abdomen, pain
| Dysentery | Colicky. |
| Food poisoning |
| Leukaemia, myeloid chron | 10% |
| Mononucleosis |
| Mumps | Obscure: may be pancreatitis or oophoritis. |
| Peptic ulcer | Some have pain even after the ulcer is healed. |
| Polyarteritis nodosa | GI tract 20%. |
| Hyperthyroidism |
| Hypothyroid, atrophic |
| SLE | 50%. |
| Hypopituitary | Luteinizing Hormone (LH) deficiency. |
| Anaemia, haemolytic | See general symptoms. |
| Anaemia, iron deficiency | General symptoms of anaemia. |
| Anaemia, pernicious Addi | General symptoms of anaemia. |
| Anaemia, sickle-cell | Chronic. |
| Takayasu's disease |
| Thalassaemia | Profound hypochromic. |
| Telangiectasia, heredita | Occult gastro-intestinal bleeding. |
| pain, chest | Dissecting or dilating aortic. |
| anaemia |
| Hyperthyroidism |
| pain, chest | Myocardial ischaemia. |
| Takayasu's disease |
| oedema | Pitting. Heart failure. |
| Cranial arteritis |
| Hyperparathyroid |
| Hyperthyroidism |
| Leukaemia, myeloid chron | 12% |
| Mononucleosis |
| Rheumatoid | May precede the onset of articular symptoms by weeks or months. |
| Weil's disease |
| Hypopituitary | Growth Hormone (GH) deficiency (from lack of hypothalmic GnRH?). Produces few obvious symptoms in the adult. Youths: poor genital organ development. |
| Anaemia, haemolytic | Glucose-6-phosphate dehydrogenase deficiency. |
| Threadworm | Especially at night. |
| Hypoglycaemia | Autonomic. |
| pain, chest |
| Hyperthyroidism |
| Hypopituitary | Thyroid Stimulating Hormone (TSH) deficiency causing secondary hypothyroidism (without frank myxoedema of primary hypothyroidism). |
| Pneumonia, pneumococcal | Accompanies fever. |
| oedema | Nephrotic syndrome. Confirmed by proteinuria. See also liver disease and protein-losing enteropathy. |
| Polyarteritis nodosa | 50%. Joint disease 70%. |
| Henoch-Schonlein | A or more joints for a few days at a time lasting < 3 months. |
| Mediterranean fever | Inflammatory. Episodic. |
| Polyarteritis nodosa | 20%. Joint disease 70%. |
| Polychondritis | Sero-negative. |
| SLE | May begin during pregnancy. Commonest presenting features. |
| Gout |
| Mixed Disease (MCTD) | Mild. |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Stroke, infarction | TIA and stroke. |
| Epilepsy |
| Ankylosing spondylosis | Low back pain. |
| Ankylosing spondylosis | Recurring episodes sometimes radiating to the buttocks or thighs. |
| Polycythaemia, primary p |
| Anaemia, haemolytic | Aplastic anaemia: especially in the skin and mucous membranes. |
| Lymphoma, non-Hodgkin's | Waldenstrom's macroglobulinaemia. |
| Thrombocytopenia |
| Stroke, infarction | TIA: transient monocular blindness. |
| Bullous diseases | Pemphigus, pemphigoid, dermatitis herpetiformis. Pemphigus: middle age, poor health; trunk, flextures and scalp, mouth blisters common. Superficial and flaccid. Pemphigoid: old, health good; often flextural. Tense and blood-filled. Dermatitis herpetiformis: primarily adults, itchy; elbows, knees, upper back, buttocks. Small, excoriated, and grouped. Gluten-free diet. |
| Hyperparathyroid | Osteitis fibrosa: bone pain, tenderness, fracture, and deformity. |
| Lymphoma, myeloma | Bone erosion due to stimulation of osteoclasts. |
| Osteomyelitis | Severe at site of bone infection. Tuberculous osteomyelitis affects the elderly usually centering on the spine. |
| Osteonecrosis | Present at rest and worse at night. |
| Paget's disease | Of a deep, aching nature aggravated by weight bearing. Unrelieved by posture or rest. |
| Hyperparathyroid | Usually of the mandible due to an isolated cyst. |
| Diabetes mellitus | Deep and sighing. Fetid and sickly sweet. |
| anaemia | On exertion. |
| Asthma | On exertion. |
| Bronchial carcinoma | Rapid development of a large pleural effusion leading to dyspoea and stridor. |
| Bronchitis | Especially in morning. |
| Heart failure | Pulmonary oedema due to left heart failure. |
| Leukaemia, myeloid chron | 21% |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Pneumonia, bronchopneumo |
