Veterinary Medicine - Differential Diagnosis Lists Flashcards
Plural Transudate
-Congestive heart failure (Dogs usually R-CHF, Cats - Usually L-CHF). -Hypoalbuminemia. -Portal hypertension (typically post-sinusoidal).
Abdominal Transudate
-Hypoalbuminemia -Portal Hypertension (typically pre-sinusoidal)
Pleural Exudate - Septic
-Foreign body -Ruptured esophagus -Parapneumonic spread -Neoplasia (with 2nd infection) -Puncture wound (trauma, bite) -Hematogenic spread
Hyperkalemia
-Uroperitoneum (typically due to rupture of bladder / urethera / ureter) -Post-renal urinary obstruction -AKI/CKD (with CKD hypokalemia more frequentlly obsevrved) -Addison’s disease -Rhabdomyolysis -Tumor lysis syndrome -Pseudo (hemolysis/thrombus/K-EDTA) -Metabolic acidosis -Reperfusion Injury -ACE-i, K-Sparing diuretics -Loss to third spaces -Salmonellosis -Iatrogenic (over-supplementation)
Hypernatremia (increased intake)
-Salt poisoning -Iatrogenic (Hypertonic saline / NaHCO3)
Hypernatremia (pure water loss)
-Adypsia / No access to water -Diabetes Insipidus (Central/Nephrogenic) -Fever -High Environmental Temp -Burns
Hypernatremia (hypotonic fluid loss)
UNFINNISHED —Extra-Renal— -GI (vomiting, diarrhea, obstruction) -Third space losses -Cutaneous (Burns) —Renal— -Non oliguric AKI -CKD -Post-obstruction diuresis -Osmotic Diuresis (DM, Mannitol)
Hypoalbuminemia
Decreased production: -Liver failure -Negative acute phase protein Loses: -Acute bleeding -PLN -PLE -Malabsorption/Maldigestion -GI parasites -Exudative skin lesions -Burns -Vasculitis Increased consumption/ Misc.: -Addison’s disease -Lactation -Cachexia
Eosinophilia
-Hyper-sensitivity complex / allergies -Neoplasia (e.g. MCT) -Parasites -Addison’s disease Misc. *Eosinophilic Bronchopneumonia *Eosinophilic IBD
Hypocholesterolemia
-Addison’s disease -Liver failure -Protein-losing enteropathies -Lymphangiectasis -EPI -Snake envenomation -Multiple myeloma
Abdominal Exudate - Septic
-Puncture wound -GI perforation -Infected tumor -Abscess (e.g. Splenic/Hepatic/Prostatic) -Septic bile/urine -Hematogenic spread -Ruptured pyometra
Gammopathy
Monoclonal: -Neoplasia (e.g. Multiple Myeloma, Lymphoid Leukemia) -Chronic Infections (e.g. Ehrlichiosis/Leishmania/FIP) Polyclonal: -Infections (e.g. Ehrlichiosis/Leishmania) -Non-Infectious Inflammation -Neoplasia (Lymphoma)
Hypercalcemia
-Hyperparathyroidism -Addison’s Disease -Renal (CKD ) -Vitamin D toxicosis -Osteomyelitis -Neoplasia -Granuloma -Idiopathic
Neutrophilia
-Bacterial infection -Inflammation -Stress leukogram -Cushing’s disease -Leukemoid reaction -Congenital (e.g. Canine leukocyte adhesion defeciet)
Eosinophilia
-Hyper-sensitivity complex / allergies -Neoplasia (e.g. MCT) -Parasites -Addison’s disease. Misc. *Eosinophilic Bronchopneumonia *Eosinophilic IBD
Epistaxis
Systemic: -Thrombocytopenia -Thrombocytopathy -Coagulopathies -Hypertension -Hyperviscosity syndrome Local: -Foreign body -Infection/Inflammation -Neoplasia -Polyps
High Urea
-Azotemia (Dehydration/Renal/Urinary Obstruction/Urinary Tract Rupture) -High protein diet -GI bleeding -Catabolic states (e.g. Steroids, Infection, Neoplasia, Fever)
Low Urea
-Liver failure -Liver shunts -Low B12 -Low Arginine (Cat) -Low Protein Diet -Urease-producing bacteria in the blood
High ALP
-Cholestasis (hepatobiliary pathologies, pancreatitis, duodenal papillary obstruction) *Common in cats - Hepatic lipidosis -Animals during their bone development period -Drugs (e.g. Steroids (Dog), Phenobarbital -Endocrine diseases (e.g. DM, Cushing’s disease, Hypothyroidism, Addison’s disease) -Osteopathies
Hyperphosphatemia
-AKI/CKD -Urinary obstruction -Uroperitoneum -Vitamin D toxicosis -Hypoparathyroidism -Animals during their bone development period -Acidosis -Phosphate enema. Rare causes: -Rhabdomyolysis -Tumor Lysis Syndrome -Hemolysis
Hypophosphatemia
Translocation: -Alkalosis -Refeeding syndrome -Insulin administration. Increased Loss: -Hyperparathyroidism -Eclampsia -Renal tubular disorders. Decreased GI Absorption: -Vitamin D Deficiency -Phosphate Binders -Dietary Deficiency
Abdominal Transudate
-Foreign body. -Ruptured esophagus. -Parapneumonic spread. -Neoplasia (with 2nd infection). -Puncture wound (trauma, bite). -Hematogenic spread.
