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Medicine Pearls

Signs & Symptoms & Syndromes
Medical Notes
Signs & Symptoms & Syndromes
The Heart of the Matter
Pediactric EKG Lecture
Study Room
Resident's Quarters


1. Amenorrhea- Primary: absence of menses by age 16.
Secondary: absence of menses for 6 months in a female with previously normal menstruation, or absence of menses for 3 normal intervals with a history of oligomenorrhea.
2. Anuria- <100 ml urine/day Foley catheter.
3. Asterixis-
Flapping with wrists hyperextended.
4. Babinskis sign-
stroke sole of foot, & toes dorsiflex if pyramidal track lesion.
5. Battles sign- Ecchymoses of mastoid process; basilar skull fracture.
6. Brudzinki's Sign- Neck flexion causes hip & knee flexion.
7. Carnett's Sign- Disappearance of tenderness when abdominal muscles are contracted, indicates intra-abdominal pain.
8. Chadwick's sign- cervix & vaginal cyanosis.
9. Chandelier Sign-
Cervical motion tenderness.
10. Charcot's Sign/Triad-
upper quadrant pain, jaundice, fever; gallstones.
11. Cheilosis- cracked lips; Riboflavin deficiency.
12. Cheyne Stokes respiration-
Periodic breathing with periods of apnea (Elevated Intracranial Pressure)
13. Chvostek's sign- Tapping cheek results in facial spasm; hypocalcemia.
14. Colon cutoff sign- Spasm of splenic flexure with no distal colonic gas. (Abdominal X-ray).
15. Courvoisers Sign- Palpable non-tender gallbladder with jaundice; pancreatic or biliary malignancy.
16. Cullens Sign-
Bluish periumbilical discoloration; peritoneal hemorrhage.
17. Cushings Triad- Bradycardia, hypertension, abnormal respirations, ascending weakness.
18. Decerebration-
Extension of legs & arms; wrists & fingers flex with midbrain & pons functioning.
19. Decortication- Noxious stimuli causes flexion of arms, wrists & fingers with leg extension, indicates damage to contralateral hemisphere above midbrain.
20. Dupuytrens contracture-
Fibrotic palmar ridge to ring finger/ Palmar contracture; cirrhosis.
21. Egophony- E to A changes.
22. Fetor Hepaticas-
Odor of breath & urine caused by Mercaptans.
23. Fever of Unknown Origin (FUO)- >/= 38.3*C,(>/=101*F), undiagnosed after 1 week of evaluation & extensive studies.
24. Free Air Under Diaphragm- Ruptured Viscus (CXR).
25. Glossitis- B12, folate deficiency.
26. Grey Turners Sign- Flank ecchymoses; retroperitoneal hemorrhage.
27. Hegars sign- Softening of uterine isthmus.
28. Hepatic angle sign-
Loss of lower margin of right, lateral, liver angle (X-ray).
29. Homans Sign- Dorsiflexion of foot elicits calf tenderness.
30. Horners syndrome-
eyelid ptosis, miosis, & anhydrosis.
31. Iliopsoas Sign-
Elevation of legs against examiners hand causes pain; retrocecal appendicitis.
32. Jugular venous distention- (at 45* measure perpendicular distance from the sternal angle to top of column of blood= jugular venous pressure in cm H2O.
33. Kayser-Fleischer rings- Bronze Corneal pigmentation; Wilsons disease.
34. Kernigs Sign- Flexing hip & extending knee elicits resistance.
35. Kussmaul respirations- Deep sighing breathing
36. Levines Sign - Patient describes pain with clenched fist over the sternum.
37. L4- S1 range or in the C5 to C7 disks- Most herniation occurs.
38. Menieres disease: inner ear disorder involving a triad of symptoms of vertigo, tinnitus, and hearing loss.
39. Mercedes Benz Sign-
Gallstones appearing as radiolucent clefts (Abdominal X-ray).
