Published on
​Symptoms and Signs – Differential Diagnosis of Chest Pain in Children
MUSCULOSKELETAL (COMMON)
• Trauma (accidental, abuse)
• Exercise, overuse injury (strain, bursitis)
• Costochondritis (Tietze’s syndrome)
• Herpes zoster (cutaneous)
• Pleurodynia
• Fibrositis
• Slipping rib
• Sickle cell anemia vaso-occlusive crisis
• Osteomyelitis (rare)
• Primary or metastatic tumor (rare)
PULMONARY (COMMON)
• Pneumonia
• Pleurisy
• Asthma
• Chronic cough
• Pneumothorax
• Infarction (sickle cell anemia)
• Foreign body
• Embolism (rare)
• Pulmonary hypertension (rare)
• Tumor (rare)
GASTROINTESTINAL (LESS COMMON)
• Esophagitis (gastroesophageal reflux)
• Esophageal foreign body
• Esophageal spasm
• Cholecystitis
• Subdiaphragmatic abscess
• Perihepatitis (Fitz-Hugh–Curtis syndrome)
• Peptic ulcer disease
CARDIAC (LESS COMMON)
• Pericarditis
• Postpericardiotomy syndrome
• Endocarditis
• Mitral valve prolapse
• Aortic or subaortic stenosis
• Arrhythmias
• Marfan syndrome (dissecting aortic aneurysm)
• Anomalous coronary artery
• Kawasaki’s disease
• Cocaine, sympathomimetic ingestion
• Angina (familial hypercholesterolemia)
IDIOPATHIC (COMMON)
• Anxiety, hyperventilation
• Panic disorder
OTHER (LESS COMMON)
• Spinal cord or nerve root compression
• Breast-related pathologic condition
• Castleman’s disease (lymph node neoplasm)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Non Pleuritic Chest Pain 
• Cardiac: myocardial ischemia/infarction, myocarditis
• Chest pain associated with mitral valve prolapse
• Dissecting aortic aneurysm
• Esophageal: spasm, esophagitis, ulceration, neoplasm, achalasia, diverticula, foreign body
• Gallbladder and biliary: cholecystitis, cholelithiasis, impacted stone, neoplasm
• Gastric and duodenal: hiatal hernia, neoplasm, peptic ulcer disease (PUD)
• Mediastinal tumors: lymphoma, thymoma
• Pain originating from skin, breasts, and musculoskeletal structures: herpes zoster, mastitis, cervical spondylosis
• Pancreatic: pancreatitis, neoplasm
• Psychoneurosis
• Pulmonary: neoplasm, pneumonia, pulmonary embolism/infarction
• Referred pain from subdiaphragmatic GI structures
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Pleuritic Chest Pain
• Subdiaphragmatic abscess
• Pulmonary: pneumothorax, hemothorax, embolism/infarction, pneumonia, empyema, neoplasm, bronchiectasis, pneumomediastinum, TB, carcinomatous effusion
• Psychoneurosis
• Pain originating from skin and musculoskeletal tissues: costochondritis, chest wall trauma, fractured rib, interstitial fibrositis, myositis, strain of pectoralis muscle, herpes zoster, soft tissues and bone tumors 
• GI: liver abscess, pancreatitis, esophageal rupture, Whipple’s disease with associated pericarditis or pleuritis
• Familial Mediterranean fever
• Collagen-vascular diseases with pleuritis
• Cardiac: pericarditis, postpericardiotomy/Dressler’s syndrome
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of  Cholangitis
• Right kidney stone
• Pyelonephritis
• Peptic ulcer disease (PUD)
• Pancreatitis
• Liver abscess
• Intestinal obstruction
• Hepatitis
• Biliary colic
• Acute cholecystitis
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Cholecystitis
• Biliary: neoplasm, stricture
• Cardiac: myocardial ischemia (particularly involving the inferior wall), pericarditis
• Cutaneous: herpes zoster
• Dissecting aneurysm
• Fitz-Hugh–Curtis syndrome (perihepatitis)
• Gastric: peptic ulcer disease (PUD), neoplasm, alcoholic gastritis, hiatal hernia
• Hepatic: hepatitis, abscess, hepatic congestion, neoplasm, trauma
• Intestinal: retrocecal appendicitis, intestinal obstruction, high fecal impaction
• Nerve root irritation caused by osteoarthritis of the spine
• Pancreatic: pancreatitis, neoplasm, stone in the pancreatic duct or ampulla
• Pulmonary: pneumonia, pulmonary infarction, right-sided pleurisy
• Renal: calculi, infection, inflammation, neoplasm, ruptured kidney
• Subphrenic abscess
• Trauma
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Cholelithiasis
• Peptic ulcer disease (PUD)
• Pancreatitis
• Nonulcer dyspepsia
• Neoplasms
• Irritable bowel syndrome
• Inflammatory bowel disease (IBD)
• Gastroesophageal reflux disease (GERD)
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Cholestasis
• α1-Antitrypsin deficiency
• Viral hepatitis
• Total parenteral nutrition
• Sarcoid
• Primary sclerosing cholangitis
• Primary sclerosing cholangitis
• Primary biliary cirrhosis
• Postoperative
• Portal lymphadenopathy
• Parasites (e.g., Ascaris, Clonorchis sinensis)
• Papillary stenosis
• Pancreatic carcinoma
• Mirizzi’s syndrome
• Lymphoma
• Intrahepatic
• Extrahepatic
• Ductopenia syndromes
• Drug induced
• Chronic pancreatitis
• Choledocholithiasis
• Choledochal cysts
• Cholangiography
• Cholangiocarcinoma
• Byler’s disease
• Biliary atresia
• Bile duct stricture
• Benign recurrent intrahepatic cholestasis
• Ampullary cancer
• Alcoholic hepatitis
• Alagille’s syndrome
• AIDS
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Chorea
• Wilson’s disease
• Vitamin B12 deficiency
• Thyroid disorder (hyperthyroidism, hypothyroidism)
• Systemic lupus erythematosus (SLE)
• Mercury poisoning
• Medications (e.g., neuroleptics, tricyclics, antiparkinsonian drugs)
• Hypoglycemia, hyperglycemia
• Huntington’s disease
• Friedreich’s ataxia
• Electrolyte abnormalities (hyponatremia, hypocalcemia, hypomagnesemia, hypernatremia)
• Cocaine
• Cerebral palsy
• Carbon monoxide poisoning
• Benign hereditary chorea
• Ataxia-telangiectasia
• Alcohol
Picture
Published on
​Symptoms and Signs – Differential Diagnosis of Choreoathetosis
SYSTEMIC DISEASES
• Systemic lupus erythematosus (SLE)
• Polycythemia
• Thyrotoxicosis
• Rheumatic fever
• Cirrhosis of the liver (acquired hepatocerebral degeneration)
• Diabetes mellitus (DM)
• Wilson’s disease
PRIMARY DEGENERATIVE BRAIN DISEASES
• Huntington’s chorea
• Olivopontocerebellar atrophies
• Neuroacanthocytosis
FOCAL BRAIN DISEASES
• Hemichorea
• Stroke
• Tumor
• Arteriovenous malformation
DRUG-INDUCED CHOREOATHETOSIS
• Parkinson’s disease drugs: levodopa
• Epilepsy drugs: phenytoin, carbamazepine, phenobarbital, gabapentin, valproate
• Psychostimulant drugs: cocaine, amphetamine, methamphetamine, dextroamphetamine, methylphenidate, pemoline, psychotropic drugs, lithium, tricyclic antidepressant drugs
• Oral contraceptive drugs: cimetidine
Picture

Kembara Xtra 

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