| Leukaemia, myeloid chron | 7% |
| Thrombocytopenia |
| Calcium phosphate |
| Gout |
| Hypothyroid, atrophic | Lemon-yellow skin especially under the eyes. |
| Rheumatoid | Nerve compression. |
| Gout |
| Hypothyroid, atrophic | Malar flush. |
| Bronchitis | Tighness; especially in morning. |
| Ankylosing spondylosis | Aggravated by breathing: results from involvement of the costovertebral joints. |
| Pneumonia, pneumococcal | Localized pain of pleural type. Occasionally refered to the shoulder or the abdominal wall. |
| Pneumonia, suppurative | Pleural pain common. |
| Huntingtons disease | Symptoms typically begin in middle adult life. |
| Reiter's | On the penis. |
| hand | Chronic liver disease. |
| Hypopituitary | Thyroid Stimulating Hormone (TSH) deficiency causing secondary hypothyroidism (without frank myxoedema of primary hypothyroidism). |
| Hypothyroid, atrophic |
| Pericardial tamponade |
| Lymphoma, myeloma | Increased blood viscosity in later stages. |
| Hypoglycaemia | Neuroglycopenic. |
| Polycythaemia, primary p |
| Hyperparathyroid |
| Hyperparathyroid |
| Hypoglycaemia | Neuroglycopenic. |
| Lymphoma, non-Hodgkin's | Waldenstrom's macroglobulinaemia. |
| Stroke, infarction | Brain stem. |
| Hyperparathyroid |
| Hypothyroid, atrophic |
| Roundworm | From obstruction. |
| Scleroderma |
| Typhoid | 1st week. |
| SLE | Commonest presenting features. |
| Pneumonia, pneumococcal | In children. |
| Asthma | Spontaneous, especially during night. |
| Bronchial carcinoma | The most common early symptom. Sputum is purulent if there is secondary infection; leading to pneumonia. |
| Bronchitis | Productive; usually after colds as the requirement for increased toxin elimination overwhelms eliminative organs, especially the lungs. |
| Measles | Day 2+ |
| Pneumonia, pneumococcal | Short, painful, dry at first but later productive of tenacious sputum which is characteristically rust-coloured and occasionally frankly blood-stained. |
| Pneumonia, suppurative | Productive with large amounts of sputum which is sometimes fetid and blood-stained. Sudden expectoration of large amounts of sputum if abcess ruptures into a bronchus. |
| TB, post-primary | Persistent. |
| TB, primary | Slight dry cough is occasionally present. |
| Trichinella | 5 - 6 days after infection. By invasion of the diaphragm. |
| Typhoid | 2nd week. |
| Tapeworm | Palpable, pea-like ovid bodies under the skin when cysts are superficially placed. |
| Acoustic neuroma | Unilateral. Early symptom. |
| Hypothyroid, atrophic |
| Paget's disease | Compression of auditory nerves. |
| Polychondritis | Conductive. Nerve. Vestibular damage. |
| Hyperthyroidism | Hyper-. Most common symptom. |
| Cranial arteritis |
| Coeliac | Skin looks like colour of coffee patches. |
| Anaemia, pernicious Addi | periodic |
| Dysentery | Stools contain blood or purulent exudate with little faecal material. |
| Food poisoning | Bloody with campylobacter infection or E coli 0157. |
| HIV |
| Hyperthyroidism |
| Scleroderma | Secondary to bacterial overgrowth. Malabsorption, too. |
| Trichinella | 24 -48 hrs after infection. |
| Typhoid | First week in children. 2nd week adults. |
| Myasthenia gravis | One of the first symptoms. |
| Stroke, infarction | TIA |
| anaemia |
| Polycythaemia, primary p |
| Cerebral tumour | Raised intracranial pressure. |
| Hyperparathyroid |
| Hypoglycaemia | Neuroglycopenic. |
| Typhoid | First week. |
| anorexia | Digitalis toxicity. |
| cough | Recognized side-effect of ACE inhibitors. |
| nausea | Digitalis toxicity. |
| vomiting | Digitalis toxicity. |
| hand | Chronic liver disease. |
| Anaemia, iron deficiency | Raises possibility of a post-circoid web (Plummer-Vinson syndrome). |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Myasthenia gravis | Weakness of chewing, swallowing, speaking. |
| Hyperthyroidism | On exertion. Common symptom. |
| Pericardial tamponade |
| Trichinella | 5 - 6 days after infection. By invasion of the diaphragm. |
