What Can Present in a Myriad of Ways?

If patient Hx (or Dx) proves tricky, always consider

• Mental illness
• Endocrine dysfunction
• Anaemia
• Chemicals (Drugs: Rx; OTC; recreational | Environmental)
• Viruses; Vector-born disease
• Auto-immune disease
• A para-neoplastic syndrome

Ix to consider in such circumstances

• Serology - CRP; LFTs; TSH; fasting BSL; infection serology; RF; ANA; (PSA)
• Haematology - FBC; ESR
• Imaging - CXR; abdo/pelvic US or CT scan; brain CT/MRI scan; (mammogram)
• Clinical tool - K10 questionnaire