TAYLOR’S DIFFERENTIAL DIAGNOSIS MANUAL SYMPTOMS AND SI GNS I N THE TI ME-LI MI TED ENCOUNTER Th ird Editio n TAYLOR’S DIFFERENTIAL DIAGNOSIS MANUAL SYMPTOMS AND SI GNS I N THE TI ME-LI MI TED ENCOUNTER Th ird Editio n Edito rs Pau l M Pau l man , MD Pro fesso r/Predo cto ral Directo r Departmento f Family Medicine University o f Nebraska Medical Center Omaha, Nebraska Au drey A Pau l man , MD Clinical Asso ciate Pro fesso r Departmento f Family Medicine University o f Nebraska Medical Center Omaha, Nebraska Jeffrey D Harriso n , MD Pro gram Directo r, Rural Residency Pro gram Departmento f Family Medicine University o f Nebraska Medical Center Omaha, Nebraska Laeth Nasir, MB B S Pro fesso r and Chairman Departmento f Family Medicine Creighto n University Scho o l o f Medicine Omaha, Nebraska Kimberl y Jarzyn ka, MD , FAAFP Asso ciate Pro gram Directo r, Residency Pro gram Departmento f Family Medicine University o f Nebraska Medical Center Omaha, Nebraska Executive Editor: Rebecca S Gaertner Senior Product Manager: Kristina Oberle Developmental Editor: Red Act Group Vendor Manager: Alicia Jackson Manufacturing Manager: Ben Rivera/Beth Welsh Marketing Manager: Kimberly Schonberger Designer: Holly McLaughlin Production Service: Integra Software Services Pvt Ltd © 2014 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com 1st edition, © 1999 Williams & Wilkins 2nd edition, © 2007 Lippincott Williams & Wilkins All rights reserved This book is protected by copyright No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright Printed in China Library of Congress Cataloging-in-Publication Data Taylor’s differential diagnosis manual : symptoms and signs in the time-limited encounter / editors, Paul M Paulman [et al.] — 3rd ed p ; cm Differential diagnosis manual Rev ed of: Taylor’s 10-minute diagnosis manual 2nd ed c2007 Includes bibliographical references and index ISBN 978-1-4511-7367-3 (pbk.) I Paulman, Paul M., 1953- II Taylor, Robert B III Taylor’s 10-minute diagnosis manual IV Title: Differential diagnosis manual [DNLM: Physical Examination—Handbooks Diagnosis, Differential—Handbooks Primary Health Care—Handbooks Signs and Symptoms—Handbooks WB 39] RC69 616.07'5—dc23 2013008379 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of the information in a particular situation remains the professional responsibility of the practitioner The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 Visit Lippincott Williams & Wilkins on the Internet: at LWW.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to pm, EST 10 6 The edito rs o f Taylo r’s Diagno stic Manual wo uld like to dedicate this bo o kto o ur chapter autho rs who wo rked hard to pro vide upto -date, clinically useful material fo r o ur readers We wo uld also like to dedicate this bo o kto Makenzie Lind-Olso n who was able to keep us all o n taskand assure successful pro ductio n o f the manual Contributors Riad Z Abdelkarim, MD, MHCM Instructor of Medicine Department of Family Medicine Johns Hopkins Institutions; Senior Consultant Tawam Hospital in affiliation with Johns Hopkins Medicine United Arab Emirates 14.4 Hypothyroidism Ahmed Salem Al Dhaheri, MBBS Dermatology Resident Tawam Hospital in affiliation with Johns Hopkins Medicine United Arab Emirates 13.8 Vesicular and Bullous Eruptions Nawar Al Falasi, MD Specialist Dermatology Medical Services Administration of Abu Dhabi Police United Arab Emirates 13.5 Pruritis Fatima Al Faresi, MD Associate Residency Program Director Specialist Dermatologist Tawam Hospital in affiliation