Differential Diagnosis Flashcards
DDx of Enlarged epitrochlear lymph nodes
- Sarcoidosis
- Rheumatoid arthritis
- Leprosy
- Secondary Syphyllis
- Melanoma
- Lymphoma
- HIV
DDx of Tall Stature
- Gigantism
- Ehler’s syndrome
- Marfan syndrome
- Klinefelter’s syndrome
- Acromegaly
- Familial tall stature
- Haemocysturia
CLUBBING
Clubbing of fingers is staged according to its severity :
STAGE I - increased sponginess of the nail fold.
STAGE II - obliteration of the angle between the nail and the nail fold.
STAGE III - increased convexity of the nail in both directions longitudinally and transversely. Schamroth’s window test
STAGE IV - Bulbous swelling of the distal end of the finger.
Stage V- hypertrophic osteoarthrophathy
Exophthalmus (Bulging of the eyes)
Hyperthyroidism
Clubbing of alimentary canal
-malabsorption syndrome,
-cirrhosis of the liver
-hepatoma or hepatocellular carcinoma
-ulcerative colitis causes inflammation or ulcers of the git
-Crohn’s disease refers to form of inflammatory bowel disease that causes inflammation of a part of the git
- abdominal Tuberculosis
-GI lymphomas
-celiac sprue or disease
MCHUC2GA
DDX of Xanthelasma
- Chronic cholestasis in primary biliary cirrhosis
- Dyslipidemia
-hypertriglyceridemia - hyperlipidemia
-paraproteinemia - myeloma
- lymphoid malignancy
CDH2PML
Skin, nails and hands in git
- Spider naevi small telangiectatic superficial blood vessels on the chest and face
- Leukonychia (Chronic liver disease)
Palmar erythema on the thenar and hypothenar eminences - Bruising
- Dupuytren’s contracture can occur in the absence of liver disease mainly occurs in chronic liver disease
- Scratch marks particularly in cholestatic liver disease, obstructive jaundice
Endocrine due to excess oestrogens
- Gynaecomastia
- Testicular atrophy
- Loss of axillary and pubic hair
- painful sex due to lack of vagina lubrication
- irregular or absent period
- hot flushes
- breast tenderness
- infertility in males
Other stigmata in git
- Parotid swelling particularly in alcohol
- Hepatic fetor characteristic sweet smell from the mouth related liver disease smelling breath
- Hepatic flap a sign of encephalopathy and advanced diseased
1) looks Younger than stated age
2) looks Older than stated age
1) Hypopituitarism Endomyocardial fibrosis Cystic fibrosis Juvenile Diabetes Mellitus (Type 1) Sickle cell disease
2) Pituitary rumor
Anarsaca
Causes liver failure (cirrhosis) kidney failure right-sided heart failure severe malnutrition, especially in cases of a protein deficiency allergic reactions
- Skin that will show simple after you press a finger onto it for several seconds
- skin that looks shiny and stretched
- swollen face thereby impairing one’s vision since it will be difficult to open the eyes
- liver is difficult to palpate due to large amount of ascites present but if palpable the liver is enlarged
- Elevated jugular venous pressure
Marfan syndrome in relation to CVS
This is a connective tissue disorder
The most common of these problems affects the aorta, the main blood vessel carrying blood from the heart to the rest of the body. Heart valves can also have problems.
- Aortic dilation
- Dissecting aorta
- Mitral valve prolapse
- Aortic regurgitation
People with Marfan syndrome are tall and thin with long arms, legs, fingers and toes
Pain areas: in the back due to dissection aorta
Heart: mitral valve prolapse or murmur, aortic regurgitation
Mouth: abnormally raised roof of the mouth or crowded teeth
Visual: blurred vision or nearsightedness
Chest: bulging chest or sunken chest
Also common: disproportionately long arms and legs, fatigue, flat feet, joint hypermobility syndrome, pneumothorax, scoliosis, small pupil, spider fingers, stretch marks, or tall and slender build
Risk of heart defects in Turner syndrome which affects only females and is related to a missing or partially missing X chromosome
The risk of congenital heart defects such as
bicuspid aortic valves,
aortic coarctation,
septal defect increased.
aortic dissection at a young age is increased, as is the risk of hypertension, ischemic heart disease, and stroke
DDx of anemia caused by not having enough Hb and oxygen in you RBC you turn pale
Hookworm infestation Malaria Lead poisoning Systemic lupus erythematous Thalassemia syndrome: less Hb than normal Sickle cell anemia Unstable haemoglobins Hypersplenism
Peripheral cyanosis
CR DMed PC2VS
- Cold exposure
- Raynaud’s phenomenon: This condition causes small blood vessels to narrow in response to cold or stress, leading to cyanosis primarily in the fingers and toes.
