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T

Tabes Dorsalis

• Vitamin B12 deficiency (subacute combined degeneration of the spinal cord)
• Vitamin E deficiency
• Chronic nitrous oxide abuse
• Spinal cord neoplasm (involving conus medullaris)
• Lyme disease

Takayasu’s Arteritis

• Giant cell arteritis
• Syphilis
• TB
• Systemic lupus erythematosus (SLE)
• Rheumatoid arthritis (RA)
• Buerger’s disease
• Behçet’s disease
• Cogan’s syndrome
• Kawasaki’s disease
• Spondyloarthropathy

Tall Stature28

CONSTITUTIONAL (FAMILIAL OR GENETIC)

Most common cause

ENDOCRINE CAUSES

• Growth hormone excess: gigantism
• Sexual precocity (tall as children, short as adults): true sexual precocity, pseudosexual precocity
• Androgen deficiency: Klinefelter’s syndrome, bilateral anorchism

GENETIC CAUSES

• Klinefelter’s syndrome
• Syndromes of XYY, XXYY

MISCELLANEOUS SYNDROMES AND DISORDERS

• Cerebral gigantism or Sotos syndrome: prominent forehead, hypertelorism, high arched palate, dolichocephaly, mental retardation, large hands and feet, and premature eruption of teeth; large at birth, with most rapid growth in first 4 years of life
• Marfan syndrome: disorder of mesodermal tissues, subluxation of the lenses, arachnodactyly, aortic aneurysm
• Homocystinuria: same phenotype as Marfan syndrome
• Obesity: tall as infants, children, and adolescents
• Total lipodystrophy: large hands and feet, generalized loss of subcutaneous fat, insulin-resistant diabetes mellitus, hepatomegaly
• Beckwith-Wiedemann syndrome: neonatal tallness, omphalocele, macroglossia, neonatal hypoglycemia
• Weaver-Smith syndrome: excessive intrauterine growth, mental retardation, megalocephaly, widened bifrontal diameter, hypertelorism, large ears, micrognathia, camptodactyly, broad thumbs, limited extension of elbows and knees
• Marshall-Smith syndrome: excessive intrauterine growth, mental retardation, blue sclerae, failure to thrive, early death

Tardive Dyskinesia13

• Medications (antidepressants, anticholinergics, amphetamines, lithium, levodopa, phenytoin)
• Brain neoplasms
• Ill-fitting dentures
• Huntington’s disease
• Idiopathic dystonias (tics, blepharospasm, aging)
• Wilson’s disease
• Extrapyramidal syndrome (postanoxic or postencephalitic)
• Torsion dystonia

Tarsal Tunnel Syndrome

• Plantar fasciitis
• Peripheral neuropathy
• Proximal radiculopathy
• Local tendinitis
• Peripheral vascular disease
• Morton’s neuroma

Taste and Smell Loss1

TASTE

• Local: radiation therapy
• Systemic: cancer, renal failure, hepatic failure, nutritional deficiency (vitamin B12, zinc), Cushing’s syndrome, hypothyroidism, diabetes mellitus (DM), infection (influenza), drugs (antirheumatic and antiproliferative)
• Neurologic: Bell’s palsy, familial dysautonomia, multiple sclerosis

SMELL

• Local: allergic rhinitis, sinusitis, nasal polyposis, bronchial asthma
• Systemic: renal failure, hepatic failure, nutritional deficiency (vitamin B12), Cushing’s syndrome, hypothyroidism, DM, infection (viral hepatitis, influenza), drugs (nasal sprays, antibiotics)
• Neurologic: head trauma, multiple sclerosis (MS), Parkinson’s disease, frontal brain tumor

Telangiectasia

• Oral contraceptive agents
• Pregnancy
• Rosacea
• Varicose veins
• Trauma
• Drug induced (corticosteroids, systemic or topical)
• Spider telangiectases
• Hepatic cirrhosis
• Mastocytosis
• Systemic lupus erythematosus (SLE), dermatomyositis, systemic sclerosis

Tendinopathy27

INTRINSIC FACTORS

Anatomic Factors

• Malalignment
• Muscle weakness or imbalance
• Muscle inflexibility
• Decreased vascularity

Systemic Factors

• Inflammatory conditions (e.g., systemic lupus erythematosus [SLE])
• Pregnancy
• Quinolone-induced tendinopathy

Age-Related Factors

• Tendon degeneration
• Increased tendon stiffness
• Tendon calcification
• Decreased vascularity