40. Moliminial symptoms- Mid-cycle ovulatory pain; premenstrual, increased discharge; breast tenderness, water retention, dysmenorrhea.
41. Muerkhe Lines- Narrow, arc-shaped bands of pallor in nail beds; hypoalbuminemia.
42. Murphys Sign-
Right Upper Quadrant Tenderness & Arrest of respiration secondary to pain/ Inspiratory arrest upon RUQ palpation; cholecystitis.
43. Myxedema- condition resulting from advanced hypothyroidism or thyroxine deficiency.
44. Normal CVP: approximately 4 to 10 cm.
45. Normal Intra Ocular Pressure: 13 to 22 mmHg
46. Normal PCWP: 4 to 13 mmHg.
47. Obtundation-
Awake but not alert.
48. Obturator Sign-
Flexion of right thigh & external rotation of leg causes pain in pelvic appendicitis.
49. Oculocephalic reflex- Dolls eyes maneuver, observation of eye movements in response to lateral rotation of head, no eye movements or loose movements occurs in bihemispheric (diencephalons) lesion.
50. Oculovestibular reflex- Cold caloric maneuver, raise head 60 degrees & irrigate ear with cold water, causes tonic deviation of eyes to irrigated ear if intact brain stem (midbrain); If conscious, causes nystagmus, vertigo, emesis.
51. Oliguria - <20 ml/h, 400-500 ml urine/day
52. Oslers Maneuver- Inflate cuff above systolic. If the radial artery pulse remains palpable, the true blood pressure may be <BP by auscultation (Pseudohypertension from hardened, calcified arteries).
53. pH of expectorated blood- alkaline= pulmonary; acidic= GI.
54. Plummers nails-
Distal onycholysis, separation of fingernail from nail bed.
55. Puddle Sign- Examiner flicks over lower abdomen while auscultating for dullness with patient on all fours; detects greater than or equal to 120 ml.
56. Pulsus paradoxus- Inspiratory drop in systolic blood pressure; >18= severe attack.
57. Racoon's eyes- Periorbital ecchymoses; skull fracture.
58. Raynaud's Syndrome- Red, blue or numb hands when exposed to cold.
59. Renal Bruits- high- pitched systolic & diastolic bruit just below costal margin lateral to midline; renal artery stenosis.
60. Rhonchi- fine, high-pitched, end-inspiratory crackles.
61. Rinne test-
Air conduction last longer than bone conduction when tuning fork is placed on mastoid process.
62. Rovsing's Sign- Pressure to left colon causes referred pain at McBurneys point (RLQ); appendicitis.
63. Sentinel loop- Spasm of transverse colon (Abdominal X-ray).
64. SGOT/AST: Serum glutamic-oxaloacetic transaminase; peaks in 24 to 36 hours in MI.
65. SGPT/ ALT: Serum glutamic pyruvic transaminase.
66. Sister Josephs Nodule-
Umbilical nodule; carcinoma metastasis.
67. Spider angiomas- Arterioles with stellate red capillaries.
68. Stigmata of Liver Disease-
Umbilical venous collaterals (Caput Medusae), jaundice, spider angiomas, palmar erythema.
69. Stupor- Unconscious but awakeable with vigorous stimulation.
70. Tactile fremitus- Increase vocal conduction when patient says 99.
71. Terrys nails- White proximal nail beds; cirrhosis.
72. Thumb Printing- Edema & gas of intestinal wall. (Abdominal X-ray).
73. Trousseau's sign- sign for hypercalcemia in which carpal spasm can be elicited by compressing the upper arm and causing ischemia to the nerves distally.
74. TSH-
T3, T3RU, T4.
75. Virchow's Triad-
Immobilization, trauma, malignancy
76. Weber test- lateralization of sound when tuning fork is placed on top of head.
77. Whispered pectoriloquy- Decreased loudness of whisper during auscultation.







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