| Polychondritis | Pain or swelling of the pinna is the most common presentation. |
| Quisy |
| pain, chest | Massive. |
| tiredness | Infective. In those with valvular disease without heart failure. |
| Scleroderma | Associated with hiatus hernia. |
| Anaemia, haemolytic | Aplastic anaemia.: common. |
| Leukaemia, Acute |
| Polycythaemia, primary p |
| Telangiectasia, heredita |
| Hypothyroid, atrophic | Granny's tartan. Occurs on heat exposed surfaces such as the shins from being warmed near the fire. |
| Anaemia, sickle-cell |
| Measles | Day 1 - 2. Red, watery. |
| Rheumatoid | Scleromalacia following episodes of scleritis. |
| Weil's disease | Suffusion. |
| Sjogren's syndrome | No tears (kerato conjunctivitis sicca). |
| Optic neuritis | Especially on movement. |
| Dermatomyositis | Characteristic purple 'heliotrope' rash on upper eyelids. |
| Rheumatoid | Lack of lacrimal secretions results in gritiness, burning, or itching: keratoconjunctivitis sicca. |
| Multiple sclerosis | Optic neuritis. |
| Multiple sclerosis | Recurrent facial palsy. |
| oedema | Nephrotic syndrome. Confirmed by proteinuria. See also liver disease and protein-losing enteropathy. |
| Pneumonia, pneumococcal | Flushed. |
| Polyneuropathy, acute | Bilateral facial weakness in 50%. |
| Acoustic neuroma | Numbness and weakness. |
| Stroke, infarction | Lateral medula. |
| Dermatomyositis | Photosensitive, erythematous, scaling rash on face, shoulders, upper arms, and chest. |
| Scleroderma | With 'beaking' of the nose. Difficulty in opening mouth. |
| anaemia |
| Anaemia, sickle-cell |
| Cranial arteritis |
| Heart failure | Low cardiac output. |
| HIV |
| Hyperthyroidism | Common. |
| Myasthenia gravis | The cardinal sign: abnormal fatigue of muscles. |
| Takayasu's disease |
| Eosinophilic fascitis | Pain, swelling, and tenderness of the hands, forearms, and feet. |
| Reiter's |
| Anaemia, haemolytic | In severe cases Warm autoimmune haemolytic anaemia. |
| Cranial arteritis |
| Dysentery |
| erythema nodosum |
| HIV |
| Lymphoma, Hodgkin's | Low-grade pyrexia or swinging fevers. |
| Lymphoma, non-Hodgkin's | Occasionally. |
| Measles | Day 1 - 2. |
| Mononucleosis |
| Mumps |
| Osteomyelitis |
| Pneumonia, pneumococcal | Temperature rises in a few hours to 39-40 C. |
| Polyarteritis nodosa | Systemic inflammation 70%. |
| Quisy |
| Reiter's |
| Takayasu's disease |
| TB, primary | Generally mild and lasts no more than 7-14 days. |
| Toxic shock |
| Trichinella | 5 - 6 days after infection. Intermittent, may reach 40 degrees. |
| Typhoid | First week. Stepladder fashion for 4 or 5 days. |
| Mediterranean fever | Episodic. |
| Mixed Disease (MCTD) | Sausage swelling. |
| SLE | Digital infarcts. Periungual erythema. |
| Scleroderma | Sausage swelling and restricted movement. |
| Giardiasis |
| Psoriasis | Red, glistening and symmetrical. |
| Leukaemia, Acute |
| Hypogonadism | Sudden loss of testosterone. |
| Leg ulcer, arterial | Cyanotic, cold. |
| Ringworm | Tinea pedis. The most common type of fungal infection. Can be scaly, powdery, or vesicular. |
| Ankylosing spondylosis | Plantar fasciitis. |
| lentigenes | On and around the lips, buccal mucosa, and fingers in the Peutz-Jeghers syndrome associated with intestinal polyposis and intussusception. |
| Osteomalacia |
| Hypothyroid, atrophic |
| Hyperprolactinaemia |
| Anaemia, haemolytic | Hereditary spherocytosis. |
| Rheumatoid | Peripheral neuropathy. |
| Ringworm | Tinea cruris. Well demarcated redness and peripheral scaling. Itchy. |
| Leukaemia, Acute |
| Hypogonadism | Loss of testosterone allows unopposed oestrogen. |
| Hypopituitary | Luteinising Hormone (LH) deficiency (lack of GnRH?). |
| Anaemia, haemolytic | 'Black water' urine. Intravascular haemolysis and Glucose-6-phosphate dehydrogenase deficiency. |
| Bronchial carcinoma | Usually repeated episodes of scanty haemoptysis. |
| Hypogonadism | Post-pubertal; late symptom. |
| Hypopituitary | Sparsity of shaving. LH deficiency. |
| Hypopituitary | Sparse or absent (LH deficiency). |