with Johns Hopkins Medicine United Arab Emirates 13.4 Pigmentation Disorders Naama Salem Al Kaabi, MBBS Dermatology Resident Department of Dermatology Tawam Hospital in affiliation with Johns Hopkins Medicine United Arab Emirates 13.3 Maculopapular Rash Khawla Rashid Alnuaimi, MBBS Dermatology Resident Tawam Hospital in affiliation with Johns Hopkins Medicine United Arab Emirates 13.1 Alopecia Mark D Andrews, MD Associate Professor Director of Procedural Training Department of Family & Community Medicine Wake Forest School of Medicine Winston-Salem, North Carolina 6.1 Halitosis Alexis M Atwater, MD Resident Physician Department of Family Medicine & Community Health Hospital of the University of Pennsylvania Philadelphia, Pennsylvania 17.7 Hypercalcemia Elisabeth L Backer, MD Clinical Associate Professor Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 16.3 Erythrocyte Sedimentation Rate and C-Reactive Protein Mandeep Bajwa, MD Resident Physician Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 16.7 Thrombocytopenia Mohammad Balatay, MM, MBBS Izmir Hospital Izmir, Turkey 13.6 Rash Accompanied by Fever Nirmal Bastola, MBBS Resident Physician Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 9.11 Rectal Bleeding Sandra B Baumberger, MD Assistant Professor of Family Medicine Creighton University School of Medicine Omaha, Nebraska 7.12 Raynaud’s Disease Ryan Becker, MD Resident Physician Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 4.4 Dementia Michelle L Benes, MD, FAAFP Medical Director of Primary Care Alegent Creighton Clinic Omaha, Nebraska 14.2 Gynecomastia Kevin K Benson, MD Clinical Instructor Department of Family Medicine Mayo Clinic Scottsdale, Arizona 12.9 Shoulder Pain Matt Bogard, MD Resident Physician Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 7.5 Cardiomegaly Deepa J Borde, MD Assistant Professor Division of Hospital Medicine University of Florida Gainesville, Florida 10.6 Oliguria and Anuria Joshua P Brautigam, MD Resident Physician Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 17.8 Hyperkalemia Dorota Brilz, MD Faculty Department of Clarkson Family Medicine Physician 10 with fever, 307–308 diagnosis of, 308 history of, 308 physical examination for, 308 testing, 308 maculopapular, 299–301, 307 allergic eruptions, 300 bacterial infection, 300 causes of, 299 differential diagnosis of, 300 epidemiology of, 299 with fever, 307, 308 history of, 299 Kawasaki’s disease, 301 physical examination for, 299 rocky mountain spotted fever, 301 testing, 300 viral exanthems, 300 petechial, 307 urticaria, 308 vesiculobullous, 307 Raynaud’s disease, 144–145 causes of, 144 differential diagnosis of, 145 epidemiology of, 144 hand–arm vibration syndrome, 144 history of, 144 physical examination for, 144 RC tendonitis, shoulder pain, 292 Rectal bleeding See Bleeding, rectal Re-emergent tremor, 64 Rectum, postmenopausal bleeding, 260 Red eye, 83–86 causes of, 83 conjunctivitis, 83 differential diagnosis of, 85 epidemiology of, 83 history of, 83 physical examination for, 84 testing, 84 Reiter’s syndrome, 105, 106 Renal and urologic problems dysuria, 216–217 erectile dysfunction, 220–222 hematuria, 217–220 nocturia, 226–227 oliguria and anuria, 227–231 priapism, 232–233 scrotal mass, 233–235 scrotal pain, 235–238 676 urethral discharge, 238–241 urinary incontinence, 223–225 Reproductive history hirsutism, 318 menorrhagia, 251 nipple discharge, 255 Respiratory system cough, 148–150 cyanosis, 151–153 hemoptysis, 153–155 pleural effusion, 155–157 pleuritic pain, 158–159 