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​Symptoms and Signs – Differential Diagnosis of Splenomegaly and Hepatomegaly
Causes of splenomegaly and hepatosplenomegaly:
MASSIVE SPLENOMEGALY
• Hematologic disease (e.g., chronic myeloid leukemia, myelofibrosis)
MODERATE SPLENOMEGALY
• The above causes
• Portal hypertension
• Hematologic disease (e.g., lymphoma, leukemia, thalassemia)
• Storage disease (e.g., Gaucher’s disease)
SMALL SPLENOMEGALY
• The above causes
• Infective (hepatitis, leptospirosis, malaria, bacterial endocarditis)
• Hematologic disease (e.g., hemolytic anemias, essential thrombocythemia, polycythemia rubra vera)
• Connective tissue diseases or vasculitis (e.g., rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa)
• Solitary cyst, polycystic syndrome, hydatid cyst
• Infiltration (amyloid, sarcoid)
HEPATOSPLENOMEGALY
• Chronic liver disease with portal hypertension
• Hematologic disease (e.g., myeloproliferative disease, lymphoma)
• Infection (e.g., acute viral hepatitis, infectious mononucleosis)
• Infiltration (e.g., amyloid, sarcoid)
• Connective tissue disease (e.g., systemic lupus erythematosus)
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​Symptoms and Signs – Differential Diagnosis of Splenomegaly in Children
DISORDERS OF THE BLOOD
• Hemolytic anemia: congenital/acquired
• Thalassemia
• Sickle cell disease
• Leukemia
• Osteopetrosis
• Myelofibrosis, myeloid metaplasia, thrombocythemia
INFECTIONS: ACUTE AND CHRONIC
Viral
• Congenital (e.g., TORCH association)
• Mononucleosis (e.g., EBV, CMV infection)
• Virus-associated hemophagocytic syndrome
• Human immunodeficiency virus infection
Bacterial
• Sepsis/abscess
• Brucellosis
• Salmonellosis
• Tularemia
• Tuberculosis
• Subacute bacterial endocarditis
• Syphilis
• Lyme disease
Fungal
• Histoplasmosis (disseminated)
Rickettsia
• Rocky Mountain spotted fever
• Cat-scratch disease
Parasitic
• Toxoplasmosis
• Malaria
• Leishmaniasis (kala-azar)
• Schistosomiasis
• Echinococcosis
HEPATIC/PORTAL SYSTEM DISORDERS
• Acute/chronic active hepatitis
• Cirrhosis, hepatic fibrosis, biliary atresia
• Portal or splenic venous obstruction (Banti’s syndrome)
AUTOIMMUNE DISEASE
• Juvenile rheumatoid arthritis
• Systemic lupus erythematosus
• Autoimmune lymphoproliferative syndrome (Canale-Smith
syndrome)
NEOPLASMS/CYSTS
• Lymphomas (Hodgkin’s and non-Hodgkin’s)
• Hemangiomas/lymphangiomas
• Hamartomas
• Congenital or acquired (post-traumatic) cysts
STORAGE DISEASES/INBORN ERRORS OF METABOLISM
• Lipidoses: Gaucher’s disease, Niemann-Pick disease, others
• Mucopolysaccharidoses
• Defects in carbohydrate metabolism: galactosemia, fructose
intolerance
• Sea-blue histiocyte syndrome
MISCELLANEOUS DISORDERS
• Histiocytoses
• Reactive Langerhans cell
• Malignant sarcoidosis
• Congestive heart failure
• Familial Mediterranean fever
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​Symptoms and Signs – Differential Diagnosis of Smallpox
• Abdominal pain may mimic appendicitis.
• Dermatitis herpetiformis
• Impetigo
• Insect bites
• Meningococcemia
• Papular urticaria
• Pemphigus
• Rash from other viral illnesses (e.g., hemorrhagic chickenpox, measles, coxsackievirus)
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​Symptoms and Signs – Differential Diagnosis of Smell Disturbance
• Dental caries, periodontal disease
• Exposure to noxious vapors
• Head trauma
• Idiopathic
• Medications
• Nasal or paranasal sinus disease
• Upper respiratory tract infection
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Symptoms and Sings - Differential Diagnosis of ​Somatization Disorder
• Conversion disorder: there is an alteration or loss of voluntary motor or sensory function with demonstrable physical cause and related to a psychological stress or a conflict. (NOTE: With multiple complaints, the diagnosis of conversion is not made.)
• Munchausen’s (factitious disorder) and malingering: the psychological basis of the complaints in somatization disorder is not conscious as in factitious disorder (Munchausen’s) and malingering, in which symptoms are produced intentionally.
• Pain disorder: distinguished from somatization disorder by the presence of other somatic complaints.
• Undifferentiated somatoform disorder: one or more physical complaints that cannot be explained by a medical condition are present for at least 6 months. (NOTE: Somatization is more severe and less common.)
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​Symptoms and Signs – Differential Diagnosis of Sexually Transmitted Diseases, Anorectal Region
ULCERATIVE
• Lymphogranuloma venereum
• Herpes simplex virus
• Early (primary) syphilis
• Chancroid (Haemophilus ducreyi)
• Cytomegalovirus
• Idiopathic (usually HIV positive)
NONULCERATIVE
• Condyloma acuminatum
• Gonorrhea
• Chlamydia (C. trachomatis)
• Syphilis
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​Symptoms and Signs – Differential Diagnosis of Shigellosis
• Bacterial gastroenteritis
• Dysentery caused by Entamoeba histolytica
• Enterotoxigenic Escherichia coli
• Pseudomembranous colitis
• Viral gastroenteritis
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​Symptoms and Signs – Differential Diagnosis of Shoulder Pain
WITH LOCAL FINDINGS IN SHOULDER
• Trauma: contusion, fracture, muscle strain, trauma to spinal cord
• Arthrosis, arthritis, rheumatoid arthritis (RA), ankylosing spondylitis
• Bursitis, synovitis, tendinitis, tenosynovitis
• Aseptic (avascular) necrosis
• Local infection: septic arthritis, osteomyelitis, abscess, herpes zoster, TB
WITHOUT LOCAL FINDINGS IN SHOULDER
• Cardiovascular disorders: ischemic heart disease, pericarditis, aortic aneurysm
• Subdiaphragmatic abscess, liver abscess
• Cholelithiasis, cholecystitis
• Pulmonary lesions: apical bronchial carcinoma, pleurisy, pneumothorax, pneumonia
• GI lesions: peptic ulcer disease (PUD), gastric neoplasm, peptic esophagitis
• Pancreatic lesions: carcinoma, calculi, pancreatitis
• CNS abnormalities: neoplasm, vascular abnormalities
• Multiple sclerosis (MS)
• Syringomyelia
• Polymyositis/dermatomyositis
• Psychogenic
• Polymyalgia rheumatica
• Ectopic pregnancy
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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.