| Ringworm | Tinea manuum. Involves palms. Dry powder, picking out of creases. |
| Eosinophilic fascitis | Induration of the skin and subcutaneous tissues is not associated with Raynaud's phenomenon or systemic sclerosis. |
| Syringomyelia | Loss of sensory function can lead to burns or ulcers, and sometimes painless deranged joints (Charcot joints). |
| Psoriasis | Producing a lumpiness which is easily felt. |
| Acromegaly |
| anaemia |
| Cerebral tumour | Raised intracranial pressure. Generally aggravated by coughing, bending, or straining. Typically most severe in the morning. |
| Cranial arteritis | Severe. |
| Hypoglycaemia | Commonly in the mornings. |
| Lymphoma, myeloma | Increased blood viscosity in later stages. |
| Lymphoma, non-Hodgkin's | Waldenstrom's macroglobulinaemia. |
| Mononucleosis |
| Paget's disease | Skull involvement. |
| Pneumonia, pneumococcal | Accompanies fever. |
| Polycythaemia, primary p |
| Scarlet fever |
| Stroke, haemorrhage |
| Stroke, infarction | Does not help distinguish between infarction or haemorrhage. |
| Stroke, subarachnoid | Sudden and severe. Radiates occipitally. |
| Takayasu's disease |
| Typhoid | First week. Increasing headache. |
| Weil's disease | Abrupt onset. |
| anorexia |
| ascites | Congestive. |
| nausea |
| vomiting |
| tiredness |
| tiredness |
| Hypoglycaemia | Autonomic. |
| Hyperthyroidism | Intolerance. |
| Myelofibrosis |
| Reiter's |
| Hypogonadism | From failure to go into puberty (long arms and legs), hairless face, high-pitched voice, small external genitalia, immature personality. |
| pain, chest | Zoster. |
| Leukaemia, Acute |
| Polychondritis |
| Hypoglycaemia | Autonomic. |
| ascites | Pulmonary or portal. |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Leukaemia, hairy cell |
| Leukaemia, lymphocytic c |
| Leukaemia, myeloid chron | 7% |
| TB, miliary |
| Diabetes mellitus | Long-term complication. Due to neuropathy. |
| Hypopituitary | Luteinising Hormone (LH) deficiency (lack of GnRH?). A male response(?). |
| Epilepsy |
| Hypoglycaemia | Neuroglycopenic. |
| Polycythaemia, primary p |
| pain, chest |
| pain, chest |
| Anaemia, haemolytic | Aplastic anaemia. |
| Anaemia, sickle-cell | Increased susceptability. |
| Diabetes mellitus | Uncontrolled diabetes is associated with an increased susceptability to infection and many patients present with skin sepsis, intractable and recurrent urinary infections. |
| Leukaemia, hairy cell | Recurrent. |
| Lymphoma, myeloma | Reduction in normal plasma cells causing impaired immune function leading to increased susceptability to infection, particularly respiratory. |
| Hypothyroid, atrophic |
| anaemia |
| pain, chest | Herniation. |
| Psoriatic |
| Hyperthyroidism |
| Atopic | The cardinal feature of atopic eczema is itch. |
| Anaemia, haemolytic | Hereditary spherocytosis. |
| Psoriatic | Inflammatory arthritis affecting the distal interphalangeal joints. |
| erythema nodosum |
| Gout | Excruciatingly painful and tender. Often on the metatarso-phalangeal joint of the great toe. |
| Rheumatoid |
| Chondrocalcinosis | The joint becomes suddenly painful, warm, swollen, and tender. The knee is the site of more than 1/2 of all attacks, the duration can vary from a few days to four weeks. Men are affected more than women. |
| Chondrocalcinosis | Polyarthritis which may last for several moinths. |
| Chondrocalcinosis | Type A & B combined. |
| Chondrocalcinosis | Types C & D account for nearly 1/2 of all patients. Prominent involvment of wrists and proximal metacarpal joints. |
| Chondrocalcinosis | Asymptomatic. Most common. |
| Chondrocalcinosis | Pseudo-neuropathic: severe destructive changes in the knee and shoulder. |
| Rheumatoid |
| Rheumatoid | Symmetrical. |
| Rheumatoid | Typically begins in small proximal joints of the fingers and toes giving them a spindled appearance. |
| Reiter's | (Keratoderma blenorrhagica rash or circinate balanitis) and foot pains may also make the diagnosis. |
| Dermatomyositis | Red patches over knuckles, elbows, and knees. |
