BOOKS FOR DOCTORS

Signs & Symptoms

         To make a clinical diagnosis doctors take a history (symptoms) and perform a physical examination (signs). Most diagnoses are obvious at this stage, or at least a selection of differential diagnoses become apparent to the doctor.

 

  This book assists doctors with these essential steps, listing every possible symptom and the associated diagnoses; then list a huge range of clinical signs with their interpretation.

 

    The data it contains is available to be used in print or electronically.

SECTION ONE

SYMPTOMS

Symptoms to Diagnosis

 

SYMPTOM: The consciousness of a disturbance in a bodily function.

Butterworths Medical Dictionary

 

FORMAT

 

Presenting Symptom

(Alternate Name)

    Explanation of terminology

System or other group of symptoms

Diagnoses that may present with this symptom [alternate name of diagnosis]  (other symptoms of each diagnosis, or a discussion of the diagnosis)

  See also Symptom of Similar Significance

 

 

SAMPLE ENTRIES:-

 

Ear Discharge

(Otorrhoea)

Trauma (i.e. direct injury or skull fracture - CSF)

Cerumen

Foreign body in canal

Acute otitis externa (pain)

Otitis media with ruptured tympanum

Other infections

Epithelial debris

Perichondritis

Otic tumours

Skin disorders (eg. eczema)

 

Ear, Smelly

Otitis media (ruptured tympanum  with discharge)

Cholesteatoma (purulent discharge, deaf)

Fungal infection of ear canal

 

Ecchymosis

    Bruise, purpuric macules

Thrombocytopenia (low blood platelets)

Coagulation defects (congenital or acquired)

Meningococcal infection

Septicaemia

Subacute bacterial endocarditis

Rickettsial diseases (eg.  typhus, Rocky Mountain spotted fever)

Allergic vasculitis (arthralgia, myalgia)

Purpura fulminans (skin infarcts)

Scurvy (bleeding gums)

Basal skull fracture (mastoid ecchymosis)

Local trauma

Drug hypersensitivity

See also Bruising, Excess

 

Ejaculation, Premature

Anxiety

Unreasonable expectations

Emotional disorders

Very rarely organic

 

Ejaculation, Retarded

Diabetes mellitus (polyuria, polydipsia)

Hypogonadism

Hyperprolactinaemia

Spinal cord tumours, trauma or disease

Parkinson's disease (tremor, rigidity)

Cerebrovascular accident

Cerebral tumour, trauma or abscess

Genitourinary developmental defects

Urethral stricture, fistula or diverticulum

Prostatic disease

Aortic aneurysm

Surgical sympathectomy

Pelvic trauma or tumour

SECTION TWO

SIGNS

Clinical Signs and their Interpretation

 

SIGN: Objective evidence of disease or deformity

Butterworths Medical Dictionary

 

FORMAT

 

Sign (Alternate Name) [Abbreviation]

Exp:    An explanation of the sign, with its methodology described in sufficient detail to enable the practitioner to perform the test.

Int:    The interpretation of the sign.

    (+) The diseases, syndromes etc. that should be considered if the test is positive

    (++) The interpretation of an exaggerated or grossly positive test

    (–) Ditto for a negative test result

    (AB) Ditto for an abnormal test result

Phys:    The pathophysiology of the sign to enable its significance to be better understood

See also Other Signs of Significance

 

 

SAMPLE ENTRIES:-

 

Rinne's Test

Exp:    A vibrating tuning fork (512 cps) is placed on the mastoid process. When it becomes inaudible to the patient, the vibrating end is placed near the external auditory meatus. If heard at the external auditory meatus, air conduction is greater than bone conduction (i.e. Rinne positive). In reverse situation, if heard on mastoid process after air conduction lost, the test is Rinne negative

Int:    (+) Air conduction < bone conduction – Conductive deafness (eg. wax, perforated tympanum, otosclerosis, glue ear, otitis media, foreign body, dislocated ossicles, tumours, meatal stenosis, exostoses, barotrauma)

    (+) Air conduction > bone conduction – Normal hearing

    (+) Reduced time – Perceptive deafness (eg. presbycousis, vascular causes, measles, mumps, influenza, meningitis, labyrinthitis, congenital causes [maternal rubella], trauma [blast], prolonged noise exposure, drugs (eg. streptomycin, aspirin, quinine), Menière's disease, late otosclerosis, CNS tumours, haemorrhage, leukaemia, multiple sclerosis, vitamin B deficit), psychogenic

See also Weber's Test

 

Risus Sardonicus

Exp:    Fixed, immobile grin

Int:    (+) Tetanus

Phys:    Excess tension of facial musculature

 

Rogoff's Sign

Exp:    Costovertebral angle pain and tenderness

Int:    (+) Adrenal crisis

Phys:    Adrenal inflammation due to steroid withdrawal; or adrenal infection or destruction

 

Romana's Sign

Exp:    Unilateral persistent oedema of upper and lower eyelids

Int:    (+) Chagas' disease

Phys:    Occurs when conjunctiva is portal of trypanasome entry

 

Romberg's Sign

Exp:    Patient stands at attention with heels close together and then shuts eyes. Positive when severe swaying or falling occurs

Int:    (+) Tabes dorsalis, posterior column lesion, subacute combined degeneration of cord, intoxication

Phys:    Due to loss of proprioceptive sensation. Negative in cerebellar disease

See also Ataxia; Proprioceptive Sense, Loss of; Heel-Knee Test; Tandem Romberg Test