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​Symptoms and Signs – Differential Diagnosis of Coma
• Vascular: hemorrhage, thrombosis, embolism
• Uremia
• Postictal
• Metabolic disturbances
• Ingestion or inhalation of toxins: carbon monoxide (CO), alcohol, lead
• Hypoxia
• Hypothyroidism
• Hypothermia, hyperthermia
• Hypotension, malignant hypertension
• Hypoglycemia, hyperglycemia
• Hepatic failure
• Head injury: subdural hematoma, cerebral concussion, cerebral contusion
• Electrolyte disorders
• Drugs: narcotics, sedatives, hypnotics
• CNS infections: meningitis, encephalitis, cerebral abscess
• Cerebral neoplasms with herniation
• Acid-base disorders
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​Symptoms and Signs – Differential Diagnosis of Coma with  Normal Computed Tomography
MENINGEAL DISORDERS
• Subarachnoid hemorrhage (uncommon)
• Bacterial meningitis
• Encephalitis
• Subdural empyema
EXOGENOUS TOXINS
• Sedative drugs and barbiturates
• Anesthetics and γ-hydroxybutyrate*
• Alcohols
• Stimulants
• Phencyclidine†
• Cocaine and amphetamine‡
• Psychotropic drugs
• Cyclic antidepressants
• Phenothiazines
• Lithium
• Anticonvulsants
• Opioids
• Clonidine§
• Penicillins
• Salicylates
• Anticholinergics
• Carbon monoxide (CO), cyanide, and methemoglobinemia
ENDOGENOUS TOXINS, DEFICIENCIES, OR
DERANGEMENTS
• Hypoxia and ischemia
• Hypoglycemia
• Hypercalcemia
• Osmolar
• Hyperglycemia
• Hyponatremia
• Hypernatremia
• Organ system failure
• Hepatic encephalopathy
• Uremic encephalopathy
• Pulmonary insufficiency (carbon dioxide narcosis)
SEIZURES
• Prolonged postictal state
• Spike-wave stupor
HYPOTHERMIA OR HYPERTHERMIA
• Brainstem ischemia
• Basilar artery stroke
• Brainstem or cerebellar hemorrhage
• Conversion or malingering
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​Symptoms and Signs – Differential Diagnosis of Coma in Pediatric Cases 
ANOXIA
• Birth asphyxia
• Carbon monoxide (CO) poisoning
• Croup/epiglottitis
• Meconium aspiration
INFECTION
• Hemolysis
• Blood loss
• Hydrops fetalis
• Meningoencephalitis
• Sepsis
• Postimmunization encephalitis
INCREASED INTRACRANIAL PRESSURE
• Anoxia
• Inborn metabolic errors
• Toxic encephalopathy
• Reye’s syndrome
• Head trauma/intracranial bleed
• Hydrocephalus
• Posterior fossa tumors
HYPERTENSIVE ENCEPHALOPATHY
• Coarctation of aorta
• Nephritis
• Vasculitis
• Pheochromocytoma
ISCHEMIA
• Hypoplastic left side of heart
• Shunting lesions
• Aortic stenosis
• Cardiovascular collapse (any cause)
PURPURIC CAUSES
• Disseminated intravascular coagulation
• Hemolytic-uremic syndrome
• Leukemia
• Thrombotic purpura
HYPERCAPNIA
• Cystic fibrosis
• Bronchopulmonary dysplasia
• Congenital lung anomalies
NEOPLASM
• Medulloblastoma
• Glioma of brainstem
• Posterior fossa tumors
DRUGS/TOXINS
• Maternal sedation
• Alcohol
• Any drug
• Lead
• Salicylism
• Arsenic
• Pesticides
ELECTROLYTE ABNORMALITIES
• Hypernatremia (diarrhea, dehydration, salt poisoning)
• Hyponatremia (syndrome of inappropriate antidiuretic hormone [SIADH], androgenital syndrome, gastroenteritis)
• Hyperkalemia (renal failure, salicylism, androgenitalism)
• Hypokalemia (diarrhea, hyperaldosteronism, salicylism, diabetic ketoacidosis [DKA])
• Hypocalcemia (vitamin D deficiency, hyperparathyroidism)
• Severe acidosis (sepsis, cold injury, salicylism, DKA)
HYPOGLYCEMIA
• Birth injury or stress
• Diabetes
• Alcohol
• Salicylism
• Hyperinsulinemia
• Iatrogenic
POSTSEIZURE
• Renal causes: nephritis, hypoplastic kidneys
• Hepatic causes: acute hepatitis, fulminant hepatic failure, inborn metabolic errors, bile duct atresia
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​Symptoms and Signs – Differential Diagnosis of Condyloma Acuminatum
• Verrucous carcinoma
• Syphilis