| anaemia |
| Hyperparathyroid |
| Lymphoma, non-Hodgkin's |
| Myelofibrosis |
| Polycythaemia, primary p |
| Leg ulcer, venous | Followed by oedema. |
| Leg ulcer, venous |
| Leg ulcer, venous | Lipodermatosclerosis: inverted champagne bottle. |
| oedema | Pitting; heart failure. Lower legs only; venous insufficiency. |
| Diabetes mellitus | Long-term complication. Muscle atrophy. |
| Lymphoma, non-Hodgkin's | Pressure effects due to extradural lymphoma compressing the cord. |
| erythema nodosum | Dusky blue-red nodules. Lesions resolve slowly over a month leaving bruise-like marks in their wake. |
| Psoriasis | Well demarcated. Elbows, knees, back. Red, with dry, silvery-white scaling. |
| Giardiasis |
| Leukaemia, myeloid chron | 13% |
| Lymphoma, myeloma | Hypercalcaemia. |
| Rheumatoid | May precede the onset of articular symptoms by weeks or months. |
| TB, post-primary |
| Hypogonadism | Post-pubertal; early symptom. |
| Hypopituitary | Luteinising Hormone (LH) deficiency (lack of GnRH?). A male response(?). |
| Typhoid | First week. |
| Diabetes mellitus |
| Hypothyroid, atrophic |
| Cerebral tumour | Raised intracranial pressure. |
| Heart failure | Low cardiac output. |
| ascites | Cirrhosis. |
| eye, dark circles (under | Chronic liver disease. |
| Lymphoma, non-Hodgkin's | Painless, discrete, and firm. |
| ascites |
| Cranial arteritis |
| erythema nodosum |
| HIV |
| Hyperparathyroid |
| Mononucleosis |
| Mumps |
| Osteomyelitis |
| Typhoid | First week. |
| Leukaemia, Acute |
| ascites |
| pain, chest | Mediastinal. |
| Hypothyroid, atrophic |
| Sjogren's syndrome | No saliva (xerostomia). |
| Quisy | Pain on swallowing and on opening mouth. |
| Hyperthyroidism | Weakness. |
| Muscular dystrophy | Wasting and weakness are symmetrical. |
| pain, chest | Injury, intercostal. |
| Amyotrophy, neuralgic | Usually severe pain over one shoulder. Could be any large muscle terminal points. |
| Dermatomyositis |
| Hypothyroid, atrophic | Aches, pains, stiffness. |
| Cranial arteritis | Proximal (shoulder-pelvic girdle) muscle stiffness. |
| Mixed Disease (MCTD) | Proximal. |
| Dermatomyositis | Shoulder and pelvic muscle groups: patient may have difficulty lifting their arms or getting up or down stairs. |
| Lymphoma, Hodgkin's | Progressive. |
| Mixed Disease (MCTD) | Proximal. |
| Osteomalacia | Difficulty climbing up stairs or out of chairs. |
| Polyneuropathy, acute | More marked proximally. AKA Guillian-Barre syndrome. |
| Scleroderma | From disuse atrophy and low-grade myosistis. |
| Trichinella | Stiffness, pain, tenderness. |
| Polyarteritis nodosa | Systemic inflammation 70%. Muscle wasting. |
| Rheumatoid | May precede the onset of articular symptoms by weeks or months. |
| Takayasu's disease |
| Weil's disease | Severe. |
| Psoriatic |
| Psoriatic | Horizontal. |
| Psoriasis | Thimble-pitting, onycholysis (separation of nail from the nail bed), subungual hyperkeratinosis. |
| Anaemia, iron deficiency |
| Ringworm | Tinea unguim. Toe nail infection more common than finger nail. Early symptoms are that the free edge of nail becomes crumbly and yellowy. |
| Hyperparathyroid |
| Hypoglycaemia |
| Trichinella | 24 -48 hrs after infection. |
| Stroke, subarachnoid | Pain and stiffness. |
| Polymyalgia | Pain and stiffness in the neck, back, shoulders, upper arms, and thighs. |
| Syringomyelia | Pain in the neck or shoulder which usually presents in the third or fourth decade. |
| ascites |
| Hyperthyroidism |
| Multiple sclerosis | Trigeminal under the age of 50. |
| pain, chest | Cardiac. |
| Lymphoma, Hodgkin's | Drenching. |
| Myelofibrosis |
| TB, miliary | Drenching sweats during sleep. |
| Osteoarthritis | Proximal interphalageal joints. |
| Osteoarthritis | Gelatinous cysts or bony outgrowths on the dorsal aspect of the terminal interphalangeal joints. Pain, swelling, inflammation. |
| erythema nodosum | Painful, palpable, dusky-blue-red nodules most commonly seen on the lower legs. |
