Reply To: CASE OF THE MONTH APRIL 2023

Replying to Kathryn B. 19/04/2023 - 19:46

Hello everyone.

Here are my thoughts regarding the problem list and differential diagnosis:

1. Episodic Weakness:
• Primary heart disease (e.g. left-sided heart failure or arrhythmia)
• Electrolyte disorder (e.g. hypokalaemia and hypocalcaemia)
• Endocrinopathies (e.g. diabetes mellitus (DM), hyperadrenocorticism (HAC), hypoadrenocorticism or pheochromocytoma)
• Acid-base disorders (e.g. acidosis or alkalosis associated with pulmonary disease)
• Anaemia
• Inflammatory conditions
• Immune medicated disease (e.g. immune mediated polyarthropathy)
• Neuromuscular disorder
• Pain
• Nutritional derangements (e.g. insufficient calories)
• Hypotension
• Toxins or drugs (e.g. anticonvulsants or antihistamines)

2. Heart Murmur
• Mitral insufficiency (e.g. endocardiosis)
• Tricuspid insufficiency (e.g. chronic degenerative valve disease)
• Aortic stenosis
• Pulmonic stenosis
• Ventricular septal defect
• Atrial septal defect
• Physiologic murmurs (e.g. anaemia or fever)

3. PUPD:
• Renal disease (e.g. chronic renal failure or pyelonephritis)
• Electrolyte disorder (e.g. hypercalaemia or hypokalaemia)
• Endocrinopathies (e.g. diabetes mellitus (DM) or hyperadrenocorticism (HAC))
• Hepatobiliary disease
• Diet (e.g. increased salt intake)
• Miscellaneous (e.g. polycythemia, psychogenic or renal glycosuria)
• Toxins or drugs (e.g. corticosteroids or diuretics)

4. Cataracts:
• Metabolic (e.g. diabetes mellitus or hypocalcaemia)
• Secondary to other ocular disease (e.g. glaucoma, generalised progressive retinal atrophy or retinal dysplasia)
• Senile cataracts
• Trauma
• Toxic or dietary
• Inherited
• Congenital

I would love to hear Liz’s comments on my heart disease DDX… nervously waits!

Scott 🙂