Disease and conditions 

Visual floaters are moving particles in the vitreous that appear as spots or dots in the visual field. Sudden onset may indicate retinal detachment, vitreous hemorrhage, or posterior uveitis, requiring urgent ophthalmologic evaluation and careful patient management to prevent vision loss.

Visual blurring, characterized by indistinct visual details and reduced acuity, may result from ocular, neurologic, systemic disorders, trauma, or drug effects. Assessment includes history, visual acuity testing, eye inspection, identification of emergencies like acute glaucoma or retinal detachment, and management to prevent permanent vision loss.

Vision loss, ranging from mild impairment to total blindness, may occur suddenly or gradually due to ocular, neurologic, systemic disorders, trauma, or drug effects. Evaluation includes history, visual acuity testing, ocular examination, identification of emergencies like central retinal artery occlusion or acute angle-closure glaucoma, and appropriate management to preserve vision.

Violent behavior is the sudden loss of self-control resulting in harm to others, oneself, or objects, often caused by psychiatric or organic disorders, substance use, or learned behavior within the family. Management involves assessing the cause, ensuring safety, environmental control, de-escalation, and, when necessary, pharmacologic or physical intervention.

A vesicular rash consists of small, fluid-filled lesions (<0.5 cm) that may appear singly or in groups, resulting from infections, inflammation, allergic reactions, burns, or drug reactions, and may be accompanied by systemic symptoms. Management involves identifying the underlying cause, preventing secondary infection, maintaining fluid and electrolyte balance, and symptomatic relief.

Vertigo is a sensation of spinning or movement, often accompanied by nausea, vomiting, nystagmus, and hearing changes, and may result from neurologic, vestibular, or systemic causes, including inner ear disorders, brainstem pathology, trauma, or drug effects. Evaluation involves detailed history, physical and neurologic examination, diagnostic testing, and patient counseling on safety and symptom management.

Vaginal discharge varies physiologically with age, menstrual cycle, and estrogen status, but changes in color, odor, consistency, or quantity may indicate infection, sexually transmitted disease, reproductive tract pathology, or malignancy. Assessment includes detailed history, physical and pelvic examination, laboratory testing, and patient counseling on hygiene, medication adherence, and safe sexual practices.

Postmenopausal vaginal bleeding, occurring ≥6 months after menopause, may indicate benign causes like atrophic vaginitis or polyps but also signals potential gynecologic malignancy. Evaluation involves detailed history, pelvic examination, imaging, and biopsy, with management directed at the underlying cause and patient counseling on risks and follow-up.

Urticaria (hives) is a hypersensitivity reaction causing transient, pruritic wheals from histamine release, triggered by drugs, foods, infections, or stress; chronic cases last > 6 weeks, and severe forms may present with angioedema or anaphylaxis. Management includes identifying triggers, antihistamines, corticosteroids for severe attacks, and emergency airway support if anaphylaxis occurs.

Cloudy or turbid urine usually signals urinary tract infection but may also result from mucus, cells, crystals, or specimen deterioration. Diagnosis relies on urinalysis and culture, with treatment focused on the underlying cause, adequate hydration, and patient education on hygiene and therapy adherence.

Urinary urgency is a sudden, compelling need to void, most often linked to urinary tract infections but also to neurologic, structural, or inflammatory conditions. Diagnosis requires targeted history, urinalysis, and neurologic assessment, with treatment directed at the underlying cause and patient education on hygiene and bladder control.

Urinary incontinence is the involuntary leakage of urine, classified as stress, overflow, urge, or total incontinence, caused by bladder dysfunction, neurologic disorders, pelvic muscle weakness, infection, prostate disease, or surgery. Diagnosis includes history, physical exam, urinalysis, and neurologic assessment, while management involves bladder retraining, Kegel exercises, catheterization if needed, treatment of underlying causes, and environmental adaptations.

Urinary hesitancy is difficulty initiating a urine stream, often accompanied by reduced force or intermittent flow, commonly caused by benign prostatic hyperplasia, prostatic cancer, urethral stricture, urinary tract infection, spinal cord lesions, or medications with anticholinergic effects. Diagnosis involves patient history, physical and genital/rectal or gynecologic examination, urinalysis, and imaging, with management directed at the underlying cause and supportive measures such as bladder monitoring, heat application, and intermittent catheterization if needed.

Urinary frequency is an increased urge to void without an increase in total urine volume, commonly caused by urinary tract infections, prostate enlargement, bladder irritation, neurologic disorders, or pressure on the bladder from tumors or pregnancy. Diagnosis involves patient history, physical examination, urinalysis, and imaging, with treatment directed at the underlying cause and supportive measures such as fluid management and Kegel exercises.

Urethral discharge is an excretion from the male urinary meatus that may be purulent, mucoid, thin, or clear, often arising from prostatitis, urethritis, or sexually transmitted infections. Diagnosis relies on patient history, physical examination, urine tests, and urethral discharge culture, with treatment targeting the underlying cause.

Tunnel vision, or tubular/gun barrel vision, is a severe constriction of the peripheral visual field, leaving only a small central area of sight. It usually develops gradually due to chronic open-angle glaucoma, retinal degeneration, or post-laser therapy, and can be assessed through visual field testing and ophthalmologic evaluation.

