French's Index of Differential Diagnosis, 15th Edition by Mark Kinirons, Harold Ellis

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By Mark Kinirons, Harold Ellis

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Extra resources for French's Index of Differential Diagnosis, 15th Edition

Example text

Within this list, there are several conditions that merit further discussion. Hyperthyroidism is justifiably the best-known differential diagnosis, first because the state of metabolic overactivity induced by thyroxine is in many respects similar to primary anxiety, and second because anxiety is a common emotional presentation of the disorder. Symptoms that point towards hyperthyroidism are increased cold tolerance, increased appetite and significant weight loss, while distinguishing signs (in addition to the classical findings in the eye and neck) are warm extremities and fine (versus coarse) finger tremor.

Larger cavernous lesions, especially on the lower lips, are common in old age (venous lakes). Small angiomas surmounted by a variable amount of hyperkeratosis (angiokeratoma) (Fig. 21) are common on the scrotum (angiokeratomas of Fordyce), but also occur scattered in the bathing trunk area in the extremely rare Anderson–Fabry disease (alpha-galactosidase deficiency) (Fig. 22). This X-linked recessive disorder is a condition in which the diagnosis is often delayed due to the inconspicuous nature of the angiokeratomas, but it is important to recognize because renal and vascular involvement can lead to early death.

APPETITE, DISORDERS OF John Meenan and Mark Kinirons accompanying physical abnormalities in the patient with established anorexia nervosa. These include amenorrhoea, osteoporosis, abnormal temperature regulation, bradycardia and hypotension, decreased glomerular filtration rate, renal calculi, oedema, constipation, and abnormality of liver biochemistry. The patient will become anaemic with leucopenia and thrombocytopenia. Loss of appetite Loss of appetite is so common and non-specific that its presence is rarely of assistance in making a diagnosis.

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