| Rheumatoid | Extensor surfaces of forearms, scalp, sacrum, Achilles tendon. Fingers and toes. |
| Polychondritis | Pain or swelling. Saddle-nose deformity. Nasal tenderness. |
| Measles | Day 1 - 2. Sneezing. |
| Hyperthyroidism | Ankle-. In absence of cardiac failure. |
| Trichinella | Face, eyelids, conjunctivae. 5 - 6 days after infection. |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Dermatomyositis | Maybe a slight oedema of the eyelids. |
| cough |
| pain, chest |
| Hypopituitary | Luteinizing Hormone (LH) deficiency. |
| Pneumonia, pneumococcal |
| Hyperthyroidism |
| pain, chest |
| Nephritis | On urination. Loin; radiating to iliac or suprapubic area. |
| Henoch-Schonlein |
| Leukaemia, myeloid chron | 21%. Also abdominal discomfort. |
| Scleroderma | Intermittent from dilation of large and small bowel segments. |
| Pneumonia, pneumococcal | Accompanies fever. |
| Osteomalacia |
| Osteoarthritis | Spine, hips, knees, hands. Relieved by rest. Heberden's nodes. |
| Lymphoma, myeloma | Pathological fracture. |
| Bronchial carcinoma | Quite common. Due to malignant invasion of the pleura. |
| Anaemia, sickle-cell | From thrombosis following an area of tissue infarction -- the 'infarction crisis.' |
| Stroke, infarction | Lateral medula. |
| Hypopituitary | see skin, pallor |
| anaemia |
| Hyperthyroidism |
| Acromegaly | Cranial nerve palsies. |
| anaemia | Fingers and toes. |
| Anaemia, pernicious Addi | Fingers and toes. |
| Diabetes mellitus | Long-term complication. |
| Polyneuropathy, chronic | Glove and stocking distribution; affecting the feet and then later the hands, which progresses proximally up the limbs. |
| Paget's disease | Vertebral involvement. |
| Syringomyelia | Upper limbs. Loss or depression of pain and temperature sensation with preservation of other sensory modalities. |
| pain, chest |
| Mediterranean fever | Episodic. |
| Polyarteritis nodosa | GI tract 20%. |
| Cerebral tumour | Apathy, irritabilitiy, withdrawl, inattention. |
| Measles | Day 2+ |
| Anaemia, iron deficiency | The eating of strange items such as coal, earth, or foods in eccess (tomatoes, greens). |
| Hyperthyroidism |
| Reiter's |
| Mediterranean fever | Episodic. |
| pain, chest | Lobar. |
| pain, chest |
| Anaemia, haemolytic | In severe cases Warm autoimmune haemolytic anaemia. |
| Diabetes mellitus | Vulvae or balanitis. Due to fungi (candida). |
| Hyperthyroidism |
| Lymphoma, Hodgkin's | In about 10%. |
| Polycythaemia, primary p |
| Leukaemia, Acute |
| Polyarteritis nodosa | palpable. Skin lesions 50%. |
| Thrombocytopenia |
| ulcer, skin | Starts as an inflamed nodule or pustule which breaks down centrally and rapidly progresses to an ulcer. May have an indurated, purplish, or pustular edge. Lesions may be singular or multiple. |
| Scarlet fever |
| Weil's disease |
| Chickenpox | Characteristic: appears on trunk the 2nd day, then the face and finally the limbs. Maximum density on the trunk. Macules appear first then within a few hours turn papular and then vesicular, and within 24 hours pustular. The spots appear in crops so lesions are at all stages of development. |
| Lichen planus | Papules: intenselt itchy. Involving the flexor surfaces, genitalia, and mucous membranes. Eruption as a whole tends to last about one year. Mucous membrane involvement asymptomatic fine white lacy network or oin-head sized papules. |
| Measles | Day 3 - 4. Exanthematous stage. Maculo-papular rash.Day 6 - 7. Exanthematous stage. Fever settles. Rash begins to fade. |
| Pityriasis rosea | Herald plaque: large, 2-5 cm. Several days later smaller, pink, oval and scaly plaques appear. Lesions on back may give a Christmas-tree distribution. Fades 4-10 weeks. |
| Rosacea | Papules and pustules on the cheeks, chin, and central forehead. |
| Toxic shock | Fever followed by the development of a punctate erythematous rash as in Scarlet fever. |
| urticaria | Eruption of itchy wheals sometimes accompanied by deeper more diffuse swelling (angioedema) which is seldom itchy. The wheals are evanescent and individual lesions are seldom present for longer than 12 hours; but the urticaria may last for weeks or years. |
