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Published on 02/06/2015 by admin

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Last modified 22/04/2025

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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

Tall Stature ²⁸

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

Tarsal Tunnel Syndrome

• Plantar fasciitis

• Peripheral neuropathy

• Proximal radiculopathy

• Local tendinitis

• Peripheral vascular disease

• Morton’s neuroma

Testicular Failure ¹⁰

Testicular Neoplasm

• Spermatocele

• Epididymitis

• Epidermoid cyst of the testicle

• Epididymis tumors

Testicular Pain

• Testicular torsion

• Epididymitis

• Urolithiasis

• Inguinal hernia

• Infection (cellulitis, abscess, folliculitis)

Testicular Torsion

• Torsion of the testicular appendages

• Testicular tumor

• Epididymitis

• Incarcerated inguinoscrotal hernia

• Spermatocele

Tetralogy of Fallot

• 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

Thrombocytopenia

INCREASED DESTRUCTION

Immunologic

• Drugs: quinine, quinidine, digitalis, procainamide, thiazide diuretics, sulfonamides, phenytoin, aspirin, penicillin, heparin, gold, meprobamate, sulfa drugs, phenylbutazone, nonsteroidal anti-inflammatory drugs (NSAIDs), methyldopa, cimetidine, furosemide, isoniazid (INH), cephalosporins, chlorpropamide, organic arsenicals, chloroquine, platelet glycoprotein IIb/IIIa receptor inhibitors, ranitidine, indomethacin, carboplatin, ticlopidine, clopidogrel

• Idiopathic thrombocytopenic purpura (ITP)

• Transfusion reaction: transfusion of platelets with plasminogen activator (PLA) in recipients without PLA-1

• Fetal/maternal incompatibility

• Collagen-vascular diseases (e.g., systemic lupus erythematosus [SLE])

• Autoimmune hemolytic anemia

• Lymphoreticular disorders (e.g., chronic lymphocytic leukemia [CLL])

Nonimmunologic

• Prosthetic heart valves

• Thrombotic thrombocytopenic purpura (TTP)

• Disseminated intravascular coagulation (DIC)

• Hemolytic-uremic syndrome (HUS)

• Giant cavernous hemangioma

HYPERSPLENISM; SPLENIC SEQUESTRATION; DILUTIONAL, AS A RESULT OF MASSIVE TRANSFUSION

Thrombophlebitis, Superficial

• Lymphangitis

• Erythema nodosum

• Panniculitis

• Kaposi’s sarcoma

Thrombotic Thrombocytopenic Purpura

• Disseminated intravascular coagulation (DIC)

• Malignant hypertension

• Eclampsia or preeclampsia

• Hemolytic-uremic syndrome (typically encountered in children, often after a viral infection)

• Gastroenteritis as a result of a serotoxin-producing serotype of Escherichia coli

• Medications: clopidogrel, ticlopidine, penicillin, antineoplastic chemotherapeutic agents, oral contraceptives

Thyroid Nodule

• Thyroid carcinoma

• Multinodular goiter

• Thyroglossal duct cyst

• Epidermoid cyst

• Laryngocele

• Nonthyroid neck neoplasm

• Branchial cleft cyst

Thyroid Storm

• Psychiatric disorders

• Alcohol or other drug withdrawal

• Pheochromocytoma

• Metastatic neoplasm

Thyroiditis

• The hyperthyroid phase of Hashimoto’s, subacute, or silent thyroiditis can be mistaken for Graves’ disease.

• Riedel’s thyroiditis can be mistaken for carcinoma of the thyroid.

• Painful subacute thyroiditis can be mistaken for infections of the oropharynx and trachea or for suppurative thyroiditis.

• Factitious hyperthyroidism can mimic silent thyroiditis.

