MEDICINE

1- ABDOMEN – EPIGESTIC PAN / DISCOMFORT

RUQ

a- Biliary: Cholecystitis, Cholangitis – Fever, Obstruction of common bile duct and inflammation
 Jaundice + RUQ pain
b- Hepatic: Abscess, Hepatitis, Mass
c- Pulmonary: Pneumonia, Embolus
d- Renal: Pyelonephritis

LUQ

a- Cardiac: MI, Angina, Pericarditis

b- Gastric: Esophagitis, Gastritis, Peptic Ulcer
c- Pancreatic: Mass, Pancreatitis
d- Renal: Pyelonephritis, Renal Colic, Shingles

PERIUMBALICAL

a- Vascular: Aortic Dissection, Mesenteric Ischemia

RLQ

a- Colonic: Appendicitis, Colitis, IBD,

b- Gynaecologic: Ectopic, Fibroid, Ovarian Mass, Torsion, PID
c- Renal: Pyelonephritis

LLQ

a- Colonic: Colitis, Diverticulitis, IBD, IBS

SUPRAPUBIC

a- Gynaecologic: Ectopic, Fibroid, Ovarian mass, PID

2- ABDOMEN – DIARRHEA ( 4 I , 2 C , H A T )
i. IBD
ii. IBS
iii. Infection
a. Viral
b. Bacterial
c. Giardiasis
iv. Intolerance
v. Celiac
vi. Cancer
vii. HIV
viii. Antibiotic
ix. Thyrotoxicosis

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3- ABDOMEN – RECTAL BLEEDING
i- Anal fissure
ii- Haemorrhoid
iii- Polyp
iv- Diverticulitis
v- Cancer
vi- IBD
vii- Mesenteric Ischemia
viii- Perforated peptic Ulcer
ix- Gastric Ulcer
x- Bleeding disorder
xi- Blood thinner

4- ABDOMEN – Pain + RACTAL–BLEEDING (Left Side)

i- Diverticulitis
ii- Diverticulosis
iii- IBD
iv- Cancer
v- Mesenteric ischemia
vi- Bowel obstruction (PAIN)
vii- Renal – U T I
viii- PID
ix- Ovarian cyst
x- Torsion of testes.

5- ASTHMA – Non-complaint TRIGERING FACTORS ( A B C D E F G H I J )

i- A llergen – Pollen
ii- B ronchial infection (Frequent infections)
iii- C old weather (affect with)
iv- D rug like Aspirin
v- E xercise induced / emotional stress
vi- F ood
vii- G ORD
viii- H ormones (Preg / OCP)
ix- I rritants – Dust / Pets / Carpet / Smoke
x- J ob – paints fumes

6- BACK PAIN (ACUTE) Lifting wt from ground.

i- Trauma
ii- Muscle Strain
iii- Fracture
iv- Infection – Osteomyelitis / ankylosing spondylitis
v- Bone – Disc prolapse

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7- C V S Risk Assessment ( A B C D E F S P )
i. A lcohol / Age < 50 ys
ii. BMI/BP
iii. C holesterol / Cigarettes
iv. D iabetes / Diet
v. E xercise
vi. F amily Hx. of Cholesterolemia
vii. S tress / Sleep Apnoea
viii. P ast hx. of heart attacks, Stroke

8- CHEST PAIN ( CARDIC PLEURATIC GUT )

i. Cardiac
a. M I
b. A C S
c. Angina
d. Aortic dissection
ii. Pleuritic chest pain with breathing ( C P6 R )
a. Pneumonia
b. Pneumothorax
c. P E
d. Pleural effusion
e. Pericarditis
f. Costochondritis
g. Rib fracture
h. Panic attack
iii. Gut
a. Esophagitis
b. GORD
c. Peptic ulcer

9- COUGH
i- Allergic Rhinitis
ii- Ch. Sinusitis
iii- Post Nasal Drip
iv- Post viral Drip
v- Pertussis
vi- Asthma
vii- Ch. Bronchitis
viii- Lung Ca
ix- Pneumonia
x- Heart failure
xi- GIT Reflex
xii- Irritant exposure
xiii- Psychogenic

