Haemoptysis. 41 H Haematemesis See Gastrointestinal bleeding Haemarthrosis ‘Trauma: iatrogenic, postUoperative, fracture, meniscus tear, ligamentous injury (e.g. anterior cruciate) Haematological: Clotting disorders, sickle cell disease, drugs Infection: Septic arthritis, TB Vascular: haemangioma, arteriovenous malformation, aneurysm Neurological: Charcot's joint Joint diseases: Osteoarthritis, gout, pseudogout Scurvy Tumour: pigmented villonodular synovitis Haematul Kidney, bladder, ureter or urethra Trauma Infection: UTI, rarely TB, schistosomiasis Stones Tumours Other causes: glomerulonephritis, IgA nephropathy, interstitial nephritis, cystic renal disease, emboli, renal vein thrombosis, vascular malformation, drugs, e.g. cyclophosphamide, excessive exercise Prostate: benign prostatic hyperplasia, prostate cancer, prostatitis General: haematological disorders (haemophilia, thrombocytopenia, sickle cell disease, leukaemia), anticoagulants Other causes of urine discoloration Food: beetroot Drugs (senna, rifamipcin) Haemoglobinuria/myoglobinuria Porphyria (acute intermittent) Haemoglobin t See Anaemia T See Polycythaemia Haemoptysis Lung: infection (TB, pneumonia, abscess, bronchitis, bronchiectasis fungi, parasites), pulmonary embolism, malignancy, vasculitis (e.g. Wegener's granulomatosis, Goodpasture’s disease), trauma, foreign body Heart: mitral stenosis General bleeding diathesis Rarer causes: arteriovenous malformation, amyloidosis, sarcoidosis Note: Nasal/upper respiratory tract and Gl bleeding may be confused with haemoptysisa2 Hair loss Hair loss See Alopecia Halitosis Mouth: Poor dental hygiene, dental plaque, gingivitis, oropharyngeal malignancy Nasopharynx: Atrophic rhinitis, chronic sinusitis and postUnasal drip, chronic tonsillitis, pharyngeal pouch GI: achalasia, oesophageal stricture, GORD Lung: infections, bronchiectasis Hallucination Psychiatric Schizophrenia/schizoaffective disorder Mania with psychosis Severe depression with psychosis Dementia Delirium Puerperal psychosis Alcoholic hallucinosis Organic Cerebrovascular (stroke), infection, toxic/metabolic (e.g. alcohol, hallucinogens, e.g. LSD), drugUinduced psychosis (e.g. amphetamine, cocaine) Sensory organ disease, e.g. retinal ischaemia/optic nerve lesions Seizures Hand pain See Finger pain Hands, enlarged Acromegaly Amyloidosis Hypothyroidism Obesity Manual work Headache Acute/subacute causes (likely to present in A&E) Head injury Meningitis/encephalitis Subarachnoid haemorrhage, intracranial haemorthage, cerebral venous thrombosis Carotid/vertebral artery dissection Acute angle closure glaucoma Giant cell arteritis Pituitary apoplexy Other causes: | | BP, drugs (e.g. GTN, Ca channel antagonists), infections (bacterial, viral illnesses etc,), electrolyte imbalances (e.g. hyponatraemia), hyperviscosity syndromes (e.g. polycythaemia) Chronic/recurrent 1 Intracranial pressure (e.g. space occupying lesion, e.g. tumour/abscess, hydrocephalus, benign intracranial hypertension) and | intracranial pressure (e.g. post lumbar puncture)Heart sounds 43, Migraine Migrainous neuralgia Tension headache, rebound headache (on stopping analgesics) Sinusitis Other causes: cervicogenic (referred from cervical spondylosis), hypnic headache, meningeal infiltration (e.g. malignancy, sarcoidosis), refractive errors, Paget's disease of bone, acromegaly, antiphospholipid syndrome See also Facial pain Heart sounds First (S1) Loud (1 intensity) Mitral stenosis, atrial myxoma Tachycardia, hyperdynamic circulation (e.g. fever, exercise) | PR interval (preUexcitation syndromes) Soft (1 intensity) Mitral regurgitation Artic regurgitation Long PR interval LBBB Severe heart failure Variable intensity Atrial fibrillation AV block Nodal or ventricular tachycardia Second (S2) Loud Systemic hypertension, tachycardia (7 a2) Pulmonary hypertension (1 p2) Soft Aortic stenosis (| a2) Pulmonary stenosis (| p2) Third (53) Normal in those < 35 years Ventricular failure Mitral regurgitation, tricuspid regurgitation, VSD Constrictive pericarditis, restrictive cardiomyopathy Fourth (54) Aortic stenosis Hypertensive heart disease Hypertrophic cardiomyopathy Myocardial infarction Pulmonary stenosis Splitting of $2 Wide Delayed activation of right ventricle RBBB, left ventricular pacing, left ventricular preexcitation (Wolff Parkinson-White syndrome)