[A diagnostic algorithm--hepatomegaly].
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Occult hyperthyroidism, a subclinical thyrotoxic state, is not readily identifiable clinically or through routine thyroid function tests. "Idiopathic" atrial fibrillation may be a manifestation of occult hyperthyroidism in the elderly. A normal response on a TRH stimulation test excludes this diagnosis. A blunted TSH response, coupled with elevation of free thyroid hormones and a high radioactive iodine uptake, will settle the diagnosis. Patients with occult hyperthyroidism frequently have toxic adenomas or nonpalpable nodular goiters, and treatment is best achieved with radioactive iodine ablation.
An algorithm for differential diagnosis of comatose conditions in patients with diabetes mellitus has been devised. The algorithm is intended for the general practitioner and non-specialized department. The algorithm uses the minimum of the crucial signs of comatose conditions, ensuring their diagnosis under the conditions of any hospital. The algorithm can be applied to the recognition of the typical variants of comatose conditions in a "pure" form. The amount of algorithm steps is minimized. The program of differential diagnosis is written in the Fokal language and realized on the computer "Elektronika BK 0010". The program is run in the dialogue mode. The algorithm is used in clinical practice and in the training process, with its efficacy being independent of the professional skills of the user.
Isolated asymptomatic hematuria in the adult, i.e. hematuria and no evidence of renal or systemic disease, is a perplexing clinical problem. It is usually difficult to decide to what extent to pursue a diagnosis, especially whether to perform renal angiography or renal biopsy. An algorithm is provided to optimize detection of structural defects and intrinsic renal diseases, in an effort to avoid subjecting the patient to unnecessary invasive tests. Since the age-related recommendations of the algorithm are controversial, a discussion of renal cell carcinoma and intrinsic glomerular diseases is proffered.
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