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Symptoms and Signs – Differential Diagnosis of Factitious Disorder
• Somatoform disorders or hypochondriasis: these disorders are produced unconsciously and are not intentionally produced.
• Self-injurious behavior is common in many other psychiatric conditions; in those conditions, the patients confess the intentional self-harm and describe motivating factors. The main intent is the self-harm and not to attain the patient role, as occurs in factitious disorder.
• Munchausen by proxy: a mother (86% of time) or other caregiver induces illness in a child (52% between the ages of 3 and 13 years) for the purpose of obtaining medical attention or some other psychological need. Mothers often have a history of somatoform, factitious, or personality disorder themselves.
• Malingering: falsifying an illness for a clear secondary gain (e.g., financial gain or avoidance of unwanted duties)
• Somatoform disorders or hypochondriasis: these disorders are produced unconsciously and are not intentionally produced.
• Self-injurious behavior is common in many other psychiatric conditions; in those conditions, the patients confess the intentional self-harm and describe motivating factors. The main intent is the self-harm and not to attain the patient role, as occurs in factitious disorder.
• Munchausen by proxy: a mother (86% of time) or other caregiver induces illness in a child (52% between the ages of 3 and 13 years) for the purpose of obtaining medical attention or some other psychological need. Mothers often have a history of somatoform, factitious, or personality disorder themselves.
• Malingering: falsifying an illness for a clear secondary gain (e.g., financial gain or avoidance of unwanted duties)
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Symptoms and Signs – Differential Diagnosis of Failure to Thrive
MALABSORPTION
• Cow’s milk protein allergy
• Cystic fibrosis (CF)
• Celiac disease
• Biliary atresia
INSUFFICIENT CALORIE INTAKE
• Parental neglect
• Feeding difficulties (CNS lesion, severe reflux, oromotor
abnormalities)
• Use of diluted formula preparation
• Food shortage (poverty)
INCREASED NEEDS
• Hyperthyroidism
• Congenital heart defects
• Malignant disease
• Renal or hepatic disease
• HIV infection
IMPROPER UTILIZATION
• Storage disorders
• Amino acid disorders
• Trisomy 13, 21, 18
MALABSORPTION
• Cow’s milk protein allergy
• Cystic fibrosis (CF)
• Celiac disease
• Biliary atresia
INSUFFICIENT CALORIE INTAKE
• Parental neglect
• Feeding difficulties (CNS lesion, severe reflux, oromotor
abnormalities)
• Use of diluted formula preparation
• Food shortage (poverty)
INCREASED NEEDS
• Hyperthyroidism
• Congenital heart defects
• Malignant disease
• Renal or hepatic disease
• HIV infection
IMPROPER UTILIZATION
• Storage disorders
• Amino acid disorders
• Trisomy 13, 21, 18
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Symptoms and Signs – Differential Diagnosis of Fatigue
pulmonary disease (COPD), liver disease
antihistamines, clonidine, methyldopa)
• Viral or bacterial infections
• Sleep apnea syndrome
• Renal failure, congestive heart failure (CHF), chronic obstructive
• Prolonged physical activity
• Pregnancy and postpartum period
• Medications (β-blockers, anxiolytics, antidepressants, sedating
• Inadequate sleep
• Hypothyroidism
• Dieting
• Depression
• Anxiety, emotional stress
• Anemia
pulmonary disease (COPD), liver disease
antihistamines, clonidine, methyldopa)
• Viral or bacterial infections
• Sleep apnea syndrome
• Renal failure, congestive heart failure (CHF), chronic obstructive
• Prolonged physical activity
• Pregnancy and postpartum period
• Medications (β-blockers, anxiolytics, antidepressants, sedating
• Inadequate sleep
• Hypothyroidism
• Dieting
• Depression
• Anxiety, emotional stress
• Anemia
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Symptoms and Signs – Differential Diagnosis of Fatty Liver
• Wilson’s disease
• Reye’s syndrome
• Obesity
• Nonalcoholic steatosis
• Medications (e.g., tetracycline, amiodarone, estrogen, methotrexate)
• Diabetes mellitus (DM)
• Alcohol abuse
• Acute fatty liver of pregnancy
• Wilson’s disease
• Reye’s syndrome
• Obesity
• Nonalcoholic steatosis