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10- DELERIUM – ( H I M E D )
i- H ypoxia – (Surgeries)
ii- I nfection – U T I
iii- M etabolic
a. Hypo Na.
b. Uraemia
c. Liver
iv- E ndocrine
a. DM
b. Thyroid
v- E C G – CVS / CNS
a. CVS:- MI / Heart Failure
b. CNS:- Trauma / Tumour / Stroke / TIA
vi- D rugs (Alcohol with drawl )
vii- D epression
viii- D ementia

11- DVT risk assessment ( COST VMPF )

i. C ontraception
ii. O besity
iii. S urgery
iv. T rauma / Travel
v. V aricose veins
vi. M alignancy
vii. P ast Hx
viii. P ost – partum
ix. F amily hx.

12- FOOT PAIN

A- FORE FOOT
a- Skin down
i- Cellulitis
ii- Planter fasciitis
b- Bone & Joints
i- Stress #
ii- Osteomyelitis
iii- Tumour
c- Joints
i- OA
ii- RA
iii- SA
d- Vessels & Nerves
i- Morton Neuroma
ii- PVD
B- HIND FOOT
a- Skin down
i- Skin infection
ii- Heal bruise (long standing)

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 iii- Planter Fasciitis
b- Bone
i- Calcaneal spur
ii- Calcaneal stress fracture
c- Joint
i- Ortho-arthritis of ankle
d- Nerve entrapment
i- Tarsal tunnel syndrome
e- Around ankle
i- Ankle sprain
ii- Achilles tendinitis
iii- Achilles tendon rupture

13- GOUT
i- Skin trauma
ii- Cellulitis
iii- Insect bite
iv- Bone and joints
a- O A
b- R A
c- P A
d- G A
e- S A

14- GYNACOMESTIA
a- Physiological
i- 0 – 3 weeks
ii- 10 – 17 yrs
iii- After 50s.
b- Pseudo
i- Obesity
ii- Breast CA to R/O
c- Pathological
i- Hyperthyroidism
ii- CLD
iii- Hypogonadism
iv- Testicular Ca
v- Medication ( D I S C 0 – A ) AMC cases
a- D igoxine
b- I sonizid
c- S pironolactone
d- C emetadine
e- O C P
f- Antiandrogen
g- Anabolic steroid
h- Alcohol

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15- HAEMATURIA
i- UTI
ii- STI
iii- PSGN
iv- IGAN
v- Stone
vi- TB
vii- Tumour
viii- Exercise
ix- Female – Period
x- Male – BPH
xi- Pseudo haematuria
xii- Bleeding disorder
xiii- Blood thinking medication

16- HEAD ACHE ( R M I T S )

i- Referred
a. Sinusitis
b. Tooth ache
c. T M Joint dysfunction
d. Ear pain
e. Neck – cervical
ii- Meningitis
iii- Migraine
iv- Head Injury
v- Tension H.A
vi- Temporal Arthritis
vii- Tumour
viii- Trauma
a- S A H
ix- Stroke

17- HOARSENESS ( S I3 T – C4 )
i- Stroke / TIA
ii- Infections
a. URTI
b. Overuse / Abuse of vocal card
c. Polyp
iii- Thyroid
iv- Cancer
a. Larynx
b. Pharynx
c. Oesophagus
d. Pancoast tumour

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18- JAUNDICE
a- Hepatitis
i- Viral
iii- Bacterial
iv- Drug induced.
b- Cirrhosis
c- C L D
d- Cholecystitis
e- Cholangitis
f- Cholangiocarcinoma (head of the pancreas)

19- JAUNDICE – ( ABP – FIT – NO-SEX )

i- A lcohol – hep
ii- B lood transfusion
iii- P earcing / tattooing
iv- F ood street
v- I licid drugs / Antibiotic
vi- T ravel
vii- N eedle injury
viii- O ccupation
ix- S exual Hx.