pneumothorax, 160–162 shortness of breath, 163–166 stridor, 167–169 wheezing, 170–172 Respiratory tract, halitosis, 91 Resting tremors, 64 Restless leg syndrome, 24, 268, 269 Retinal artery occlusion, 74 Retinal detachment, 75 Rheumatoid arthritis arthralgia, 266 joint pain, monoarticular, 280, 281 neck pain, 284 Riley-Day syndrome, 405 Rhinitis, 102–104 causes of, 102 differential diagnosis of, 104 epidemiology of, 103 history of, 103 physical examination for, 103 testing, 104 Rinne test, 93 Rocky Mountain spotted fever (RMSF), 301, 308 Rotor’s syndrome, 209 Rytand’s murmur, 131 S S3 gallop/ventricular gallop, 131 S4/atrial gallop, 131 Saline infusion sonohysterography, postmenopausal bleeding, 261 Saline-infused sonography, menorrhagia, 253 Schirmer’s test, 92 Schizophrenia anorexia, suicide risk, 43 Scintillating scotoma, 86 677 Scleritis, 83, 85 Scotoma, 86–89 absolute, 86 causes of, 87, 87t central, 86 color, 86 differential diagnosis of, 89 epidemiology of, 87 history of, 87 negative, 86 paracentral, 86 peripheral, 86 physical examination for, 88 positive, 86 relative, 86 scintillating, 86 testing, 88 Screening breast cancer, 397–399 corneal foreign body and corneal abrasion, 69 congestive heart failure, 128 depression, 41 erectile dysfunction, 221 hearing loss, 94 fatigue, 15 menorrhagia, 253 nystagmus, 77 pap smear abnormality, 258 weight loss, unintentional, 33 Scrotal mass, 234–235 age factor, 234 diagnosis of, 235 gastrointestinal symptoms, 234 history of, 234 infection, 234 pain, 234 physical examination for, 234 testicular torsion, 234 testing, 235 trauma, 234 Scrotal pain, 235–238 causes of, 235 cremasteric reflex, 237 differential diagnosis of, 238 epidemiology of, 236 history of, 236 physical examination for, 237 testing, 237 Scrotal trauma, 236 Seasonal affective disorder, 42 678 Second-degree atrioventricular (AV) block, 122 Secondary Raynaud’s disease (SRD), 144 Seizures, 60–62 causes of, 60 chronology, 61 differential diagnosis of, 62 epidemiology of, 61 family history, 61 generalized, 62 absence (Petit mal), 62 tonic–clonic (Grand mal), 62 history of, 61 partial (focal), 62 complex, 62 simple, 62 Seizures physical examination for, 61 testing, 61 Semantic memory, 56 Sensorineural hearing loss (SNHL), 92 causes of, 93 Sexual intercourse, painful See Dyspareunia Sexually transmitted disease, urethral discharge, 238 Sheehan’s syndrome, 242, 321 Shoulder pain, 290–292 causes of, 290 diagnosis of, 292 history of, 290 physical examination for, 293 testing, 291t, 292 Sick sinus syndrome, 121 Sigmoidoscopy, rectal bleeding, 211 Single photon emission computed tomography (SPECT) osteoporosis, 407 tremors, 65 Sinus bradycardia, 122 Sinus node block, 122 Sinus tachycardia, 146 Sjögren’s syndrome acute pericarditis (AP), 142 halitosis, 91, 92 hoarseness, 96 red eye, 84 Skin alopecia, 294–296 in anorexia, cyanosis, 151–153 erythema multiforme, 297–298 maculopapular rash, 299–301 petechiae and purpura, 339–340 679 pigmentation disorders, 301–304 pruritus, 305–306 rash with fever, 306–308 urticaria, 309–310 vesicular and bullous eruptions, 310–312 Sleep apnea See also Obstructive sleep apnea (OSA) cyanosis, 152 fatigue, 20 hypothyroidism, 323 night sweats, 28 nocturia, 226 polycythemia, 353 Sleep disorders in arthralgia, 266 in demetia, 54 in depression, 40 fatigue, 14 hypersomnia, 21–23 insomnia, 24–25 in tinnitus, 108, 109 Small bowel bacterial overgrowth (SBBO), 215 Smoking cough, 148, 149 cyanosis, 152 and dysmenorrhea, 248 and erectile dysfunction, 220, 221 and halitosis, 91 and