- DVT
- medications such as beta blockers
- Peripheral Artery disease: buildup of plaque in the peripheral arteries can decrease blood flow to the extremities, causing cyanosis.
- congestive heart failure Although this condition primarily causes central cyanosis due to poor oxygenation of blood in the lungs, it can also lead to peripheral cyanosis, especially if there is accompanying peripheral vasoconstriction or cold exposure.
- COPD
- venous insufficiency: Inability of the veins to adequately return blood to the heart can lead to blood pooling in the extremities, resulting in cyanosis.
Shock
Temperature and moisture
Cold and sweaty-anxiety, ď‚®Cold and dry-raynauds phenomenomen,congestive heart failureď‚®Hot and sweaty-hyperthyroidismď‚®Dry coarse skin-hypothyrodism
1) Older nodes( tender papules found on the pulp of the finger)
2) Janeway lesions( non tender erythematous macules found on the palm of the hand)
1) - Infective endocarditis
- Systemic lupus erythematous
- typhoid fever
- gonococcal infections
- haemolytic anaemia
Glasgow Coma Scale
Talks about the level of consciousness of the individual when he or she gets a traumatic brain injury
Divided into Motor, Vision and Verbal
Eye opening scores See the list below: 4: Spontaneously 3: To verbal command 2: To pain 1: No response
Motor scores
6: Obeys command
5: Localizes pain
4: Flexion withdrawal
3: Flexion abnormal (decorticate)
2: Extension (decerebrate)
1: No response
Verbal Response
- Well oriented to time and place and person
- Confused conversation
- Inappropriate words
- Incomprehensible sounds like groans, grunts
- Absence of speech
DDx of unconsciousness
Neurologic ::- Meningitis
- Encephalitis
- head trauma
- stroke
- epilepsy
- orthostatic or postural hypertension
- brain hypoxia
- tetralogy of fallot
- endomyocardial fibrosis
Metabolic: - low blood sugar
- low blood pressure
- dehydration
- drug poisoning
- alcohol intoxication
DDx of clubbing cvs
~~~
- cyanotic congenital disease:
.Tetralogy of fallot
. Transposition of the great vessels
. Truncus arteriosus
. Tricuspid atresia
. Total anomalous pulmonary venous return
- atrial myxoma
- Infective endocarditis
- endomyocardial fibrosis
Where will you see wasting
- Dorsal interrossei
- wasting of the thernar and hypotherna eminences
- head of the humerus
- biceps
- triceps
- prominent temporalis muscle
- prominent zygomatic bone
- prominent intercostal spaces
- sunken supraclavicular fossa
- bony pelivic landmark
DDx of generalized wasting
External
Malignancy via release of cytokines to cause Cachexia
- infection such as TB, HIV
By yourself
- anorexia nervousa
-malabsorption
- liver disease due to not able to absorb nutrients
- chronic kidney disease due to breakdown of protein muscle
- post gastroectomy syndrome
Hormones
- Addison disease decreased production of hormone levels
- thyrotoxicosis since body burns more energy while it is at rest
DDx of bilateral Anosmia ( loss of sense of smell)
11
- COVID-19 Head - upper respiratory tract infection - tumors of ethmoid bone - head trauma - subfrontal meningioma Done by you - smoking -old age Dx - Parkinson’s disease - Huntington’s disease: genetic dx in which nerve cell in the brain breakdown over time - multiple sclerosis: immune system eats away protective covering of nerves - Kallman syndrome delayed puberty
Unilateral anosmia
2
- subfrontal meningioma
- mucous blocked nostril
Shortening of the metacarpals of the ring and little finger
Pseudohypoparathytoidism