EXTRINSIC FACTORS

Repetitive Mechanical Load

• Excessive duration
• Excessive frequency
• Excessive intensity
• Poor technique
• Workplace factors

Equipment Problems

• Footwear
• Athletic field surface
• Equipment factors (e.g., racquet size)
• Protective gear

Testicular Failure10

PRIMARY

• Klinefelter’s syndrome (XXY)
• XYY
• Vanishing testes syndrome (in utero or early postnatal torsion)
• Noonan’s syndrome
• Varicocele
• Myotonic dystrophy
• Orchitis (mumps, gonorrhea)
• Cryptorchidism
• Chemical exposure
• Irradiation to testes
• Spinal cord injury
• Polyglandular failure
• Idiopathic oligospermia or azoospermia
• Germinal cell aplasia (Sertoli cell–only syndrome)
• Idiopathic testicular failure
• Testicular torsion
• Testicular trauma
• Diethylstilbestrol (maternal use during pregnancy resulting in estrogen exposure in utero)
• Testicular tumor with subsequent radiation therapy, chemotherapy, or surgery (retroperitoneal lymph node dissection or orchiectomy)

SECONDARY

• Delayed puberty
• Kallmann’s syndrome
• Isolated gonadotropin deficiency
• Prader-Labhart-Willi syndrome
• Lawrence-Moon-Biedl syndrome
• CNS irradiation
• Prepubertal panhypopituitarism
• Postpubertal panhypopituitarism
• Hypogonadism secondary to hyperprolactinemia
• Adrenogenital syndrome
• Chronic liver disease
• Chronic renal failure/uremia
• Hemochromatosis
• Cushing’s syndrome
• Malnutrition
• Massive obesity
• Sickle cell anemia
• Hyperthyroidism/hypothyroidism
• Anabolic steroid use

Testicular Neoplasm

• Spermatocele
• Varicocele
• Hydrocele
• Epididymitis
• Epidermoid cyst of the testicle
• Epididymis tumors

Testicular Pain

• Testicular torsion
• Trauma
• Epididymitis
• Orchitis
• Neoplasm
• Urolithiasis
• Inguinal hernia
• Infection (cellulitis, abscess, folliculitis)
• Anxiety

Testicular Size Variations10

SMALL TESTES

• Normal variant
• Hypothalamic-pituitary dysfunction
• Gonadotropin deficiency
• Growth hormone deficiency
• Primary hypogonadism
• Autoimmune destruction, chemotherapy, cryptorchidism, irradiation, Klinefelter’s syndrome, orchiditis, testicular regression syndrome, torsion, trauma

LARGE TESTES

• Adrenal rest tissue
• Compensatory
• Fragile X syndrome
• Idiopathic
• Tumor

Testicular Torsion

• Torsion of the testicular appendages
• Testicular tumor
• Epididymitis
• Incarcerated inguinoscrotal hernia
• Orchitis
• Spermatocele
• Hydrocele

Tetanus27

• Acute abdomen
• Black widow spider bite
• Dental abscess
• Dislocated mandible
• Dystonic reaction
• Encephalitis
• Head trauma
• Hyperventilation syndrome
• Hypocalcemia
• Meningitis
• Peritonsillar abscess
• Progressive fluctuating muscular rigidity (stiff-man syndrome)
• Psychogenic
• Rabies
• Sepsis
• Subarachnoid hemorrhage
• Status epilepticus
• Strychnine poisoning
• Temporomandibular joint syndrome

Tetralogy of Fallot

• Asthma
• Isolated ventricular septal defect (VSD)
• Pulmonary atresia
• Patent ductus arteriosus
• Aortic stenosis
• Pneumothorax

Thoracic Outlet Syndrome

• Carpal tunnel syndrome
• Cervical radiculopathy
• Brachial neuritis
• Ulnar nerve compression
• Reflex sympathetic dystrophy
• Superior sulcus tumor

Thromboangiitis Obliterans

• Limb ischemia resulting from emboli or atherosclerotic occlusive disease
• Antiphospholipid antibody syndrome
• Autoimmune disorders
• Acrocyanosis
• Carpal tunnel syndrome
• CREST (calcinosis cutis, Raynaud’s phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) syndrome
• Systemic lupus erythematosus
• Diabetes mellitus
• Repetitive vibratory equipment use
• Hypothenar hammer syndrome
• Raynaud’s phenomenon
• Ergotamine intoxication
• Polyarteritis nodosa
• Cannabis arteritis
• Peripheral neuropathy

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