20- KNEE PAIN

a- Trauma
b- Tumour
c- Infection – S.A / O. M
d- Inflammation – JRA / HSP
e- Age – < 4 ( DDH – Transient synovitis)
f- Age - 4 – 8 ( Transient synovitis / Perthes )
g- Age – 10 – 15 ( O S D / SCFE
h- Age – 15 – 20 Chondromalacia Patella (Joggers Knee) / Patella tendinitis ( Jumper’s Knee)

21- LEG PAIN & SWELLING

a- SWELLING
j- Heart failure
k- Kidney failure
l- Liver failure
m- Lymphedema
b- LEG PAIN WITH SWELLING
i- PVD
ii- DVT
iii- Cellulitis
iv- Trauma
v- Insect bite

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22- LUMP IN THE NECK
a- CONGENITAL
i- Cystic Hygroma is a fluid-filled sac that results from a blockage in the lymphatic system. It is most commonly
located in the neck or head area, but can be located anywhere in the body. It may be discovered in a fetus during a
pregnancy ultrasound, or it may be apparent at birth as a soft bulge under the skin.
ii- Thyroglossal cyst
b- ACQUIRED
i- Post viral lymph adenitis
ii- Bacterial pharyngitis
iii- TB
iv- EBV
v- Cat stretch disease / Toxoplasmosis
vi- Lymphoma
vii- Leukemia

23- NECK / SHOULDER PAIN / CERVICAL SPONDYLOSIS

i- Trauma
ii- Muscle Strain
iii- Bone infection ( O M )
iv- Inflammation
a- Rheumatoid arthritis
b- Ankylosing Spondylitis
v- Metastasis – in the bone
vi- Disc – Spinal Cord. (CERVICAL SPONDYLOSIS )
vii- Refer pain from HEART.
viii- Pancoast tumour
ix- Shoulder pain
a- P M R
b- Polymyositis / Dermatomyositis
c- Fibromyalgia
d- C . F . Syndrome

24- NERVOUSNESS
i- Hyperthyroidism
ii- Pheochromocytoma
iii- Hypoglycaemia
iv- Arrythmia
v- Menopause
vi- POF
vii- GAD
viii- Panic Attack

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25- PALPITATION
a- CARDIA
ix- Arrythmias
x- Flutter
xi- A. Fibrillation
xii- SVT
xiii- IHD
xiv- Valvular Heart disease
xv- HTN
b- ENDOCRINE
i- Hyperthyroid
ii- Pheochromocytoma
c- HEAMODYNAMICS
i- Electrolytes – HYPERKALEMIA
ii- Alcohol
d- STAMULENTS
i- Tea
ii- Coffee
e- PANIC ATTACK
f- MEDICATION – Metoprolol, Atenolol, C. C. Blocker (Given for the treatment of High BP
or Irregular heartbeats).

26- Papilledema causes

i- Brain tumour
ii- C N S inflammation
iii- Idiopathic intracranial HTN
iv- Deceased CSF resorption (e.g.
a- venous sinus Thrombosis
b- meningitis
c- SAH
v- Cerebral Oedema / Encephalitis
vi- Medication ( e.g : tetracycline / Minocycline / Lithium / Corticosteroid (both use and
withdrawal )

27- RASH ON TRUNK ( HERPES ZOSTER)

a- Herpes zoster
b- H. Simplex (unlikely)
c- Contact dermatitis
d- Allergic rash
e- Post viral rash

28- RED EYE ( ZIKA / DANGUE )

i- Local
a- Trauma
b- F . B
c- Conjunctivitis
I- VIRAL

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 II- BACTERIAL
III- ALLERGIC
d- Keratitis – H S V ( Viral / Microbial )
e- Uveitis
f- Glaucoma
ii- Systemic ( Rheumatological)
a- Ankylosing Spondylitis
b- I B D
c- Bechet disease
d- Zika Disease
e- Dengue
f- Chickengonia
g- Travel

29- S O B ( ACUTE)
i- Pneumonia
ii- Pneumothorax
iii- Pulmonary Embolism
iv- Pleural Effusion
v- Acute exacerbation of ASTHMA or COPD
vi- Lung Ca
vii- Acute CCF
viii- MI
ix- Acute Panic ATTACK

