Disease and conditions 

​

Dysmenorrhea is a prevalent cause of painful menstruation caused by primary prostaglandin-mediated uterine contractions or secondary pelvic pathology. Accurate history and physical exam guide diagnosis, with NSAIDs and lifestyle measures as mainstays of treatment.

Dysarthria is a motor speech disorder resulting from neurological injury affecting speech muscles, with diverse etiologies including degenerative diseases, stroke, toxins, and infections. Diagnosis requires detailed neurologic and speech assessment, and management involves treating underlying causes and supportive rehabilitation.

Drooling refers to the unintentional loss of saliva from the mouth, commonly associated with neurological disorders, oral structural abnormalities, or medication side effects. It requires assessment of underlying causes to guide appropriate management.

Absent doll’s eye sign is a vital neurological bedside test indicating brainstem integrity. It assists in localizing lesions, assessing coma severity, and guiding further diagnostic and therapeutic interventions.

Dizziness results from disrupted integration of vestibular, visual, and proprioceptive inputs or reduced cerebral perfusion, causing imbalance or faintness. Vertigo specifically arises from vestibular system dysfunction, producing a false sensation of spinning or motion.

Diplopia is the perception of double vision caused by dysfunction of extraocular muscles or cranial nerves controlling them. It may be monocular or binocular and can result from neurologic, muscular, orbital, or systemic disorders.

Diarrhea is the frequent passage of loose, watery stools, caused by infections, inflammatory diseases, malabsorption, or medication effects. Severe cases may lead to dehydration or shock, requiring prompt fluid resuscitation and investigation of the underlying cause.

Diaphoresis is excessive sweating triggered by physical, emotional, or pathological stress, often indicating underlying conditions like hypoglycemia, infection, or myocardial infarction. It may be localized or generalized and requires urgent evaluation when accompanied by systemic symptoms.

Depression is a mood disorder marked by persistent sadness, loss of interest, and impaired daily functioning. It requires timely diagnosis, risk assessment for suicide, and combined medical and psychological treatment for recovery.

Hypoactive deep tendon reflexes indicate reduced or absent reflex activity due to dysfunction in the reflex arc. They are associated with neuromuscular, metabolic, toxic, and structural disorders and require careful clinical evaluation to determine the underlying cause.

Are exaggerated reflex responses often caused by upper motor neuron lesions or electrolyte imbalances like hypocalcemia or hypomagnesemia. They may signal serious neurologic, metabolic, or obstetric conditions and require thorough clinical evaluation and appropriate management.

Decorticate posture is a clinical sign of corticospinal tract damage, marked by arm flexion and leg extension, often due to severe brain injury. It indicates a serious neurological condition but has a better prognosis than decerebrate posture.

Decerebrate posture is a severe abnormal motor response indicating brain stem damage. It signals a grave neurological insult and requires urgent airway support, diagnostic evaluation, and neurocritical care.

Cyanosis is a bluish discoloration of the skin or mucosa due to inadequate oxygenation or perfusion. It signals serious cardiopulmonary or vascular pathology requiring prompt evaluation and oxygenation support.

A high-pitched (cerebral) cry in neonates or infants is a late but serious sign of increased intracranial pressure, often indicating life-threatening conditions such as meningitis, hemorrhage, or trauma. Prompt recognition, neuro-assessment, and emergency intervention are crucial to prevent permanent brain damage or death.

Subcutaneous crepitation is a critical clinical sign indicating air or gas in soft tissues due to trauma, infection, or iatrogenic causes, requiring urgent evaluation. Its presence mandates airway monitoring and prompt identification of underlying life-threatening conditions like pneumothorax, esophageal rupture, or gas gangrene.

Bony crepitation is a clinically important sign indicating bone or joint pathology, such as fractures or arthritis, and should prompt thorough assessment to guide diagnosis and treatment. It must be elicited carefully to avoid worsening injuries, especially in acute trauma cases.

Crackles are abnormal breath sounds signaling underlying pulmonary or cardiovascular pathology. Accurate interpretation through clinical assessment, differential diagnosis, and targeted management is crucial for guiding appropriate interventions and improving patient outcomes.

This article provides clinical guidelines on managing productive cough, emphasizing airway clearance, fluid intake, humidification, and appropriate use of medications. It also includes special considerations for pediatric and geriatric patients, highlighting risks and tailored care approaches.

Nonreproductive cough is a dry cough not related to reproductive system causes, often resulting from respiratory, gastrointestinal, cardiovascular, or environmental conditions. Common examples include asthma, pneumonia, GERD, and inhalation injuries.