hematuria, 218 and hemoptysis, 154 and hoarseness, 95, 96 and nipple discharge, 254 and pneumothorax, 160 and polycythemia, 353 stridor, 168 and vaginal discharge, 262, 263 and weight loss, unintentional, 33 and wheezing, 171 Social history amenorrhea, 243 anorexia, depression, 40 dyspareunia, 249 heart murmurs, 133 hypertension, 136 lower back pain, 277 lymphadenopathy, generalized, 335 menorrhagia, 251 pleural effusion, 156 principles of, shoulder pain, 290 680 splenomegaly, 341 stomatitis, 106 weight loss, unintentional, 33 wheezing, 171 Somnolence, 22t Sore throat See Pharyngitis Spasmodic dysphonia, hoarseness, 96 Spasmus nutans, 76 Spermatocele, 234, 236 Sphincter pupillae, 81 Spirometry, 149, 172 Splenomegaly, 341–343 causes of, 341 differential diagnosis of, 342, 343t epidemiology of, 341 history of, 341 hyperplastic, 341 hypersplenism, 342 massive, 341 physical examination for, 341 testing, 342 Spontaneous pneumothorax, 160 Sputum, hemoptysis, 154 ST bursitis, shoulder pain, 292 Steatocrit, 214 Steatorrhea, 213–215 causes of, 213 celiac disease, 213, 215 differential diagnosis of, 215 epidemiology of, 213 history of, 213 luminal phase, 213 mucosal phase, 213 physical examination for, 214 postabsorptive process, 213 testing, 214 Stevens-Johnson syndrome (SJS), 310 erythema multiforme, 296, 297t stomatitis, 105, 106 vesiculobullous eruptions, 310 Stomatitis, 105–106 causes of, 105 differential diagnosis of, 106 epidemiology of, 105 history of, 105 medical history, 105 physical examination for, 106 social factors, 106 testing, 106 Stridor, 167–169 681 acute, 169 biphasic, 167 causes of, 168t chronic, 169 diagnosis of, 169 history of, 167 physical examination for, 168 testing, 169 Stroke, 63–64 causes of, 63 differential diagnosis of, 64 epidemiology of, 63 history of, 63 physical examination for, 63 risk factors for, 63 testing, 63 Subacromial bursitis, shoulder pain, 292 Subacute cough, 148, 150 Subconjunctival hemorrhage, 83, 86 Substance abuse, 43 Suicide risk, 43–45 assessment of, 44 causes of, 43 diagnosis of, 45 epidemiology of, 43 factors of, in adolescents, 43 history of, 44 level of risk, 44 Patient Health Questionnaire-9, 44 risk factors for, 43 suicidal ideation, 44 Superior oblique myokymia, 78 Supraclavicular lymph nodes (SCLN), 338 Sweat chloride test, 172 Syncope, 29–31 causes of, 29, 30f diagnosis of, 31 differential diagnosis of, 31 epidemiology of, 29 falls, 13t history of, 30 physical examination for, 31 testing, 31 Synovial fluid aspiration, arthralgia, 266 Systemic lupus erythematosus (SLE), 144 arthralgia, 266 stomatitis, 105, 106 T 682 Tachycardia, 145–147 history of, 146 physical examination for, 146 symptoms of, 145 testing, 146 Tanner stage, 316 Task-specific tremor, 65 Temporal arteritis shoulder pain, 292 visual loss, 74 Tension pneumothorax, 161 Teratoid lesions, 402 Testes gynecomastia, 317 scrotal pain, 235, 236 Testosterone, and erectile dysfunction, 221 Third nerve palsy, pupillary inequality, 81 Third-degree AV block See Complete heart block Thoracentesis pleural effusion, 156 pneumothorax, 161 Thoracic outlet syndrome, shoulder pain, 292 Thoracotomy, 409, 410 Throat problems See Head, eyes, ears, nose, and throat Thrombocytopenia, 355–356 causes of, 355 differential diagnosis of, 356 drug-induced, 356 history of, 356 physical examination for, 356 testing, 356 Thymoma, 402 Thyroid gland enlargement/goiter, 326–328 causes of, 326 differential diagnosis of, 327 endemic, 326 epidemiology of, 326 history of, 326 multinodular, 326 physical examination