30- S O B ( CHRONIC )
i- A typical pneumonia
ii- Asthma
iii- COPD
iv- C T Disease
v- Heart failure
vi- Lung Ca
vii- Mesothelioma
viii- Occupational Lung Disease
ix- Pleural Effusion
x- Pulmonary Embolism
xi- Panic attack
xii- TB

31- SORE THROAT

i- Viral pharyngitis
ii- Bacterial pharyngitis
iii- Quincy
iv- EBV
v- Gonorrhoea ( In pead CONDIDA / STEROID )
vi- Reflex
vii- Irritant Exposure

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32- SYNCOPE
a- CNS
i. TIA / Stroke
ii. Epilepsy
iii. Meningitis
iv. Head injury
b- CVS
i. Arrythmia
ii. Prolong QT with arrythmia
iii. Aortic stenosis or HOCM
iv. MI
c- Situation
i. Vasovagal
ii. Orthostatic  patient standing and fall up
iii. Dehydration
iv. Polypharmacy
d- Endocrine
i. Diabetes
a. Hypoglycaemia
b. Diabetic Neuropathy
e- Older
i. Vision
ii. Hearing & Balance
iii. Muscular Skeletal

33- TIREDNESS / Infective Endocarditis ( S - TEA - I )

a- S leep apnoea / stress (depression)
b- T umour
c- E ndocrine
i. Diabetes
j. Thyroid
k. Haemochromatosis
d- A naemia
e- I nfection / Inflammation (SLE / RA) / Infective Endocarditis

34- URINARY RETENTION.

i. Trauma
ii. UTI
iii. STI
iv. Stone
v. Stricture
vi. Bladder Ca
vii. Diabetes
viii. MALE
a- Prostatitis
b- P P H
c- Prostate Ca
ix. FEMALE

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 a- Herpes
b- Fibroid
c- Ovarian Mass
d- Uterine Prolapse

35- WEAKNESS OF UPPER / LOWER LIMB

i- CENTRAL
a- Brain – trauma ( SDH)
b- Tumour
c- Stroke / T I A
d- M. Sclerosis
ii- PERIPHERAL
a- Neuropathies
b- G B S
c- Charcot Meri tooth
d- Diabetic Neuropathy.
e- Alcoholic Neuropathy
f- Vit. B 12 Deficiency
iii- CONVERSION DISORDER

36- WEIGHT LOSS

1- Diet – Eating disorder
2- Malabsorption
a- Celiac Disease
b- I B D
3- Stress / Depression
4- Tumour
5- Endocrine
a- D M
b- Thyroid
6- Anaemia
7- Infection
a- H I V
b- T B
8- Inflammation
a- R. A
b- Hepatitis

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Paediatrics
1- Abdomen – VOMITING
i. Pyloric stenosis
ii. Reflex
iii. Over feeding
iv. INEFCTION
a. Meningitis
b. Gastroenteritis
c. U T I
v. SURGICAL
a. Appendicitis
b. Hernia
c. Intussusception
d. Gut Obstruction
vi. Congenital Adrenal Hyperplasia

2- Abdomen – CHRONIC PAIN

i. IBD
ii. IBS
iii. Intolerance
iv. Infection
a. Giardiasis
b. Gastroenteritis
c. Warm
d. U T I
v. Celiac
vi. Constipation
vii. Abdominal Migraine
viii. Non specific Abdominal Pain (Functional abdo. Pain)

3- C P ( CEREBRAL PALSY )
i. Epilepsy
ii. Down syndrome ( Genetic )
iii. Hypothyroidism ( Metabolic )
iv. Vison
v. Hearing
vi. Trauma to brain
vii. Tumour
viii. Infection;
d. Meningitis
e. Encephalitis
ix. Spinal cord abnormality
e. Spinal binefida
f. Myopathies

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4- DARK URINE
i. Post S G N
ii. UTI
iii. Stone
iv. HSP
v. Pseudo-haematuria
vi. Bleeding disorder
vii. Blood thinner

5- DIARRHEA
i. IBD
ii. IBS
iii. Intolerance
a. Lactose
b. Protein Cow Milk
iv. INFECTIONS
a. Viral
b. Bacterial
c. Protozoal (Giardiasis)
d. Food poisoning
v. Celiac
vi. Cystic fibrosis (thyroid adult)
vii. Antibiotic
viii. Toddler diarrhea.

