Thickened tethered skin is usually suggestive of an underlying rheumatological/ immune condition.
Oh no, why on earth did you order a CRP?!
Autoimmune conditions may coexist, look for these conditions in patients with an autoimmune disorder.
Differential diagnosis of anosmia - loss of the sense of smell.
Anaphylaxis is a severe, life-threatening, generalised or systemic hypersensitivity reaction. It is characterised by rapidly developing life-threatening airway (pharyngeal or laryngeal edema) and/or breathing (bronchospasm and tachypnea) and/or circulation (hypotension and tachycardia) problems usually associated with skin and mucosal changes.
Lower gastrointestinal haemorrhage is classically bleeding from below the ligament of Trietz (the suspensory muscle of duodenum that connects to the diaphragm), and is characterised by hematochezia (blood passed in or with the stools) or rectorrhagia (blood leaking from the rectum). Massive upper GI bleeding may also present with hematochezia.
Abnormalities of the liver detected on palpation include: firm and irregular liver, tenderness, and pulsatility. See also hepatomegaly and hepatosplenomegaly. Differential diagnosis
Rectal masses may be intra-luminal, mural or palpable through the rectum but arising from outside of it. Differential diagnosis.
Splenomegaly refers to enlargement of the spleen. Differential diagnosis
Central pontine myelinolysis is a demyelinating disorder that affects the brainstem white matter, mostly central pons and occasionally cerebral hemispheres (then called ‘extrapontine myelinolysis’)
Important causes of diseases affecting the cerebellum
Dementia is a syndrome of acquired intellectual impairment characterized by persistent deficits in at least three of the following areas of mental activity: memory; language; visuospatial skills; personality/emotional state; cognition (abstraction, mathematics, and judgment)