| Weil's disease | With petechiae. |
| Mixed Disease (MCTD) |
| Scleroderma | Severe. Usually presenting syndrome. |
| Polyneuropathy, acute | Widespread loss of reflexes. |
| Polyarteritis nodosa | Renal disease 70%. |
| nose | Chronic liver disease. |
| Tetanus | Spreads to involve muscles of the face, neck, and trunk; back usually arched; board-like abdominal wall. |
| Nephritis |
| Pneumonia, pneumococcal |
| oedema | Pitting. Heart failure. In a patient who is largely bed-bound. |
| Ringworm | Tinea captis. Balding, slightly scaly, hairs broken off. Inflammation minimal. Altewrnatively can be boggy and inflammed. |
| Cranial arteritis |
| TB, post-primary | Extension of tuberculosis infection to the skin from underlying tissues. |
| Stroke, infarction | hemisensory |
| Hypogonadism | Post-pubertal; late symptom. |
| Scarlet fever |
| Toxic shock |
| Erysipelas | Heat and pain. Rapidly spreading red patch with underlying oedema. Patch is palpable with a clearly defined edge. Vesicles and bullae appear in the central part of the affected area. |
| Leg ulcer, arterial | Skin surrounding ulcer is atrophic and hairless. |
| Mixed Disease (MCTD) | Changes resembling dermatomyositis or scleroderma. |
| Phenylketonuria | Hypopigmentation. |
| pigmentation | Acanthosis nigricans: velvety thickening and pigmentation of the major flextures. |
| Pneumonia, pneumococcal | Hot, dry. |
| Rosacea | Intermittent blushing followed by fixed erythema and telangiectasia. |
| Diabetes mellitus | Loose, dry skin. |
| Hypothyroid, atrophic | Dry, flaky. |
| Hypopituitary | Characteristic from LH deficiency. FSH secretion lost later than LH. |
| Polyarteritis nodosa | Skin lesions 50%. |
| Carcinoma, basal cell | Earliest lesion is a small, glistening, skin coloured papule, often with fine telangietatic vessels on the surface. |
| necrobiosis lipidica | Shiny, atrophic, and slightly yellow plaques on the shins. Underlying telangiectasis is easily seen. |
| Hepatitis C | Sarcoidal. |
| Psoriatic | Widespread scaling lesions typically over extensor surfaces, or insignificant and confined to such areas as the scalp, natal cleft, umbilicus. |
| Scleroderma | Morphoea: well demarcated lesions are a limited form of the disease. |
| Anaemia, pernicious Addi |
| Hypopituitary | Adrenocorticotrophic Hormone (ACTH) deficiency causing lack of melanin in the skin. |
| SLE | Butterfly rash. Discoid lupus or vasculitic rash. |
| Scleroderma |
| Atopic | Infancy: often acute involving the face and trunk. Childhood: backs of knees, fronts of elbows, wrists, and ankles. Adults: face and truck, often with lichenification. |
| Seborrhoeic | Three patterns: scalp, ears, face, and eyebrows; presternal and interscapular; flextures of the axillae, umbilicus, breasts and groin. |
| Typhoid | 2nd week. Rose spots on upper abdomen and on the back: sparse, slightly raised; fade on pressure. |
| TB, primary | Erythema nodosa. |
| Scleroderma | With atrophy and ulceration of the fingertips. |
| Polyarteritis nodosa |
| Anaemia, pernicious Addi |
| Hypothyroid, atrophic |
| pain, chest |
| Tetanus | Induced by stimuli: movement or noise. |
| Hypoglycaemia | Neuroglycopenic. |
| Rheumatoid | Neck pain and stiffness from cervical spine disease is common. |
| Hyperthyroidism |
| Polymyalgia | Early morning stiffness. |
| Rheumatoid |
| Paget's disease | After confinement to bed (the rapid mobilizing of calcium). |
| Threadworm | Adult worms may be seen. |
| Hypogonadism | Post-pubertal; late symptom. |
| Lymphoma, myeloma | Increased blood viscosity in later stages. |
| Hyperthyroidism | Increased. Common symptom. |
| Hypoglycaemia | Autonomic. May be profuse. |
| Leukaemia, myeloid chron | 11% |
| Lymphoma, non-Hodgkin's | Occasionally. |
| Hypogonadism | Sudden loss of testosterone. |
| Takayasu's disease |
| Multiple sclerosis | Worsened by exercise or rise in body temperature. |