• Seborrheic keratosis
• Lichen planus
• Erythroplasia of Queyrat
• Dysplastic warts
• Bowenoid papulosis
• Abnormal anatomic variants or skin tags around labia minora and introitus, pearly penile papules
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​Symptoms and Signs – Differential Diagnosis of Congenital Adrenal Hyperplasia
• Addison’s disease
• Adrenocortical carcinoma
• Androgen resistance syndromes
• Leydig cell tumors
• Mixed gonadal dysgenesis
• Pituitary adenoma
• Polycystic ovary syndrome
• Precocious puberty
• Pseudohermaphroditism
• Testicular carcinoma
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​Symptoms and Signs – Differential Diagnosis of Congestive Heart Failure
• Venous occlusive disease
• Pulmonary embolism
• Pneumonia
• Nephrotic syndrome
• Hypothyroidism
• Heroin overdose
• Cirrhosis
• Chronic obstructive pulmonary disease (COPD), asthma
• Acute respiratory distress syndrome (ARDS)
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​Symptoms and Signs – Differential Diagnosis of Conjunctival Neoplasm
MALIGNANT
• Squamous cell carcinoma
• Melanoma
• Sebaceous carcinoma
• Kaposi’s sarcoma
• Metastatic neoplasms
BENIGN
• Melanocytic nevus
• Squamous papilloma
• Hemangioma
• Lymphangioma
• Myxoma
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​Symptoms and Signs – Differential Diagnosis of Constipation
• Volvulus
• Tuberculous stricture
• Strangulated femoral hernia
• Poor dietary habits: insufficient bulk in diet, inadequate fluid intake
• Painful anal conditions: hemorrhoids, fissure, stricture
• Irritable bowel syndrome, pregnancy, anorexia nervosa, depression
• Intussusception
• Intestinal obstruction
• Inflammatory bowel disease (IBD)
• Hypercalcemia or hypokalemia, uremia
• Hirschsprung’s disease, meconium ileus, congenital atresia in infants
• Hematoma of bowel wall, secondary to trauma or anticoagulants
• GI neoplasm
• Gallstone ileus
• Fecal impaction
• Drugs: codeine, morphine, antacids with aluminum, verapamil, anticonvulsants, anticholinergics, disopyramide, cholestyramine, alosetron, iron supplements
• Diverticular disease
• Decreased intestinal peristalsis: old age, spinal cord injuries, myxedema, diabetes, multiple sclerosis, parkinsonism and other neurologic diseases
• Change from daily routine: travel, hospital admission, physical inactivity
• Ameboma
• Adhesions
• Acute abdominal conditions: renal colic, salpingitis, biliary colic, appendicitis, ischemia
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​Symptoms and Signs – Differential Diagnosis of Adult Constipation 
NO GROSS STRUCTURAL ABNORMALITY
• Inadequate fiber intake
• Irritable bowel syndrome (associated with abdominal pain) or
functional constipation
• Idiopathic slow-transit constipation
• “Obstructed defecation”: pelvic floor dysfunction (or dyssynergia)
STRUCTURAL DISORDERS
• Anal fissure, infection, or stenosis
• Colon cancer or stricture
• Aganglionosis or abnormal myenteric plexus
• Hirschsprung’s disease
• Chagas’ disease
• Neuropathic pseudo-obstruction
• Abnormal colonic muscle
• Myopathy
• Dystrophia myotonica
• Systemic sclerosis
• Idiopathic megarectum or megacolon
• Proximal megacolon
NEUROLOGIC CAUSES
• Diabetic autonomic neuropathy
• Damage to the sacral parasympathetic outflow
• Spinal cord damage or disease (e.g., multiple sclerosis)
• Parkinson’s disease
• Blunting of consciousness, mental retardation, psychosis
• Pain induced by straining (e.g., sciatic nerve compression)
ENDOCRINE OR METABOLIC CAUSES
• Hypothyroidism
• Hypercalcemia
• Porphyria
• Pregnancy
PSYCHOLOGICAL DISORDERS
• Depression
• Anorexia nervosa
• Denied bowel habit
DRUG SIDE EFFECTS
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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.