for, 327 pregnancy-induced, 326 risk factor for, 326 simple, 326 smoking, 326 sporadic, 326 testing, 327 hyperthyroidism See Thyrotoxicosis/ hyperthyroidism hypothyroidism, 320–323 nodules, 328–330 683 causes of, 328 colloid nodule, 328 differential diagnosis of, 330 epidemiology of, 328 history of, 328 physical examination for, 329 risk of cancer, 329f testing, 329 Thyroid hormones, hypothyroidism, 320–323 Thyroid lesions, 402, 403 Thyroid lobectomy, 329 Thyroiditis, 331, 332 Thyrotoxicosis/hyperthyroidism, 330–332 causes of, 331t differential diagnosis of, 332 epidemiology of, 331 history of, 331 physical examination for, 332 testing, 332 toxic nodular goiter, 332 Tilt table testing, 31 Tinnitus, 107–109 causes of, 107 differential diagnosis of, 109 epidemiology of, 108 hearing loss, 93 history of, 108 objective (somatosounds), 107 physical examination for, 109 subjective, 108 testing, 109 Tobacco See Smoking Torsade de Pointes (TdP), 147 Toxic adenoma, 331 Toxic epidermal necrolysis, erythema multiforme, 296, 297t Toxic multinodular goiter, 331 Toxic nodular goiter, hyperthyroidism, 332 Toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex syndrome (TORCH), 340 Transient ischemic attacks (TIAs), 62, 63 Transvaginal ultrasound dysmenorrhea, 249 menorrhagia, 253 postmenopausal bleeding, 261 Trauma hoarseness, 95 knee pain, 273 neck pain, 283 nosebleed, 97–99 pneumothorax, 161 scrotal mass, 234 684 scrotal pain, 235, 236 shoulder pain, 290, 292 stridor, 169 visual loss, 74 Traumatic pneumothorax, 161 Traveler’s diarrhea, 186 Tremor, 64–65 action, 64 differential diagnosis of, 65 intention, 64 kinetic, 64 posture-specific, 65 postural, 64 resting, 64 task-specific, 65 testing, 65 Tricuspid stenosis, 129f, 131 Triple test, breast mass, 244 Tumors, brain, headache, 20 Turner’s syndrome amenorrhea, 242, 243 diastolic heart murmur, 130 osteopenia, 405 Tympanic membrane (TM), 92 Tzanck smear, 312 U Ulcerations, 86 Ulcerative colitis, 105 Ulcers, hoarseness, 95 Ultrasonography abdominal pain, 175 abnormal mammogram, 399 in anorexia, 12 breast cancer, 399 breast mass, 244 hepatitis, 203 hepatomegaly, 207 hip pain, 272 jaundice, 209 mediastinal mass, 404 nipple discharge, 255 oliguria, 231 osteopenia, 407 pleural effusions, 156 priapism, 233 pulmonary nodule, solitary, 410 scrotal mass, 235 scrotal pain, 237 685 splenomegaly, 342 stridor, 169 thyroid enlargement, 327 thyroid nodules, 323, 328, 329, 330, 332 Undifferentiated problems anorexia, 5–7 dizziness, 7–9 edema, 9–10 falls, 11–13 fatigue, 14–16 fever, 16–18 headache, 19–20 hypersomnia, 21–23 insomnia, 24–25 nausea and vomiting, 26–27 night sweats, 28–29 syncope, 29–31 weight loss, unintentional, 32–33 Upbeat, nystagmus, 76 Urethral discharge (UD), 238–241 complications, 241 diagnosis of, 240 history of, 239 physical examination for, 240 testing, 240 Urethritis arthralgia, 266 dysuria, 216 urethral discharge, 240, 241 Urinalysis abdominal pain, 175 nocturia, 227 oliguria and anuria, 230 petechiae and purpura, 339 polydipsia, 325 postmenopausal bleeding, 260 scrotal pain, 237 urinary incontinence, 225 weight loss, unintentional, 33 Urinary incontinence (UI), 223–225 acute, 223 causes of, 223 chronic, 224 diabetes insipidus, 224 diagnosis of, 225 DRIP mnemonic, 224 epidemiology of, 223 history of, 224 medications for, 224 physical examination for, 225 686 testing, 225 types of, 223 urinalysis, 225 urine volume, postvoiding of, 225 voiding history, 224 voiding journal, 225 Urinary indices, 230, 231t Urinary tract infection (UTI), 216 Urticaria, 