- Published on
Symptoms and Signs – Differential Diagnosis of Dysgeusia
Chronic nasal blockage
Old age
Facial nerve palsy
Drugs/toxins: metronidazole, ACE inhibitors, anti-thyroid drugs, Lithium,
clarythromicin, heavy metals (e.g. lead poisoning)
Dental procedures
Rare:
Malignancy, bone marrow transplantation, GI (GORD, irritable bowel disease,
cirrhosis)
Nutritional: Zn/8 12 deficiency
Haemodialysis
HIV
Hypothyroidism
Depression
Chronic nasal blockage
Old age
Facial nerve palsy
Drugs/toxins: metronidazole, ACE inhibitors, anti-thyroid drugs, Lithium,
clarythromicin, heavy metals (e.g. lead poisoning)
Dental procedures
Rare:
Malignancy, bone marrow transplantation, GI (GORD, irritable bowel disease,
cirrhosis)
Nutritional: Zn/8 12 deficiency
Haemodialysis
HIV
Hypothyroidism
Depression
- Published on
Symptoms and Signs – Differential Diagnosis of Dysmenorrhoea
Primary
No organic cause found
Secondary
Fibroids
Adenomyosis
Endometriosis
Pelvic inflammatory disease
Ovarian tumours
Primary
No organic cause found
Secondary
Fibroids
Adenomyosis
Endometriosis
Pelvic inflammatory disease
Ovarian tumours
- Published on
Symptoms and Signs – Differential Diagnosis of Dyspareunia
Superficial
Psychological
syndrome, scleroderma), childbirth, episiotomy, surgery
Vagina: infection, atrophic vaginitis (post-menopausal), dryness (Sjogren's
Vulva: infection, dermatological disease, dysplasias
Deep
Endometriosis
Pelvic infection (chronic)
Pelvic mass
Irritable bowel syndrome
Superficial
Psychological
syndrome, scleroderma), childbirth, episiotomy, surgery
Vagina: infection, atrophic vaginitis (post-menopausal), dryness (Sjogren's
Vulva: infection, dermatological disease, dysplasias
Deep
Endometriosis
Pelvic infection (chronic)
Pelvic mass
Irritable bowel syndrome
- Published on
Symptoms and Signs – Differential Diagnosis of Dyspepsia
cancer
Gall bladder: chronic cholecystitis
Non-ulcer dyspepsia
Oesophagus: gastro-oesophageal reflux, oesophagitis
Stomach/duodenum: peptic ulcer, hiatus hernia, gastritis, duodenitis, gastric
cancer
Gall bladder: chronic cholecystitis
Non-ulcer dyspepsia
Oesophagus: gastro-oesophageal reflux, oesophagitis
Stomach/duodenum: peptic ulcer, hiatus hernia, gastritis, duodenitis, gastric
- Published on
Symptoms and Signs – Differential Diagnosis of Dysphagia
lntraluminal
Foreign body
Intramural
Achalasia
Benign stricture: Oesophageal webs or rings
Cancer (oesophageal, gastric, pharyngeal)
Diffuse oesophageal spasm
GORD, corrosives, radiotherapy
Oesophagitis: infection, e.g. candidiasis, HSV, CMV, HIV or inflammation, e.g.
Others: scleroderma, Chagas' disease
Extramural
Aberrant subclavian artery (dysphagia lusoria)
Aortic aneurysm
Atrial (left) enlargement
Lung cancer
Lymphadenopathy
Paraoesophageal hiatus hernia
Pharyngeal pouch
Retrosternal goitre
Neuromuscular
Bulbar and pseudobulbar palsy
CVA
Guillain-Barre
Inflammatory myositis
Motor neurone disease
Myasthenia gravis
Syringobulbia
lntraluminal
Foreign body
Intramural
Achalasia
Benign stricture: Oesophageal webs or rings
Cancer (oesophageal, gastric, pharyngeal)
Diffuse oesophageal spasm
GORD, corrosives, radiotherapy
Oesophagitis: infection, e.g. candidiasis, HSV, CMV, HIV or inflammation, e.g.
