis, leptospirosis, abscess
(amoebic, pyogenic), hydatid cyst
Infiltration: fatty infiltration (alcohol), haemochromatosis, amyloidosis,
sarcoidosis, lymphoproliferative diseases
'Apparent hepatomegaly': lowered diaphragm (e.g. in COPD) or Reidle's lobe (an
extension of the right lobe)
Also see Hepatosplenomegaly


Picture
Published on
Symptoms and Signs – Differential Diagnosis of Gait
Antalgic gait due to pain
Apraxic gaits: frontal lobe lesions
Festinant, shuffling gait: Parkinson's disease
heavy metal poisoning, e.g. lead
Leg length discrepancies
Spastic, scissoring: See Spastic paraparesis
Steppage gate: peroneal nerve palsy, Charcot-Marie-Tooth disease, old polio,
Waddling: See Proximal myopathy
Wide-base: See Ataxia


Picture

Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.