309–310 acute, 309 causes of, 309 chronic, 309 differential diagnosis of, 310 epidemiology of, 309 history of, 309 immunologic, 309 nonimmunologic, 309 physical examination for, 309 rash, 308 testing, 309 Uveitis, 83, 85 V Varicocele, 236 Vascular and lymphatic systems lymphadenopathy, generalized, 335–337 lymphadenopathy, localized, 337–338 petechiae and purpura, 339–340 splenomegaly, 341–343 Vascular dementias, 54 Venous hums, 107, 109 Venous thromboembolism, Wells Criteria, 382, 383t Ventilation–perfusion, 119, 162, 166 Ventricular fibrillation (VF), 147 Ventricular tachycardia (VT), 146 Vertigo, 110–113 causes of, 110 DH test, 112 differential diagnosis of, 112 dizziness, epidemiology of, 111 head thrust, 112 history of, 111 neurologic examination, 112 otoscopy, 112 physical examination for, 112 testing, 112 Vesicular and bullous eruptions, 310–312 causes of, 310 687 differential diagnosis of, 312 history of, 311 physical examination for, 311 testing, 312 Vesiculobullous rashes, 307, 308 Video-assisted thoracic surgery (VATs) advantage of, 410 pulmonary nodule, solitary, 410 Videoradiography, dysphagia, 192 Viral hepatitis, 199, 200, 201, 203t Vision blurred, 66–67 causes of, 66, 67t differential diagnosis of, 67 epidemiology of, 66 history of, 66 physical examination for, 66 pupillary examination, 67 loss of, 72–75 bilateral, 73 binocular, partial, 74 binocular, total, 72 causes of, 72 differential diagnosis of, 74 history of, 72 monocular, 73 physical examination for, 74 red eye, 83 testing, 67 Visual acuity blurred vision, 66 nystagmus, 77 scotoma, 87, 88 Vitamin D deficiency, 333–334 causes of, 333 clinical manifestations, 333 diagnosis of, 334 dietary sources for, 333 Dowager’s hump, 334 epidemiology of, 333 history of, 333 parathyroid hormone, 333, 334 physical examination for, 333 risk factors for, 333 Vitiligo, 301, 304 Vocal cord lesions, hoarseness, 96 Vocal cord paralysis, hoarseness, 96, 169 Voice strain, 96 Voice use, 95, 96 von Willebrand’s disease 688 nosebleed, 98 petechiae and purpura, 339, 340 W Water deprivation test, 325 Weber test, 93 Weight change depression, 41 menorrhagia, 251 Weight loss, unintentional, 32–33 causes of, 32 chronic medical conditions, 32 diagnosis of, 33 GI disorders, 32 history of, 33 infection, 32 malignant conditions, 32 neurologic/neuromuscular disorders, 32 pathophysiology, 32 physical examination for, 33 psychiatric causes, 33 social and age-related causes, 33 testing, 33 tinnitus, 109 Wheezing, 170–172 asthma, 170 causes of, 171t chronic obstructive pulmonary disease, 171 differential diagnosis of, 172 history of, 171 physical examination for, 171 purified protein derivative skin test, 172 shortness of breath, 165 vs stridor, 172 testing, 172 Wide complex tachycardia, 146 Torsade de Pointes, 147 ventricular fibrillation, 147 ventricular tachycardia, 146 Wilms tumor hematuria, 219 nystagmus, 78 Wilson’s disease hepatitis, 200, 201 jaundice, 208, 209 Wolff-Parkinson-White syndrome, 146 Working memory, 56 689 X Xerostomia, 90, 91 X-ray biphasic esophagram, dysphagia, 192 Z Zollinger-Ellison syndrome, 215 690 [...]