Thyromegaly

• Graves’ disease

• Thyroiditis (lymphocytic, granulomatous, suppurative)

• Toxic adenoma

• Neoplasm (primary, metastatic)

Tick-Related Infections

• Lyme disease

• Rocky Mountain spotted fever

• Colorado tick fever

• Ehrlichiosis

• Relapsing fever

Tinea Barbae and Tinea Faciei

• Folliculitis

• Furunculosis

• Actinomycosis

Tinea Cruris

• Seborrheic dermatitis

• Candidiasis

• Tinea versicolor

Tinea Pedis

• Contact dermatitis

• Toe web infection

• Keratolysis exfoliativa

• Juvenile plantar dermatosis

Tinea Versicolor (Pityriasis Versicolor)

• Pityriasis alba

• Secondary syphilis

• Pityriasis rosea

• Seborrheic dermatitis

Tinnitus

• Pulsatile sounds: carotid stenosis, aortic valve disease, high cardiac output, arteriovenous malformations

• Muscular sounds: palatal myoclonus, spasm of stapedius or tensor tympani muscle

• Spontaneous autoacoustic emissions

• Auditory hallucinations

• Anxiety disorder

Trichinosis

• Early illness may resemble gastroenteritis.

• Later symptoms may be confused with measles, dermatomyositis, or glomerulonephritis.

Trichotillomania

• Iron deficiency

• Malnutrition

• Hypothyroidism

• Telogen effluvium

• Traction alopecia

• Alopecia areata

• Anagen effluvium

• Tinea capitis

Tricuspid Stenosis

• Congenital tricuspid atresia

• Endomyocardial fibrosis

• Right atrial thrombi

• Constrictive pericarditis

Trigger Finger

• Dupuytren’s contracture

• de Quervain’s tenosynovitis

• Acute digital tenosynovitis

• Proliferative tenosynovitis

• Carpal tunnel syndrome

• Flexion tendon rupture

Tropical Sprue

• Celiac disease

• Parasitic infestation

• Inflammatory bowel disease (IBD)

• Other causes of malabsorption (e.g., Whipple’s disease)

Tuberculosis, Miliary

• Widespread sites of possible dissemination associated with myriad differential diagnostic possibilities

• Typhoid fever

• Brucellosis

• Collagen-vascular disease

Tumor Markers Elevation ³⁹

Causes of elevated levels of tumor markers:

CARCINOEMBRYONIC ANTIGEN (CEA)

• Colonic cancer (higher levels if the tumor is more differentiated or is extensive or has spread to the liver)

• Lung or breast cancer; seminoma

• Cigarette smokers

• Cirrhosis, inflammatory bowel disease, rectal polyps, pancreatitis

• Advanced age

ALPHA-FETOPROTEIN

• Hepatocellular cancer: very high titers or a rising titer is strongly suggestive, but >10% of patients do not have an elevated level

• Hepatic regeneration (e.g., cirrhosis, alcoholic or viral hepatitis)

• Cancer of the stomach, colon, pancreas, or lung

• Teratocarcinoma or embryonal cell carcinoma (testis, ovary, extragonadal)

• Ataxia-telangiectasia

• Normal variant

PROSTATE-SPECIFIC ANTIGEN

• Prostate carcinoma (localized disease)

• Prostatic hyperplasia

• Prostatitis

• Prostatitic infarction

CANCER-ASSOCIATED ANTIGEN (CA19-9)^*

• Pancreatic carcinoma (80% with advanced, well-differentiated cancer have an elevated level)

• Other gastrointestinal cancers: colon, stomach, bile duct

• Acute or chronic pancreatitis

• Chronic liver disease

• Biliary tract disease

Turner’s Syndrome

• Noonan’s syndrome, an autosomally dominant inherited disorder also characterized by loose nuchal skin, midface hypoplasia, canthal folds, and stenotic cardiac valvular defects and affecting males and females equally; also have normal chromosome constitutions

• Other conditions in the differential diagnosis of loose skin, whether or not associated with edema:

• Fetal hydantoin syndrome (loose nuchal skin, midface hypoplasia, distal digital hypoplasia)

• Disorders of chromosome constitution (trisomy 21, tetrasomy 12p mosaicism)

• Congenital lymphedema (Milroy’s edema)

Typhoid Fever

• Brucellosis

• Amebic liver abscess

^* Preeclampsia/eclampsia is usually not associated with overt DIC.

^* Patients who cannot synthesize Lewis blood group antigens (∼5% of the population) do not produce CA19-9 antigen.

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