BOOKS FOR DOCTORS

Signinterp

 Signinterp is a guide to virtually every clinical sign that can be detected by physically examining a patient.

It lists every possible disease, syndrome or condition that may cause the sign, as well as explaining how the examination is performed and the physiology behind the results.

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

Its circulation currently exceeds 75,000 copies.

SIGNINTERP

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:-

Hypertension

Exp:    Blood pressure above 145 mmHg systolic and/or 85 mmHg diastolic. Significant variations for age, sex and circumstances

Int:    (+) Anxiety, exertion, essential hypertension, renal artery stenosis, acute and chronic glomerulonephritis, polycystic kidneys, nephrotic syn., other renal diseases, phaeochromocytoma, aortic coarctation, pre-eclampsia of pregnancy, hyperthyroidism, raised intracranial pressure (tumour or trauma), overdistended neurogenic bladder, polyarteritis nodosa, SLE, scleroderma, Conn syn., malignant hypertension, Cushing syn., porphyria, ovarian tumours, lead poisoning, diabetes mellitus, pseudohermaphroditism,  adrenogenital syn., Liddle syn., Irukandji syn.,  Riley-Day syn., alcoholism, drug and food interactions (eg. MAOIs and cheese), drugs (eg. analgesics, anorectics, antidepressants, cyclosporin, carbenoxolone, liquorice, MAOIs,NSAIDs, oral contraceptives, steroids)

Phys:    85% essential form. Generally due to increased peripheral resistance, abnormalities of the renin-angiotensin-aldosterone system, increased levels of adrenaline or noradrenaline, or increased cardiac output (eg. thyrotoxicosis)

Hypertonicity

Exp:    Involuntary resistance is encountered when limb is passively moved. Muscles are firm to touch

Int:    (+) Upper motor neurone lesions, extrapyramidal system lesions, CVA, parkinsonism,       cord transection, postasphyxia, kernicterus, premature infant, encephalitis, cerebral oedema, trauma, meningitis, hydrocephalus, cerebral space occupying lesion, cerebral palsy

Phys:    Disinhibition of the stretch reflex

See also Myotonia

Hyperventilation

Exp:    Rapid respiratory rate (generally above 35 breaths per minute in adult)

Int:    (+) Anxiety, pain, fever, hysteria, pulmonary embolism, metabolic acidosis (diabetic ketoacidosis, renal disease), most infections, cerebral haemorrhage, pneumothorax, anoxia, congenital heart lesions, drugs (eg. adrenaline), Rett syn.

Phys:    Due to low pO2, high pCO2, or direct cerebral action

See also Kussmaul's Breathing or Sign