Barking cough, often caused by croup syndrome, is a harsh, seal-like cough resulting from upper airway inflammation in children. It requires prompt assessment and management to prevent airway obstruction and respiratory distress.

Costovertebral angle (CVA) tenderness is a key clinical sign indicating renal capsular distention, often from infection, obstruction, or vascular compromise. Accurate elicitation and interpretation help in early diagnosis of serious renal conditions such as pyelonephritis or renal calculi.

An absent corneal reflex indicates dysfunction in either the trigeminal (CN V) or facial nerve (CN VII), often due to lesions in the brainstem or peripheral neuropathies. It may signal serious neurological conditions and requires immediate evaluation and ocular protection.

Constipation can arise from various medical conditions including anorectal, metabolic, neurological, and gastrointestinal disorders, each with unique clinical features. It may also result from medications, diagnostic tests, surgery, or radiation, requiring thorough evaluation for effective management.

Confusion is a state of disorganized thinking or inappropriate behavior that may be sudden or gradual, reversible or permanent. It can result from medical, neurological, metabolic, infectious, or drug-related causes and requires thorough evaluation and patient safety measures.

Cogwheel rigidity is a ratchety resistance to passive movement, typically seen in Parkinson’s disease due to the combination of rigidity and tremor. It aids in diagnosis and is best elicited at the wrist during physical examination.

Clubbing is a painless, bilateral enlargement of the soft tissue around the nail beds, commonly indicating chronic pulmonary or cyanotic cardiovascular diseases. It reflects underlying tissue hypoxia and vascular changes and warrants investigation for serious systemic conditions.

Chvostek’s sign, an abnormal facial muscle twitch upon tapping the facial nerve, is an early clinical sign of hypocalcemia. It helps assess calcium imbalance, particularly in patients with parathyroid issues or undergoing neck surgery.

Chills are sudden feelings of coldness often accompanied by shivering, usually caused by a rapid rise in body temperature during fever or infection. They are the body’s natural response to generate heat and fight off illness.

Cheyne-Stokes respirations are a cyclic breathing pattern of gradually increasing then decreasing breaths followed by apnea, often caused by heart failure or neurologic impairment. Management focuses on treating the underlying condition and supportive respiratory care.

Chest pain is a potentially life-threatening symptom caused by various cardiac, pulmonary, gastrointestinal, musculoskeletal, or psychological conditions. Accurate diagnosis requires thorough history-taking, physical examination, and prompt emergency interventions in severe cases.

Asymmetrical chest expansion occurs when one side of the chest moves less than the other during breathing, often indicating underlying pathology. Causes include airway obstruction, chest trauma, pleural diseases, neuromuscular disorders, spinal deformities, and surgical interventions.

Cat’s cry syndrome (Cri-du-chat) is a rare chromosomal disorder marked by a high-pitched, kitten-like cry, microcephaly, and profound developmental delay. It is caused by a deletion on the short arm of chromosome 5 and may lead to multiple congenital anomalies.

Carpopedal spasm is a painful involuntary muscle contraction of the hands and feet, often indicating hypocalcemia or alkalosis and requiring urgent evaluation. Prompt management is essential to prevent complications such as laryngospasm, seizures, and cardiac arrest.

Increased capillary refill time indicates impaired peripheral perfusion and can result from conditions such as arterial occlusion, aortic aneurysm, cardiac tamponade, or Raynaud’s disease. It may also arise from external factors like vasoconstrictive drugs, trauma, or improper medical devices.

Butterfly rash can result from autoimmune conditions like systemic and discoid lupus erythematosus, as well as infections, dermatologic disorders, and drug reactions. Its appearance and associated symptoms vary, often involving facial erythema, scaling, and systemic signs depending on the underlying cause.

Bruits are abnormal vascular sounds caused by turbulent blood flow from conditions like arterial stenosis, aneurysms, or arteriovenous fistulas. They often signal underlying diseases such as atherosclerosis, anemia, or thyrotoxicosis, accompanied by specific clinical symptoms depending on the affected vessel.

Brudzinski’s sign, seen as hip and knee flexion during neck flexion, is a key indicator of meningeal irritation, often pointing to serious conditions like meningitis or subarachnoid hemorrhage. It requires prompt neurological assessment and emergency management to monitor for increased intracranial pressure and prevent deterioration.

Fruity breath odor is a key sign of ketoacidosis, caused by excess acetone from fat breakdown due to lack of usable glucose. It signals a medical emergency requiring prompt insulin, fluid, and electrolyte treatment to prevent coma or death.