DIFFERENTIAL DIAGNOSIS Flashcards

1
Q

What is the pathophysiological cause of renal pain?

A

Distension of the renal capsule due to obstruction or inflammation.

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2
Q

How might renal pain differ in character between obstruction and inflammation?

A

Obstruction - colicky pain as ureteric peristalsis increases renal pelvic pressure

Inflammation - steady pain

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3
Q

What is the differential diagnosis for flank pain?

A

Obstructive:

Obstruction of ureteropelvic junction
Renal stones
Tumours
Schistosomiasis
Renal clots (iatrogenic)
Papillary necrosis
Retroperitoneal fibrosis

Inflammation:

Pyelonephritis
Renal abscess
Papillary necrosis
Polycystic kidney disease
Acute renal infarct

Non-renal:

AAA
Pneumonia
Musculoskeletal

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4
Q

How much fluid needs to build up in the bladder before pain is felt as a result of retention?

A

This is not dependent on volume but more on timescale. Slowly progressive obstruction causing chronic retention is painless despite residuals of over 1 litre.

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5
Q

What is the differential diagnosis for bladder pain?

A

Interstitial cystitis

UTI

Bladder cancer

Acute retention

Renal stones

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6
Q

What is the differential diagnosis for testicular pain?

A

Acute:

Epididymo-orchitis
Testicular torsion
Trauma
Mumps

Chronic:

Varicocele
Spermatocele
Testicular cancer
Benign testicular masses
Retractile testicle
Cryptorchidism (undescended testicle)
Hydrocele
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7
Q

How do we split up the causes of haematuria?

A

Innocent (pseudohaematuria)

Pre-renal

Renal

Post-renal - Ureteric / Bladder / Prostatic / Urethral

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8
Q

What are the innocent causes of apparent haematuria?

A

Haemoglobinuria

Myoglobinuria

Menstruation

Sexual intercourse

Acute intermittent porphyria

Beetroot, blackberries, rhubarb

Drugs: nitrofurantoin, senna, rifampicin, chloroquine and doxorubicin

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9
Q

What are the pre-renal causes of haematuria?

A

Bleeding diathesis

Atrial fibrillation - warfarin therapy and embolism

Infective endocarditis

Scurvy

Purpura

Leukaemia

Thrombocytopenia

Haemophilia

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10
Q

What are the renal causes of haematuria?

A

IgA nephropathy

Glomerulonephritis

Polyarteritis nodosa

Goodpasture’s syndrome

Acute pyelonephritis

Polycystic kidney disease

Haemolytic uremic syndrome

Alport’s syndrome

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11
Q

What are ureteric causes of haematuria?

A

Calculus

Carcinoma

Papilloma

Schistosomiasis

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12
Q

What are the bladder related causes of haematuria?

A

Cancer

Calculus

Cystitis

Injury

Purpura

Schistosomiasis

Ketamine

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13
Q

What are the prostatic causes of haematuria?

A

BPH

Cancer

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14
Q

What are the urethral causes of haematuria?

A

Acute urethritis

Calculus

Injury

Carcinoma

Papilloma

Urethral meatal ulcer

Foreign body

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15
Q

What is a good question to ask in the history to rule out organic causes of erectile dysfunction?

A

Early morning erections

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