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Symptoms and Signs – Differential Diagnosis of Microcytic Anaemia
Anaemia of chronic disease (often normocytic, but may be microcytic)
Iron deficiency: blood loss (GI [e.g. peptic ulcer, malignancy), urogenital [e.g. menorrhagia, haematuria)), hookworm (Ancylostroma duodenale)
Lead poisoning
Reduced absorption (gastrectomy, small bowel disease),increased demands (growth, pregnancy), reduced intake (e.g. vegans)
Sideroblastic anaemia: congenital (X-linked), alcohol, drugs (isoniazid, chloramphenicol), lead, myelodysplasia
Thalassaemia
Anaemia of chronic disease (often normocytic, but may be microcytic)
Iron deficiency: blood loss (GI [e.g. peptic ulcer, malignancy), urogenital [e.g. menorrhagia, haematuria)), hookworm (Ancylostroma duodenale)
Lead poisoning
Reduced absorption (gastrectomy, small bowel disease),increased demands (growth, pregnancy), reduced intake (e.g. vegans)
Sideroblastic anaemia: congenital (X-linked), alcohol, drugs (isoniazid, chloramphenicol), lead, myelodysplasia
Thalassaemia
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Symptoms and Signs – Differential Diagnosis of Normocytic
Anaemia of chronic disease (chronic infection, inflammatory/connective tissue diseases, malignancy)
Bone marrow failure
Haemolytic anaemia (may also cause macrocytic anaemia)
Hypothyroidism (may also cause macrocytic anaemia)
Pregnancy
Renal failure
Anaemia of chronic disease (chronic infection, inflammatory/connective tissue diseases, malignancy)
Bone marrow failure
Haemolytic anaemia (may also cause macrocytic anaemia)
Hypothyroidism (may also cause macrocytic anaemia)
Pregnancy
Renal failure
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Symptoms and Signs – Differential Diagnosis of Haemolytic Anemia
Hereditary
Metabolic defects: pyruvate kinase deficiency, glucose-6-phosphate dehydrogenase deficiency
Haemoglobinopathies: sickle cell anaemia, thalassaemia Membrane defects: spherocytosis, elliptocytosis
Acquired
Paroxysmal nocturnal haemoglobinuria, secondary to liver and renal disease
Non-immune: trauma: microangiopathic haemolytic anaemia (TIP, HUS, DIC, malignant hypertension, pre-eclampsia), artificial heart valves, March haemoglobinuria
Infection: malaria, clostridia
Drugs: penicillin, quinidine
Autoimmune: Warm antibodies (idiopathic, SLE, lymphoma, drugs, e.g. methyldopa), Cold antibodies (idiopathic, infections, e.g. Mycoplasma sp., EBV, other viruses, lymphoma)
Alloimmune: Transfusion reaction, haemolytic disease of newborn
Hereditary
Metabolic defects: pyruvate kinase deficiency, glucose-6-phosphate dehydrogenase deficiency
Haemoglobinopathies: sickle cell anaemia, thalassaemia Membrane defects: spherocytosis, elliptocytosis
Acquired
Paroxysmal nocturnal haemoglobinuria, secondary to liver and renal disease
Non-immune: trauma: microangiopathic haemolytic anaemia (TIP, HUS, DIC, malignant hypertension, pre-eclampsia), artificial heart valves, March haemoglobinuria
Infection: malaria, clostridia
Drugs: penicillin, quinidine
Autoimmune: Warm antibodies (idiopathic, SLE, lymphoma, drugs, e.g. methyldopa), Cold antibodies (idiopathic, infections, e.g. Mycoplasma sp., EBV, other viruses, lymphoma)
Alloimmune: Transfusion reaction, haemolytic disease of newborn
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Symptoms and Signs – Differential Diagnosis of Aplastic Anemia
Inherited: Fanconi anaemia, dyskeratosis congenita
Idiopathic
Acquired: drugs (cytotoxics, chloramphenicol, gold, methotrexate), chemicals (parathion, benzene), radiation, viral infection (B19 parvovirus, HIV, hepatitis, measles), paroxysmal nocturnal haemoglobinuria, sepsis
Inherited: Fanconi anaemia, dyskeratosis congenita
Idiopathic
Acquired: drugs (cytotoxics, chloramphenicol, gold, methotrexate), chemicals (parathion, benzene), radiation, viral infection (B19 parvovirus, HIV, hepatitis, measles), paroxysmal nocturnal haemoglobinuria, sepsis
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Symptoms and Signs – Differential Diagnosis of ANCA
p-ANCA
Microscopic polyangiitis
Churg-Strauss disease
Also: inflammatory bowel disease, sclerosing cholangitis, biliary cirrhosis, autoimmune hepatitis, rheumatic autoimmune diseases
c-ANCA
Infections, e.g. amoebic colitis
Wegener's granulomatosis
p-ANCA
Microscopic polyangiitis
Churg-Strauss disease
Also: inflammatory bowel disease, sclerosing cholangitis, biliary cirrhosis, autoimmune hepatitis, rheumatic autoimmune diseases
c-ANCA
Infections, e.g. amoebic colitis
Wegener's granulomatosis
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Symptoms and Signs – Differential Diagnosis of Androgenization
Adrenal tumours
Congenital adrenal hyperplasia
Cushing's syndrome
PCOS
Adrenal tumours
Congenital adrenal hyperplasia
Cushing's syndrome
PCOS
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Symptoms and Signs – Differential Diagnosis of Angioid streaks
Acromegaly, hypercalcaemia, lead poisoning
Ehlers-Danlos syndrome
Paget's disease of bone
Pseudoxanthoma elasticum
Sickle cell anaemia
Acromegaly, hypercalcaemia, lead poisoning
Ehlers-Danlos syndrome
Paget's disease of bone
Pseudoxanthoma elasticum
Sickle cell anaemia
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Symptoms and Signs – Differential Diagnosis of Anisocoria
Physiological inequality
Prosthetic eyeball
Unilateral miosis or mydriasis
Physiological inequality
Prosthetic eyeball
Unilateral miosis or mydriasis
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Symptoms and Signs – Differential Diagnosis of Anisocytosis
Iron deficiency
Megaloblastic anaemia
Thalassaemia
Iron deficiency
Megaloblastic anaemia
Thalassaemia
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Symptoms and Signs – Differential Diagnosis of Annular skin lesions
Erythema annulare centrifugum
Erythema chronicum migrans
Erythema multiforme
Granuloma annulare
Leprosy
Nummular eczema
Pityriasis rosea
Psoriasis
Sarcoidosis
Subacute cutaneous lupus erythematosus
Tinea corporis
Urticaria
Erythema annulare centrifugum
Erythema chronicum migrans
Erythema multiforme
Granuloma annulare
Leprosy
Nummular eczema
Pityriasis rosea
Psoriasis
Sarcoidosis
Subacute cutaneous lupus erythematosus
Tinea corporis
Urticaria