| Stroke, infarction | TIA |
| pain, chest | Mallory-Weiss; Bornholm (epidemic myalgia); Tietze's (costocondritis); Thoracic outlet. |
| Pericardial tamponade |
| dizziness |
| dyspnoea |
| syncope |
| Rheumatoid | Nerve compression. |
| Myasthenia gravis | Unable to work above shoulder -- brushing teeth. |
| Telangiectasia, heredita | Fingertips, face, nasal passages, tongue, and gastrointestinal tract. |
| Calcium phosphate | Acute inflammation from peritendonitis or bursitis following sudden release of HA crystals from a primary deposit in the tendon. |
| Reiter's |
| Dysentery |
| Gout |
| SLE | Commonest presenting features. |
| oedema | Pitting. Heart failure. |
| Hyperthyroidism |
| Lymphoma, myeloma | Hypercalcaemia. |
| Leukaemia, Acute |
| Scarlet fever |
| anaemia | In head and ears. |
| Multiple sclerosis | In spine or limbs on neck flexion. |
| Acoustic neuroma | Unilateral. Early symptom. |
| anaemia |
| Hyperparathyroid |
| Hypoglycaemia |
| Hypogonadism | Post-pubertal; early symptom. |
| Hypothyroid, atrophic |
| Leukaemia, Acute |
| Leukaemia, lymphocytic c | This is the commonest variety of leukaemia. Peak age 65 yrs. |
| Leukaemia, myeloid chron | 37% |
| Lymphoma, myeloma | Bone marrow failure: anaemia. |
| Lymphoma, non-Hodgkin's | Also in Waldenstrom's macroglobulinaemia. |
| Mononucleosis |
| Anaemia, iron deficiency | Usually not sufficient to make patients seek help. |
| Epilepsy | Biting. |
| Diabetes mellitus |
| Anaemia, pernicious Addi | intermittent soreness |
| pain, chest |
| Hypoglycaemia | Autonomic. |
| hand | Chronic liver disease. |
| Tetanus | Spasm of the masseter muscles 'lock jaw'. |
| Ringworm | Tinea corporis. Erythematous scaly plaques. Glow slowly in rings; clearing in middle. Itchy when set. |
| pain, chest |
| Osteomalacia | Carpopedal spasm and facial twitching; tetany. |
| Diabetes mellitus | Hands and feet: due to a combination of neuropathy, peripheral vascular disease, and infecton. |
| Leg ulcer, arterial | Punched-out looking, deep, painful on the lower leg (shin or foot). |
| Leg ulcer, venous | Around medial malleolus, usually. |
| SLE | painful oral or nasopharangeal ulcers. |
| Anaemia, haemolytic | Hereditary spherocytosis. |
| Anaemia, sickle-cell | Increased susceptability. |
| Anaemia, haemolytic | Aplastic anaemia.: necrotic; reflects the neutropenia. |
| Leukaemia, Acute |
| Anaemia, haemolytic | Aplastic anaemia.: necrotic; reflects the neutropenia. |
| Sjogren's syndrome |
| pain, chest | Prolapse. |
| syncope | Pulmonary embolism or aortic stenosis. |
| Acoustic neuroma | Insideous. Early symptom. |
| Lymphoma, myeloma | Increased blood viscosity in later stages. |
| Stroke, infarction | Transient Ischaemic Attack (TIA) from stenosis of a major artery. Triggered by postural changes or neck movements. |
| Acromegaly | Visual field defect. |
| Lymphoma, myeloma | Increased blood viscosity in later stages. |
| Optic neuritis | Blurring of central vision. |
| anaemia |
| Diabetes mellitus | Long-term complication. Retinopathy. |
| Hypothyroid, atrophic |
| Measles |
| Hypothyroid, atrophic |
| Anaemia, haemolytic | In severe cases Warm autoimmune haemolytic anaemia. |
| Cerebral tumour | Raised intracranial pressure. |
| Food poisoning |
| Hyperparathyroid |
| Hyperthyroidism |
| Lymphoma, non-Hodgkin's | Pressure effects. |
| Pneumonia, pneumococcal | In children. |
| Scarlet fever |
| Weil's disease |
| Hyperparathyroid |
| Hyperthyroidism | Loss despite appetite. |
| Anaemia, pernicious Addi | Appears well nourished. |
| Leukaemia, myeloid chron | 26% |
| Myelofibrosis |
| Hypothyroid, atrophic |
| Cranial arteritis |
| Dermatomyositis |
| Giardiasis |
| Heart failure | Cardiac cachexia caused by anorexia and impaired absorption. |
| HIV |
| Hyperparathyroid |
| Lymphoma, Hodgkin's |
| Lymphoma, non-Hodgkin's |
| Polyarteritis nodosa | Systemic inflammation 70%. |
| Reiter's |
| Rheumatoid | May precede the onset of articular symptoms by weeks or months. |
| Takayasu's disease |
| TB, post-primary |