Others: scleroderma, Chagas' disease
Extramural
Aberrant subclavian artery (dysphagia lusoria)
Aortic aneurysm
Atrial (left) enlargement
Lung cancer
Lymphadenopathy
Paraoesophageal hiatus hernia
Pharyngeal pouch
Retrosternal goitre
Neuromuscular
Bulbar and pseudobulbar palsy
CVA
Guillain-Barre
Inflammatory myositis
Motor neurone disease
Myasthenia gravis
Syringobulbia
- Published on
Symptoms and Signs – Differential Diagnosis of Dystonia
(metoclopramide), anticonvulsants
Autosomal dominant, e.g. spinocerebellar degenerations, Huntington's disease
Autosomal recessive, e.g. Wilson's disease
Drugs: antipsychotics (phenothiazines, chlorpromazine, haloperidol), antiemetics
Idiopathic
Mitochondrial disease
X-linked, e.g. Lesch-Nyhan syndrome
(metoclopramide), anticonvulsants
Autosomal dominant, e.g. spinocerebellar degenerations, Huntington's disease
Autosomal recessive, e.g. Wilson's disease
Drugs: antipsychotics (phenothiazines, chlorpromazine, haloperidol), antiemetics
Idiopathic
Mitochondrial disease
X-linked, e.g. Lesch-Nyhan syndrome
- Published on
Symptoms and Signs – Differential Diagnosis of Dysuria
Prostatitis
Urethritis: chlamydia!, gonococcal, others: Trichomonas vagina/is, Candida albicans
Urinary tract infection: cystitis, urethritis, acute pyelonephritis (uncommon cause of dysuria)
Vaginitis: Candida albicans, Trichomonas vagina/is, bacterial vaginosis
Interstitial cystitis
Female urethral syndrome
Prostatitis
Urethritis: chlamydia!, gonococcal, others: Trichomonas vagina/is, Candida albicans
Urinary tract infection: cystitis, urethritis, acute pyelonephritis (uncommon cause of dysuria)
Vaginitis: Candida albicans, Trichomonas vagina/is, bacterial vaginosis
Interstitial cystitis
Female urethral syndrome
- Published on
Symptoms and Signs – Differential Diagnosis of Ear ache
External ear
Boil, furuncle
Inclusion dermoid
Malignancy (e.g. squamous cell carcinoma, basal cell carcinoma)
Otitis externa
Trauma/subperichondral haematoma
Middle ear
Foreign body
Mastoiditis
Otitis media
Referred
Teeth
Temporomandibular joint
Tongue (tumour of the posterior third)
Tonsillitis, pharyngitis
Neurological
Herpes zoster
Glossopharyngeal neuralgia
External ear
Boil, furuncle
Inclusion dermoid
Malignancy (e.g. squamous cell carcinoma, basal cell carcinoma)
Otitis externa
Trauma/subperichondral haematoma
Middle ear
Foreign body
Mastoiditis
Otitis media
Referred
Teeth
Temporomandibular joint
Tongue (tumour of the posterior third)
Tonsillitis, pharyngitis
Neurological
Herpes zoster
Glossopharyngeal neuralgia
- Published on
Symptoms and Signs – Differential Diagnosis of Cranial nerve lesions
Ill
Vascular:
Aneurysm: posterior communicating artery, basilar (in the brainstem), in the
cavernous sinus
Infarction in the brainstem
Infarction in the nerve trunk ('medical' causes) diabetes, hypertension, SLE,
polyarteritis nodosa, giant cell arteritis
Thrombosis: in the cavernous sinus
Inflammation/infiltration of the basal meninges: TB, sarcoid, lymphoma,
carcinoma, syphilis
Tumour: brainstem, cavernous sinus, superior orbital fissure/orbit tumour/
granuloma
Tentorial herniation ('coning')
Brainstem CVA/demyelination/tumour