6- ENCOPRESIS ( CAUSES ) F – D T P – C
i. Functional Constipation & Fissure
ii. Diet & drugs (codeine)
iii. Thyroid ( hypo)
iv. Psychosocial factor
v. Congenital Hergespring Disease & Cystic fibrosis

7- EPIGLOTITIS – Noisy Breathing & SOB ( A B C D E F – P )

i. Asthma
Anaphylaxis / Wheezing / Steroids
Abscess (Peritoneal Abscess)
ii. Bronchiolitis / bacterial trichiasis (o/e tenderness Trachea)
iii. Croup – Stridor / SOB
iv. Developmental abnormalities ( Vascular Ring / Laryngomalacia (stridor)
v. Epiglottitis
vi. Foreign Body ( Upper – stridor / Lower – wheeze)
vii. Pneumonia – SOB

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8- FIT (CONVULSIONS)
A. PROVOKED FITS
i. Trauma
ii. Tumour
iii. Meningitis
iv. Febrile convulsions
v. Hypoglycaemia
vi. Teenage – drugs & alcohol
B. UN-PROVOKED FITS
i. Epilepsy 1st attack
ii. Breath Holding Attack

9- HEAD ACHE
i. Migrane
ii. Tension
iii. Cluster
iv. 2ndry causes
a. Trauma
b. Brain tumour
c. Menigitis
d. Encephalitis
e. S A H
v. Visual abnormalities
vi. Referred pain
a. Sinusitis
b. Ear ache
c. Neck pain

10- HERPES STOMATITIS

i. Traumatic Ulcer due to hot-food.
ii. H F M disease
iii. Harpings
iv. Drug induced (steroid)
v. Sore o/s – Herpes stomatitis (AMC – Picture given)
vi. Impetigo
vii. Eczema
viii. Allergic rash

11- I D A
i. Nutritional
a. P I C A
ii. Cow mild protein intolerance
iii. Celiac disease
iv. IBD
v. Bleeding disorder

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12- INTESTINAL OBSTRUCTION
a. Early days.
i. Duodenal Atresia
ii. Jejunal Atresia
iii. Ílial Atresia
iv. Imperforated Anus
v. Hirschsprung disease.
b. Elderly month
i. Malrotation
ii. Intussusception
iii. Hernia
iv. Cystic fibrosis

13- INTUSUSCEPTION
i. INFECTIONS
a. Menigitis
b. Ear infection
c. Pneumonia
d. Gastroenteritis
e. U T I
ii. SURGICAL
a. Appendicitis
b. Hernia
c. Testicular torsion
d. D K A
e. INTUSUSCEPTION

14- IRRITABLE BABY

i. Med GIT
a. Reflex
b. Intolerance cow milk protein / Lactose
c. Insufficient milk
d. Coeliac
ii. Surgical
a. Intussusception
b. Hernia
c. Torsion
iii. Infection
a. Meningitis
b. U T I
iv. Post-P depression (child well but mother is depress)
v. Non Accidental Injury or Abuse.

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15- JAUNDICE
CONGUGATED.
i. Neonatal Hepatitis
ii. Galactosemia
iii. Biliary Atresia
iv. Choledochal cyst.
v. Sepsis
vi. Hypothyroidism
UNCONGUGATED.
i. A B O / RH incompatibility
ii. Hereditary:-
G6PD
Hereditary Spirocytosis
iii. Physiology Jaundice
a. Breat Milk Jaundice
b. Breast Feeding Jaundice

16- KAWASAKI ( M – HEART )

i. Mucosal involvement; dry cracked lips, Straw-berry tongue
ii. Hands & feet desquamation
iii. Eyes. Bilaterally purulent conjunctivitis
iv. Adenopathy – unilateral painful cervical LA
v. Rash; Erythematous blanchable
vi. Temp; move than 39 at least 5 days.

