Differentials

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

There may be signs of acute intoxication, withdrawal, or cravings with cocaine/sympathomimetics use.

History of treatment with or ingestion of non-steroidal anti-inflammatory drugs, oral contraceptive pills, sympathomimetics, herbal medications (e.g., black cohosh, capsicum, ma huang), liquorice, immunosuppressants (cyclosporin, tacrolimus), erythropoietin, higher dose steroids, or chemotherapeutic anti-endothelial growth factor agents (bevacizumab) and tyrosine kinase inhibitors (e.g., sunitinib, sorafenif).[60]

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Drug toxicology screen may detect an illicit substance.

Hypokalaemia if excessive liquorice.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

There may be pruritus, oedema, or change in urine output.

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High serum creatinine.

Chronic anaemia may be seen.

Renal ultrasound may identify sclerotic or polycystic kidneys.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Typically younger patients with difficult-to-control hypertension or older patients at risk of atherosclerotic disease.

Renal artery bruits may be present.

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Renal duplex ultrasound or magnetic resonance angiogram of renal arteries confirms diagnosis.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Differential blood pressure in upper and lower extremities. Absent femoral pulses.

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CT, angiogram, or MRI confirms diagnosis.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Typically obese patients with daytime somnolence, snoring, or choking during sleep.

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Polysomnography shows nocturnal oxygen desaturation.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Few signs and symptoms other than mild metabolic alkalosis, relative hypernatraemia, potassium depletion, and elevated fasting glucose.

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Unprovoked hypokalaemia.

Plasma aldosterone high.

Plasma renin low.

Failure to suppress aldosterone with salt loading.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Dry skin, cold intolerance, weight gain, sluggishness, and goitre.

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Thyroid-stimulating hormone elevated in primary hypothyroidism.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Heat intolerance, weight loss, hyperphagia, palpitations.

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Thyroid-stimulating hormone suppressed and levels of free thyroid hormones elevated.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

There are often no differentiating symptoms; however, renal colic, abdominal pain, or bone fracture may occur.

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Hypercalcaemia, with elevated or inappropriately normal serum PTH.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Classic symptoms and signs include weight gain, moon face, dorsocervical fat pad, abdominal striae, and easy bruisability.

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Abnormal dexamethasone suppression, 24-hour urine free cortisol, and/or late-night salivary cortisol.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Paroxysms of hypertension, flushing, and headache.

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24-hour urine screen shows elevated vanillylmandelic acid, metanephrines, and/or catecholamines.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Acral (hand/foot/jaw) enlargement.

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Elevated insulin-like growth factor-1. Elevated serum growth hormone level, not suppressed by glucose load.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Signs/symptoms of systemic lupus erythematosus, rheumatoid arthritis, sclerodactly, or history of vasculitis.

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Elevated erythrocyte sedimentation rate, abnormal complement levels, positive anti-DNA, anti-ribonucleoprotein, anti-Smith antibodies, positive rheumatoid factor.

SIGNS / SYMPTOMS
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SIGNS / SYMPTOMS

Detected after 20 weeks' gestation in a previously normotensive patient.

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Urinary albumin excretion of 300mg/L/24 hours if pre-eclampsia occurs.

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