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
lnfective/carcinomatous meningitis
Orbital tumour
Nerve trunk infarction
IV
Head trauma
V
Sensory: trigeminal neuralgia, herpes zoster, nasopharyngeal carcinoma
Cerebellopontine angle tumour (acoustic neuroma, meningioma)
Brainstem CVA/tumour/demyelination
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
Neoplastic infiltration of skull base
Petrositis (Gradenigo's syndrome)
VI
Damage to the nerve's blood supply (vasa nervosum): diabetes mellitus,
hypertension
False localizing sign of increased intracranial pressure
Brainstem CVA/demyelination/tumour, Wernicke-Korsakoff syndrome
Cavernous sinus lesions
Cerebellopontine angle tumour
lnfective/carcinomatous meningitis
Petrositis (Gradenigo's syndrome)
Orbital tumour
Multiple palsies
Trauma
Basal meningeal infiltration: carcinoma, TB, sarcoid, lymphoma,
leukaemia
Brainstem lesions (CVA, tumour)
Guillain-Barre syndrome
Mononeuritis multiplex
Arnold-Chiari malformation
Paget's disease
CSF
Ill
Vascular:
Aneurysm: posterior communicating artery, basilar (in the brainstem), in the
cavernous sinus
Infarction in the brainstem
Infarction in the nerve trunk ('medical' causes) diabetes, hypertension, SLE,
polyarteritis nodosa, giant cell arteritis
Thrombosis: in the cavernous sinus
Inflammation/infiltration of the basal meninges: TB, sarcoid, lymphoma,
carcinoma, syphilis
Tumour: brainstem, cavernous sinus, superior orbital fissure/orbit tumour/
granuloma
Tentorial herniation ('coning')
Brainstem CVA/demyelination/tumour
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
lnfective/carcinomatous meningitis
Orbital tumour
Nerve trunk infarction
IV
Head trauma
V
Sensory: trigeminal neuralgia, herpes zoster, nasopharyngeal carcinoma
Cerebellopontine angle tumour (acoustic neuroma, meningioma)
Brainstem CVA/tumour/demyelination
Cavernous sinus lesions (aneurysm, tumour, thrombosis)
Neoplastic infiltration of skull base
Petrositis (Gradenigo's syndrome)
VI
Damage to the nerve's blood supply (vasa nervosum): diabetes mellitus,
hypertension
False localizing sign of increased intracranial pressure
Brainstem CVA/demyelination/tumour, Wernicke-Korsakoff syndrome
Cavernous sinus lesions
Cerebellopontine angle tumour
lnfective/carcinomatous meningitis
Petrositis (Gradenigo's syndrome)
Orbital tumour
Multiple palsies
Trauma
Basal meningeal infiltration: carcinoma, TB, sarcoid, lymphoma,
leukaemia
Brainstem lesions (CVA, tumour)
Guillain-Barre syndrome
Mononeuritis multiplex
Arnold-Chiari malformation
Paget's disease
CSF
- Published on
Symptoms and Signs – Differential Diagnosis of raised and reduced plasma concentration of creatinine
Increased Creatinine
Reduced GFR (renal failure), high muscle mass, acute muscle damage (rhabdomyolysis)
Transient/minimal increase: after exercise, high meat meal
Reduced Tubular secretion: trimethoprim, cimetidine
Reduced Creatinine
Raised GFR (pregnancy)
Low muscle mass
Increased Creatinine
Reduced GFR (renal failure), high muscle mass, acute muscle damage (rhabdomyolysis)
Transient/minimal increase: after exercise, high meat meal
Reduced Tubular secretion: trimethoprim, cimetidine
Reduced Creatinine
Raised GFR (pregnancy)
Low muscle mass