17- LIMPING
i. Trauma
ii. Tumour
iii. Infection
f. Osteomyelitis
g. Septic arthritis
iv. Inflammation
g. H S P
h. J R A
v. Age
a. < 4 yrs
a) DDH
b) T S
b. 4 – 8 yrs
TS
Perthes disease
c. 10 – 15 yrs.
SCFE
Osgood Schlitter disease
d. 15 – 20 yrs
Chondromalacia
Petalla Tendinitis

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18- NECK LUMP
Cervical lymph node (normal) 3 – 5 yrsof 1cm soft mobile non-tender.
i. Cervical
h. Cystic hygroma ( one side of the neck )
i. Thyroglossal duct cyst ( in the mid line )
ii. Viral (Post viral lymphadenitis)
iii. Bacterial tonsillitis
iv. EBV
v. TB
vi. Cat scretch disease
vii. Lymphoma
viii. Leukemia

19- ORBITAL CELLULITIS

i. Orbital cellulitis
ii. Peri-orbital cellulitis
iii. Trauma
iv. Insect bite
v. Severe conjunctivitis
vi. Drug allergic reaction
vii. Kidney:-
Nephritic – Nephrotic Syndrome
viii. Heart failure
ix. Kidney failure
x. Liver failure
xi. Non-accidental injury

20- RASH with FEVER

i. Meningococcemia
ii. Kawasaki Disease
iii. Scarlet Fever
iv. EBV
v. Erythema Infectiosium (JM – 1323, 7ed)
vi. Roseola infectiosum

21- RASH with-out FEVER

i. Eczema
ii. Psoriqases
iii. Seboriac
iv. Contact
v. Allergic
vi. Scabies
vii. HSP
viii. ITP
ix. Leukemia
x. N A Injuries

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22- RASH BLENCHABLE ( SKERV-A )
i. Scarlet
ii. Kawasaki
iii. Erythema infectiosium / Eczema
iv. Roseola infectiosium
v. Viral
a. Measals
b. Mumps
c. Chicken pox
vi. Allergic Rashes

23- RASH – NON BLENCHABLE ( HIMAL – V )

i. HSP
ii. ITP
iii. Meningcoccemia
iv. Allergic rash
v. Leukemia
vi. Viral infection
a. Rubella
b. E B V

24- RESPIRATORY HX – COUGH CLUSTER (Bronchiolitis, Croup, Whooping cough, Post-viral , Psychogenic )
i. URTI
ii. Allergic Rhinitis
iii. Post-viral
iv. Croup
v. Pertussis
vi. Asthma
vii. Bronchiolitis
viii. F. B
ix. Pneumonia
x. TB
xi. Cystic Fibrosis
xii. Heart failure
xiii. Reflex
xiv. Irritant Exposure
xv. Psychogenic
xvi. drugs

25- RUNNY NOSE

i. Rhinitis
a- Viral
b- Bacterial
ii. Sinusitis
iii. Allergic rhinitis
iv. Nasal polyp
v. DNS

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 vi. F.B
BEHIND NOSE
vii. Adenoid
viii. EXP. Irritants e.g SMOKE

26- SNORING – DIFFICULT BREATHING.

iii- Allergic Rhinitis (Buggy mucosa)
iv- Nasal polyp
v- DNS
vi- Increased Adenoid
vii- Increased Tonsiles
viii- Tongue fell back (Obesity)
ix- Down syndrome (Hypotonia of the Pharynx, wall collapse)

27- SORE THROAT

i- Tonsillitis
a- Viral
b- Bacterial
ii- Quincy
iii- EBV
iv- Reflex
v- Irritant Exposure (smoking)

28- TESTICULAR TORSION

i. Intussusception
ii. Inguinal hernia (strangulated)
iii. epididymorchitis
iv. Testicular Torsion
v. UTI

29- TIRDNESS ( S TEA I )

vi. Sleep (OSA), Stress
vii. Tumour
viii. Endocrine
a. Thyroid
b. Diabetes
ix. Anaemia – (Haemochromatosis)
x. Infection & Inflammation

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