Hypophosphatemia
Translocation: -Alkalosis -Refeeding syndrome -Insulin administration. Increased Loss: -Hyperparathyroidism -Eclampsia -Renal tubular disorders. Decreased GI Absorption: -Vitamin D Deficiency -Phosphate Binders -Dietary Deficiency
Hypocalcemia
Common: -Hypoparathyroidism -Eclampsia -Hypoalbuminemia -AKI/CKD -Pancreatitis -Ethylene glycol toxicity. Less Common: -Rhabdomyolysis (Hyperphosphatemia) -Tumor Lysis Syndrome (Hyperphosphatemia) -Dietary -Hypo-Vitaminosis D
Thrombus Formation
-IMHA -Pancreatitis -Cushing’s Disease / Steroid Administration -Neoplasia -PLN / PLE -HCM/HOCM -SIRS/Sepsis -Hypothyroidism -Liver disease -long recumbency
Pu/ Pd
Endocrine: -Hyperthyroidism -Diabetes Miletus -Diabetes Insipidus -Cushing’s Disease / Steroids -Addison’s Disease (Rare). Renal: -CKD -Pyelonephritis / Leptospira / Pyometra -Tubular Disorders -Post Obstructive Diuresis. Electrolytes: -Hypercalcemia -Hypokalemia -Hypernatremia. Liver Failure.
Hemoptysis
Systemic causes: -Thrombocytopenia -Thrombocytopathy -Decrease in coagulation factors Local causes: -Foreign body -Lung contusion -Infection -Inflammation -Cardiogenic/Non-Cardiogenic Edema -Neoplasia
Thrombocytopenia
Platelet destruction: -Infections (e.g. Babesia, Ehrlichiosis, Leishmaniasis, Anaplasmosis, Hepatozoonosis) -IMT (Primary/Secondary). Consumption: -Bleeding/Vasculitis/DIC. Decreased production (e.g. Myelophthisis, Myelofibrosis, Myelotoxicity). Splenic sequestration
Hypocoagulation
-Hemophilia -Specific Factor Deficiencies -Liver Failure -Rodenticides -DIC -SIRS/Sepsis -Snake Venom -EPI -Lymphangiectasis
Pancytopenia
-Chronic Ehrlichiosis, FeLV -Bone marrow neoplasia -Druga (e.g. TMS, Phenobarbital) -Estrogen treatment / Sertoli cell tumor -Chemotherapy
Thrombocytopenia
Platelet destruction: -Infections (e.g. Babesia, Ehrlichiosis, Leishmaniasis, Anaplasmosis, Hepatozoonosis) -IMT (Primary/Secondary). Consumption: -Bleeding/Vasculitis/DIC. Decreased production (e.g. Myelophthisis, Myelofibrosis, Myelotoxicity). Splenic sequestration
Dysbiosis
Achlorhydria: -PPI administration -Atrophic gastritis. EPI. Motility dysfunction: -Ileus -Partial Obstruction (e.g. Intussusception, Neoplasia). Mucosal Disease: -Chronic inflammatory enteropathies -Infectious enteritis -Lymphangiectasis -Neoplasia
Diarrhea (Extra GI)
-Endocrinopathies: (Addison’s Disease, Hyperthyroidism, DKA ). -Pancreas: Pancreatitis, EPI. -Liver failure / Cholestasis. -Renal (usually only due to severe uremia). -Ileus. -Drugs/ Toxins (e.g. Organic Phosphates). -R-CHF / Portal Hypertension
Diarrhea (Extra GI)
-Endocrinopathies: (Addison’s Disease, Hyperthyroidism, DKA ). -Pancreas: Pancreatitis, EPI. -Liver failure / Cholestasis. -Renal (usually only due to severe uremia). -Ileus. -Drugs/ Toxins (e.g. Organic Phosphates). -R-CHF / Portal Hypertension
Diarrhea (Intra GI - Acute)
-Garbage Intoxication. -Dietary change / Hypersensitivity / Intolerance. -Infections: Viral (Rota, Noro, Corona., AdenoV / Parvo, Distemper, FIV, FelV, FIP) / Protozoa (Giardia, Coccidia, Cryptosporidium), Bacterial (E.Coli, Campylobacter, Salmonella, Clostridium), Helminths (Ascarids - Toxocara/Toxocaris, Anchylosotoma). -GI Accidents: Intussusception (partial), Foreign body. -AHDS (HGS). -Drugs (e.g. Antibiotics).
Diarrhea (Intra GI - Chronic)
-GI parasites (e.g. worms). -Chronic inflammatory enteropathies. (Antibiotic Responsive, Food Responsive, True IBD) -Dysbiosis. -Neoplasia. -Giardia. -Lymphangiectasis. -Chronic GI accidents: Intussusception, Foreign Body.
Proteinuria
Pre-Renal: Hemoglobin, Myoglobin, Bence-Jones proteins, Cushing’s disease. Renal: Glomerulonephritis, Amyloidosis, Tubular damage / defects. Post-Renal: Inflammation (Infection, Neoplasia, Stones), Hemorrhage. **Many other systemic disease processes can cause proteinuria - which can be transient or persistent