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  • Abdominal Distention

  • Abdominal Pain

  • Adrenal Mass

  • Alopecia

  • Amenorrhea

  • Anorexia

  • Anuria

  • Arthritis

  • Ascites

  • Back Pain

  • Breast Lump

  • Chest Pain

  • Chills

  • Clubbing

  • Coma

  • Constipation

  • Cough: Acute and Chronic

  • Cyanosis

  • Delirium

  • Dementia

  • Diaphoresis

  • Diarrhea: Acute and Chronic

  • Diplopia

  • Dizziness

  • Dyspareunia

  • Dysphagia

  • Dyspnea

  • Dysuria

  • Earache

  • Edema

  • Epistaxis

  • Facial Swelling

  • Failure to Thrive

  • Fever

  • Fever of Unknown Origin (FUO)

  • Flank Pain

  • Flatulence

  • Frequency

  • Galactorrhea

  • Genital Sore

  • Gynecomastia

  • Headache

  • Heartburn

  • Hematemesis, Melenemesis, and Melena

  • Hematochezia

  • Hematuria

  • Hemoptysis

  • Hepatomegaly

  • Hiccups (Singultus)

  • Hirsutism

  • Hypersomnia

  • Impotence (Erectile Dysfunction)

  • Incontinence (Urinary)

  • Insomnia

  • Jaundice

  • Loss of Consciousness

  • Low Back Pain

  • Lymphadenopathy and Splenomegaly

  • Melena

  • Nausea and Vomiting

  • Night Sweats

  • Nystagmus

  • Oliguria/Anuria

  • Palpitations

  • Pleural Effusion

  • Pruritis

  • Seizures

  • Sleep Disturbance: Insomnia, Hypersomnia

  • Smell Disorders: Anosmia, Hyposmia, Parosmia, Olfactory hallucination

  • Splenomegaly

  • Syncope

  • Taste Disorders: Dysgeusia, Hypogeusia, Ageusia

  • Tremors

  • Vaginal Bleeding

  • Vaginal Discharge

  • Vertigo

  • Vision Loss, Acute

  • Vomiting

  • Weight loss

  • Wheezing

  • Xerostomia

This section presents some of the more common presenting symptoms, physical signs, and other conditions that are encountered in daily patient care. It is not an all-inclusive listing but provides a starting point for patient care. This primarily notes common diagnostic possibilities in adults with select pediatric differentials.

Chapter update by Brian Calio, MD, and Leonard G. Gomella, MD


Ascites, intestinal obstruction, ovarian/renal cysts, tumors, hepatosplenomegaly, abdominal aortic aneurysm, uterine enlargement (pregnancy), bladder distention/retention, inflammatory mass


Characterized by location of abdominal pain based on Figure 9-1.

Figure 9-1

Abdominal pain differential based on location. (From Stern SC, Cifu AS, Altkorn D. [eds.]. Symptom to Diagnosis: An Evidence-Based Guide, 4e, New York, NY: McGraw-Hill; 2006.)

Diffuse: Gastroenteritis, intestinal angina, early appendicitis, colitis, diabetic ketoacidosis, hereditary angioedema, mesenteric thrombosis, mesenteric lymphadenitis, peritonitis, porphyria, sickle cell crisis, uremia, renal colic, renal infarct, pancreatitis

Right upper quadrant: Gallbladder disease (cholecystitis, cholangitis, choledocholithiasis), hepatitis, hepatomegaly, pancreatitis, pneumonia, pulmonary embolus, pyelonephritis, renal colic, renal infarct, appendicitis (retroperitoneal)

Left upper quadrant: Esophagitis, hiatal hernia, esophageal rupture, gastritis, pancreatitis, PUD, myocardial infarction, pericarditis, dissecting aneurysm, pneumonia, pulmonary embolus, pyelonephritis, renal colic, renal infarct, splenic abscess, splenic rupture, splenic infarct

Lower abdomen: Aortic aneurysm, colitis including inflammatory bowel disease, diverticulitis including Meckel diverticulum, intestinal obstruction, hernia, perforated viscus, pregnancy, ectopic pregnancy, dysmenorrhea, endometriosis, mittelschmerz (ovulation), ovarian cyst or tumor (especially with torsion), PID, renal colic, UTI, rectal hematoma, bladder distension

Right lower quadrant: Appendicitis, ectopic pregnancy, ovarian cyst or tumor, salpingitis, mittelschmerz, cholecystitis, perforated duodenal ulcer, Crohn’s disease


Adenoma, hyperplasia, metastasis, adrenocortical carcinoma, pheochromocytoma, cyst, varices, hemorrhage, congenital adrenal hyperplasia, ganglioneuroma, micronodular adrenal disease


Male pattern baldness (androgenic type ...

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