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​Symptoms and Signs – Differential Diagnosis of Vulvovaginitis, Trichomonas
• Atrophic vulvovaginitis
• Bacterial vaginosis
• Cervicitis
• Chronic lymphocytic leukemia
• Fungal vulvovaginitis
• Hairy cell leukemia
• Lymphoma
• Monoclonal gammopathy of unknown significance (MGUS)
• Multiple myeloma
• Waldenström’s macroglobulinemia
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​Symptoms and Signs – Differential Diagnosis of Red Urine
WITH A POSITIVE DIPSTICK
• Hematuria
• Hemoglobinuria: negative urinalysis
• Myoglobinuria: negative urinalysis
WITH A NEGATIVE DIPSTICK
Drugs
• Aminosalicylic acid
• Deferoxamine mesylate
• Ibuprofen
• Phenacetin
• Phenolphthalein
• Phensuximide
• Rifampin
• Anthraquinone laxatives
• Doxorubicin
• Methyldopa
• Phenazopyridine
• Phenothiazine
• Phenytoin
Dyes
• Azo dyes
• Eosin
Foods
• Beets, berries, maize
• Rhodamine B
Metabolic
• Porphyrins
• Serratia marcescens (red diaper syndrome)
• Urate crystalluria
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​Symptoms and Signs – Differential Diagnosis of Urolithiasis
• Appendicitis
• Diverticulitis
• Ectopic pregnancy
• Factitious (drug addicts)
• Ovarian pathology
• Pelvic inflammatory disease (PID)
• Pyelonephritis
• Small bowel obstruction
• Urinary tract infection
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​Symptoms and Signs – Differential Diagnosis of Obstructive Uropathy 
INTRINSIC CAUSES
• Intraluminal: intratubular deposition of crystals (uric acid, sulfas), stones, papillary tissue, blood clots
• Intramural
• Functional: ureter (ureteropelvic or ureterovesical dysfunction); bladder (neurogenic): spinal cord defect or trauma, diabetes, multiple sclerosis (MS), Parkinson’s disease, cerebrovascular accidents (CVA), bladder neck dysfunction
• Anatomic: tumors, infection, granuloma, strictures
EXTRINSIC CAUSES
• Originating in the reproductive system
• Prostate: benign hypertrophy or cancer
• Uterus: pregnancy, tumors, prolapse, endometriosis
• Ovary: abscess, tumor, cysts
• Originating in the vascular system: aneurysms (aorta, iliac vessels), aberrant arteries (ureteropelvic junction), venous (ovarian veins, retrocaval ureter)
• Originating in the gastrointestinal tract: Crohn’s disease, pancreatitis, appendicitis, tumors
• Originating in the retroperitoneal space: inflammations, fibrosis, tumor, hematomas
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​Symptoms and Sings – Differential Diagnosis of Urticaria (Hives)
• Bullous pemphigoid
• Drug eruption
• Erythema infectiosum
• Erythema marginatum
• Erythema multiforme
• Herpes gestationis
• Multiple insect bites
• Urticarial vasculitis
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​Symptoms and Signs – Differential Diagnosis of Abnormal  Uterine Bleeding
PREGNANCY
• Threatened abortion
• Incomplete abortion
• Complete abortion
• Molar pregnancy
• Ectopic pregnancy
• Retained products of conception
OVULATORY
• Vulva: infection, laceration, tumor
• Vagina: infection, laceration, tumor, foreign body
• Cervix: polyps, cervical erosion, cervicitis, carcinoma
• Uterus: fibroids (submucous fibroids most likely to cause abnormal bleeding), polyps, adenomyosis, endometritis, intrauterine device, atrophic endometrium
• Pregnancy complications: ectopic pregnancy; threatened, incomplete, complete abortion; retained products of conception
• Abnormality of clotting system
• Midcycle bleeding
• Halban’s disease (persistent corpus luteum)
• Menorrhagia
• Pelvic inflammatory disease (PID)
ANOVULATORY
• Physiologic causes
• Puberty
• Perimenopausal
• Pathologic causes
• Ovarian failure (follicle-stimulating hormone [FSH] >40 IU/ml)
• Hyperandrogenism
• Hyperprolactinemia
• Obesity
• Hypothalamic dysfunction (polycystic ovaries); luteinizing hormone (LH)/FSH ratio >2 : 1
• Hyperplasia
• Endometrial carcinoma
• Estrogen-producing tumors
• Hypothyroidism
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​Symptoms and Signs – Differential Diagnosis of Uveitis
• Glaucoma
• Conjunctivitis
• Retinal detachment
• Retinopathy
• Keratitis
• Scleritis
• Episcleritis
Vaginal Bleeding
ANY GESTATIONAL AGE
• Cervical lesions: polyps, decidual reaction, neoplasia
• Vaginal trauma
• Cervicitis/vulvovaginitis
• Postcoital trauma
• Bleeding dyscrasias
GESTATION <20 WEEKS
• Spontaneous abortion
• Presence of intrauterine device
• Ectopic pregnancy
• Molar pregnancy
• Implantation bleeding
• Low-lying placenta
GESTATION >20 WEEKS
• Molar pregnancy
• Placenta previa
• Placental abruption
• Vasa previa
• Marginal separation of the placenta
• Bloody show at term
• Preterm labor
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​Symptoms and Signs – Differential Diagnosis of Vaginal Bleeding in Pregnancy
FIRST TRIMESTER
• Implantation bleeding
• Abortion
• Threatened
• Complete
• Incomplete
• Missed
• Ectopic pregnancy
• Neoplasia
• Hydatidiform mole
• Cervix
THIRD TRIMESTER
• Placenta previa
• Placental abruption
• Premature labor
• Choriocarcinoma
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​Symptoms and Signs – Differential Diagnosis of Vaginal Discharge, Prepubertal Girls
• Associated systemic illness (group A streptococci, chickenpox)
• Chlamydia trachomatis
• Escherichia coli with foreign body
• Foreign body
• Infections
• Infections (consider sexual abuse)
• Irritative (bubble baths, sand)
• Neisseria gonorrhoeae
• Poor perineal hygiene
• Shigella organisms
• Trichomonas vaginalis
• Tumor (rare)
• Yersinia organisms
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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.