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Table5. Major symptoms

Major SymptomsDifferential diseases to consider
FeverMeningitis, acute sinusitis, tonsillitis, upper respiratory tract infection, influenza (flu), pneumonia, tuberculosis, infective endocarditis, cholecystitis, cholangitis, urinary tract infection, cellulitis, drug-induced fever
General malaiseHypothyroidism, tuberculosis, heart failure, hepatitis, iron deficiency anemia, depression
AnorexiaPeptic ulcers, acute hepatitis, acute adrenal insufficiency, depression
Weight lossHyperthyroidism, chronic obstructive pulmonary disease (COPD), malignant tumors, diabetes mellitus, anorexia nervosa, depression
Weight gainHypothyroidism, heart failure, nephrotic syndrome
Altered mental statusCerebral hemorrhage, cerebral infarction, intracranial hematoma, encephalitis, epilepsy, subarachnoid hemorrhage, meningitis, myocardial infarction, acute aortic dissection, acute gastrointestinal bleeding, sepsis, drug intoxication, alcoholic intoxication, carbon dioxide (CO2) narcosis, hypoglycemia, abnormal sodium metabolism, shock
SyncopeEpilepsy, pulmonary embolism, arrhythmia, valvular disease (aortic valve disease)
SeizureCerebral infarction, cerebral hemorrhage, encephalitis, encephalopathy, febrile convulsions, epilepsy
Vertigo and dizzinessCerebral hemorrhage, cerebral infarction, benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuronitis
EdemaHypothyroidism, heart failure, cirrhosis of liver, nephrotic syndrome, chronic kidney disease, drug-induced edema, deep vein thrombosis, lymphedema, angioedema
RashViral exanthem (measles, rubella, chicken pox, herpes simplex virus), shingles, erythema infectiosum, drug related-rash, urticaria, dermatitis (atopic dermatitis), erythema nodosum, eczema
Cough and sputum productionSinusitis, allergic rhinitis, upper respiratory tract infection, common cold, whooping cough, bronchitis, bronchial asthma, pneumonia, pulmonary tuberculosis, lung cancer, interstitial lung disease, gastroesophageal reflux disease (GERD), drug-induced cough
Blood in sputum and hemoptysisBronchiectasis, pulmonary tuberculosis, lung cancer
DyspneaAcute epiglottitis, asphyxia, bronchial asthma, pulmonary embolism, acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), pneumonia, interstitial lung disease, pulmonary tuberculosis, tension pneumothorax, spontaneous pneumothorax, heart failure, anaphylaxis
Chest painPulmonary embolism, pneumothorax, pleurisy, acute coronary syndrome, acute pericarditis, acute aortic dissection, aortic aneurysm rupture, shingles, panic disorder
PalpitationsHyperthyroidism, arrhythmia, iron deficiency anemia, secondary anemia, panic disorder, anxiety disorder
DysphagiaCerebral hemorrhage, cerebral infarction, tonsillitis, esophageal cancer
Abdominal painPeptic ulcers, functional dyspepsia (FD), acute gastroenteritis, acute appendicitis, diverticulitis, ischemic colitis, mesenteric artery embolism, constipation, irritable bowel syndrome, intestinal obstruction, intussusception, generalized peritonitis, inguinal hernia, cholecystitis, cholelithiasis, acute pancreatitis, acute coronary syndrome, acute aortic dissection, endometriosis, ectopic pregnancy, miscarriage, premature birth, ovarian cyst (torsion), ovarian cancer (torsion), urinary stone disease, diabetic ketoacidosis
Nausea and vomitingCerebral hemorrhage, subarachnoid hemorrhage, intracranial hematoma, meningitis, migraine, acute gastroenteritis, acute appendicitis, intestinal obstruction, food poisoning, acute myocardial infarction, pregnancy, diabetic ketoacidosis, abnormal calcium metabolism
HematemesisEsophageal varices, Mallory-Weiss syndrome, gastric cancer, peptic ulcers
MelenaPeptic ulcers, inflammatory bowel disease, ischemic colitis, diverticular hemorrhage, colorectal cancer, hemorrhoids, anal fissure
ConstipationParkinson’s disease, hypothyroidism, constipation, irritable bowel syndrome, intestinal obstruction, colorectal cancer, drug-induced constipation
DiarrheaHyperthyroidism, acute gastroenteritis, inflammatory bowel disease, irritable bowel syndrome, drug-induced diarrhea
JaundiceAcute hepatitis, chronic hepatitis, cirrhosis of liver, liver cancer, cholangitis, bile duct cancer, pancreatic cancer, hemolytic anemia, drug-induced jaundice, physiologic jaundice
Abdominal distention and abdominal massCirrhosis of liver, intestinal obstruction, inguinal hernia, pregnancy
LymphadenopathyTonsillitis, viral rash (rubella), tuberculosis, infectious mononucleosis, malignant lymphoma, other malignant tumors
Abnormal urine output/urinationUrinary tract infections, prostatic hyperplasia, overactive bladder, neurogenic bladder, drug-induced, diabetes mellitus
HematuriaGlomerulonephritis syndrome, renal cell carcinoma, urinary stone disease, urinary tract infections, bladder cancer
Menstrual abnormalityDysmenorrhea, endometriosis, uterine cancer, pregnancy, drug-induced menstrual irregularities, menopausal and female climacteric states
Anxiety/depressionDementia, Parkinson’s disease, hyperthyroidism, hypothyroidism malignancy, drug-induced, depression, bipolar disorder, anxiety disorders, adjustment disorders
Cognitive dysfunctionDementia, Parkinson’s disease, cerebral infarction, normal pressure hydrocephalus, chronic subdural hematoma, hypothyroidism, drug-induced, depression
HeadacheMigraine, tension headache, cluster headache, cerebral hemorrhage, subarachnoid hemorrhage, meningitis, glaucoma, acute sinusitis, giant cell arteritis (temporal arteritis), drug-induced headache
Skeletal muscle paralysis/muscle weaknessCerebral infarction, transient ischemic attack, cerebral hemorrhage, intracranial hematoma, epilepsy, spinal cord injury, herniated intervertebral disc, amyotrophic lateral sclerosis, Guillain-Barré syndrome, polymyositis, dermatomyositis, abnormal potassium metabolism
Gait disturbanceCerebral hemorrhage, intracranial hematoma, cerebral infarction, Parkinson’s disease, osteoarthritis, spinal stenosis, herniated intervertebral disc, osteoarthritis, bone fracture
Sensory disturbanceSpinal stenosis, herniated intervertebral disc, polyneuritis, diabetes mellitus
Back painAcute aortic dissection, acute pancreatitis, pancreatic cancer, urinary stone disease, herniated intervertebral disc, osteoarthritis, spinal stenosis, vertebral fracture, acute low back pain, pyogenic spondylitis
Arthralgia/joint swellingPyogenic arthritis, osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus (SLE), reactive arthritis, gout, pseudogout, trauma