• Medications (e.g., tetracycline, amiodarone, estrogen, methotrexate)
• Diabetes mellitus (DM)
• Alcohol abuse
• Acute fatty liver of pregnancy
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Symptoms and Signs – Differential Diagnosis of Fatty Liver of Pregnancy
• Systemic lupus erythematosus (SLE)
• Reye’s syndrome
• Preeclampsia or eclampsia with liver involvement
• Intrahepatic cholestasis of pregnancy
• Hemolytic-uremic syndrome (HUS)
• Hemolysis, elevated liver enzyme levels, and low platelet count
• Gallbladder disease
• Fulminant hepatitis
• Drug-induced hepatitis caused by halothane, phenytoin, methyldopa, isoniazid, hydrochlorothiazide, or tetracycline
• Budd-Chiari syndrome
• Acute viral hepatitis
• Acute gastroenteritis,(HELLP) syndrome
• Systemic lupus erythematosus (SLE)
• Reye’s syndrome
• Preeclampsia or eclampsia with liver involvement
• Intrahepatic cholestasis of pregnancy
• Hemolytic-uremic syndrome (HUS)
• Hemolysis, elevated liver enzyme levels, and low platelet count
• Gallbladder disease
• Fulminant hepatitis
• Drug-induced hepatitis caused by halothane, phenytoin, methyldopa, isoniazid, hydrochlorothiazide, or tetracycline
• Budd-Chiari syndrome
• Acute viral hepatitis
• Acute gastroenteritis,(HELLP) syndrome
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Symptoms and Signs – Differential Diagnosis of Felty’s Syndrome
• Drug reaction
• Myeloproliferative disorders
• Lymphoma/reticuloendothelial malignant neoplasms
• Hepatic cirrhosis with portal hypertension
• Sarcoidosis
• TB
• Amyloidosis
• Chronic infections
• Drug reaction
• Myeloproliferative disorders
• Lymphoma/reticuloendothelial malignant neoplasms
• Hepatic cirrhosis with portal hypertension
• Sarcoidosis
• TB
• Amyloidosis
• Chronic infections
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Symptoms and Signs – Differential Diagnosis of Femoral Neck Fracture
• Osteoarthritis of hip
• Pathologic fracture
• Lumbar disk syndrome with radicular pain
• Insufficiency fracture of pelvis
• Osteoarthritis of hip
• Pathologic fracture
• Lumbar disk syndrome with radicular pain
• Insufficiency fracture of pelvis
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Symptoms and Signs – Differential Diagnosis of Fetal Alcohol Syndrome
• Williams syndrome
• Velocardiofacial syndrome
• Toluene embryopathy
• Syndromes with overlapping features of FAS
• Other causes of symmetric growth retardation including
• Maternal phenylketonuria
• Fetal anticonvulsant syndrome
• Dubowitz syndrome
• Cornelia de Lange syndrome
• Aneuploidy (T21, T18, T13), intrauterine infection and aneuploidy
• Williams syndrome
• Velocardiofacial syndrome
• Toluene embryopathy
• Syndromes with overlapping features of FAS
• Other causes of symmetric growth retardation including
• Maternal phenylketonuria
• Fetal anticonvulsant syndrome
• Dubowitz syndrome
• Cornelia de Lange syndrome
• Aneuploidy (T21, T18, T13), intrauterine infection and aneuploidy
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Symptoms and Signs – Differential Diagnosis of Episcleritis
• Subconjunctival hemorrhage
• Scleritis
• Conjunctivitis
• Congenital or lymphoid masses
• Acute glaucoma
• Subconjunctival hemorrhage
• Scleritis
• Conjunctivitis
• Congenital or lymphoid masses
• Acute glaucoma
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Symptoms and Signs – Differential Diagnosis of Epistaxis
• Trauma
• Systemic disorders (hypertension, uremia)
• Rhinitis
• Nasal polyps
• Nasal polyps
• Medications (nasal sprays, nonsteroidal anti-inflammatory drugs [NSAIDs], anticoagulants, antiplatelets)
• Local neoplasms (benign and malignant)
• Infections
• Foreign body
• Desiccation
• Cocaine use
• Coagulopathy (hemophilia, liver disease, disseminated intravascular coagulation [DIC], thrombocytopenia)
• Anatomic malformations
• Trauma
• Systemic disorders (hypertension, uremia)
• Rhinitis
• Nasal polyps
• Nasal polyps
• Medications (nasal sprays, nonsteroidal anti-inflammatory drugs [NSAIDs], anticoagulants, antiplatelets)
• Local neoplasms (benign and malignant)
• Infections
• Foreign body
• Desiccation
• Cocaine use
• Coagulopathy (hemophilia, liver disease, disseminated intravascular coagulation [DIC], thrombocytopenia)
• Anatomic malformations