... Southern Mississippi Hattiesburg, Mississippi 3.4 Suicide Risk David C Holub, MD, FAAFP Assistant Professor of Family Medicine University of Rochester School of Medicine and Dentistry Rochester, New York 5.7 Pupillary Inequality 5.8 Red Eye 5.9 Scotoma James E Hougas, III, MD Family Medicine Staff Physician 341st Medical Group Malmstrom AFB Montana 7.8 Systolic Heart Murmurs 20 Michael J Hovan, MD Associate... Nebraska 4 Problems Related to the Nervous System 4.2 Coma 7.7 Diastolic Heart Murmurs Scott Ippolito, MD, FAAFP Associate Dean of Clinic Sciences and Professor Ross University School of Medicine Dominica, West Indies; 21 Chair Department of Family Medicine South Nassau Communities Hospital Oceanside, New York 18.5 Solitary Pulmonary Nodule David S Jackson Jr, MD Associate Professor Department of Family... Curtiss B Cook, MD Professor of Medicine Division of Endocrinology Mayo Clinic College of Medicine Mayo Clinic Scottsdale, Arizona 14.1 Diabetes Mellitus Lauri Costello, MD Family Physician Assistant Professor Introduction to Clinical Medicine Department 12 Ross University Dominica, West Indies 18.2 Bone Cyst Ronnie Coutinho, MD Associate Professor Ross University School of Medicine Dominica, West Indies... on the basis of undifferentiated and sometimes confusing presenting complaints or concerns The increasing “pressure to produce” in the clinical setting and the demands for high-quality health care have made the effective use of time in the clinic essential for primary care practitioners Taylor s Differential Diagnosis Manual is designed to support the busy practitioner in the process of diagnosing patient... Base, Nebraska; Adjunct Assistant Professor Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 4.5 Memory Impairment Iriana Hammel, MD, FACP Associate Professor Internal Medicine & Geriatrics Ross University School of Medicine Dominica, West Indies 18.4 Osteopenia Thomas J Hansen, MD Associate Dean for Medical Education Creighton University School of Medicine; Associate... Winston-Salem, North Carolina 6.7 Stomatitis Ashley J Falk, MD Assistant Professor Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 15 Vascular and Lymphatic System Problems Nathan Falk, MD, CAQSM Assistant Professor Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska; Chief Primary Care Sports Medicine Offutt Air Force Base, Nebraska... MD Associate Professor Department of Community Health & Family Medicine University of Florida College of Medicine Gainesville, Florida 10.7 Priapism Enrique S Fernandez, MD, MSBD, FAAFP Senior Associate Dean for Clinical Sciences Professor of Family Medicine Ross University School of Medicine Dominica, West Indies 18 Diagnostic Imaging Abnormalities 18.3 Mediastinal Mass N Benjamin Fredrick, MD Associate... Associate Director, Rural Training Track Regional West Medical Center Scottsbluff, Nebraska; Rural Training Track Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 9.2 Ascites 9.6 Epigastric Distress 9.7 Upper Gastrointestinal Bleeding 9.8 Hepatitis 9.12 Steatorrhea Rahul Kapur, MD, CAQSM 22 Assistant Professor Family Medicine & Sports Medicine University of Pennsylvania... Clarkson Family Practice Residency Omaha, Nebraska 2.7 Headaches 2.12 Syncope David K Gordon II, MD Family Physician Flight Surgeon Pentagon Flight Medicine Clinic Arlington, Virginia 8.7 Shortness of Breath Health A Grames, PhD, LMFT Assistant Professor/Program Director Marriage and Family Therapy Program Department of Child and Family Studies The University of Southern Mississippi Hattiesburg, Mississippi... Phosphatase, Elevated Christy A Thomas, MD Senior Resident Department of Family Medicine Wake Forest Baptist Health Winston-Salem, North Carolina 6.8 Tinnitus Denae M Torpey, DO Chief Resident Department of Family Medicine University of Nebraska Medical Center Omaha, Nebraska 4.7 Seizures Diego R Torres-Russotto, MD Assistant Professor Department of Neurological Sciences; Director UNMC Movement Disorders