Tremors are involuntary, rhythmic oscillations of muscles caused by alternating contractions of opposing muscle groups. They may be classified as resting, postural, or intention tremors and result from neurologic, metabolic, drug-induced, or systemic disorders, with clinical evaluation guiding diagnosis and management.

Tracheal tugging (Cardarelli’s, Castellino’s, or Oliver’s sign) is a downward pulsation of the trachea synchronous with cardiac systole, usually indicating an aortic arch aneurysm or mediastinal mass compressing nearby airways and vessels. Prompt evaluation for respiratory distress, imaging, and management of the underlying cause are essential to prevent airway obstruction or aneurysm rupture.

Tracheal deviation is displacement of the trachea from the midline, often caused by conditions that shift mediastinal structures such as tension pneumothorax, atelectasis, mediastinal tumors, or retrosternal thyroid. Because it may signal life-threatening respiratory compromise, prompt assessment, emergency support (oxygen, semi-Fowler’s, possible chest tube), and evaluation for underlying causes are essential.

Tinnitus is the perception of abnormal sounds in the ears or head, ranging from ringing to buzzing or roaring, and can be caused by ear disorders, systemic diseases, drugs, or noise exposure. Management involves identifying and treating underlying causes, protecting hearing, and using strategies such as biofeedback, masking devices, or hearing aids to improve patient adaptation.

Tics are sudden, involuntary, repetitive movements or sounds, often involving the face, neck, or upper body, usually triggered or worsened by stress and anxiety. Management includes careful history and observation, addressing underlying causes (e.g., Tourette’s syndrome), stress reduction, psychotherapy, and, if needed, medications such as antipsychotics to control severe tics.

Thyroid enlargement (goiter) may result from inflammation, iodine deficiency, tumors, drugs, or physiologic changes, and can be associated with hyperthyroidism or hypothyroidism depending on hormone activity. Management involves detailed history and neck examination, laboratory and imaging tests, treatment of underlying causes, hormone therapy if needed, and monitoring for complications such as airway obstruction or thyroid storm.

Throat pain (sore throat) refers to discomfort in the nasopharynx, oropharynx, or hypopharynx, caused by infections, trauma, allergies, cancer, systemic disorders, or nonpathologic factors such as dry mucosa or vocal strain. Management involves thorough history-taking, physical and laryngoscopic examination, analgesia, culture if indicated, and treatment of the underlying cause.

Tachypnea is an abnormally fast respiratory rate (≥20 breaths/min) often caused by cardiopulmonary disorders, metabolic acidosis, hypoxia, anxiety, or pain. Management includes identifying the underlying cause, monitoring vital signs and oxygenation, providing supplemental oxygen, and preparing for advanced airway management if respiratory failure develops.

Tachycardia is a heart rate exceeding 100 beats per minute, commonly caused by stress, fever, stimulants, or underlying cardiovascular, respiratory, metabolic, or endocrine disorders. Management involves identifying the cause, monitoring vital signs and cardiac rhythm, providing oxygen or fluids if needed, and considering antiarrhythmic therapy, defibrillation, or ablation for persistent or symptomatic cases.

Syncope is a transient loss of consciousness due to decreased cerebral perfusion or hypoxia, often preceded by light-headedness, pallor, and hypotension. Evaluation includes assessing underlying cardiac, neurologic, or vascular causes, monitoring vital signs, ensuring patient safety, and providing emergency interventions such as supine positioning, leg elevation, oxygen, cardiac monitoring, and treatment of arrhythmias if present.

Clay-colored stools result from impaired bile pigment excretion, commonly due to hepatic, biliary, or pancreatic disorders. Evaluation includes assessing associated symptoms (jaundice, dark urine, abdominal pain), reviewing medical and surgical history, and performing laboratory and imaging studies to identify the underlying cause.

Splenomegaly, an enlarged spleen, is a nonspecific finding that may indicate infection, hematologic, hepatic, autoimmune, or neoplastic disorders, and requires careful palpation and imaging for accurate assessment. Evaluating associated symptoms—fatigue, infections, bruising, abdominal fullness—and monitoring for complications like splenic rupture are essential for diagnosis and management.

Decreased skin turgor, indicated by slow return of pinched skin, is a clinical sign of dehydration or fluid volume depletion and can result from illness, vomiting, diarrhea, or excessive fluid loss. Accurate assessment, vital sign monitoring, and prompt fluid replacement are essential, especially in children, the elderly, or critically ill patients.

Scaly skin arises from abnormal keratinization, leading to flaking that can range from fine and dry to thick and greasy, often indicating underlying dermatologic, infectious, or systemic conditions. Careful history, examination, and targeted investigations help distinguish benign causes from serious disorders like psoriasis, lymphoma, or drug-induced scaling.

Mottled skin is a patchy discoloration caused by impaired dermal blood flow, ranging from benign cold-induced cutis marmorata to serious disorders such as shock or acute arterial occlusion. Prompt assessment of perfusion, pulses, and associated symptoms is essential to distinguish emergencies from chronic causes.

Clammy skin is cool, moist, and pale skin caused by sympathetic activation from stress or serious illness such as shock, hypoglycemia, arrhythmias, or heat exhaustion. Management requires rapid assessment, treating the underlying cause, monitoring vitals, and supporting the patient’s comfort and safety.

The setting sun sign is a late indicator of increased intracranial pressure in infants, marked by downward eye deviation with visible scleral rim above the irises. Management includes urgent evaluation of ICP causes, supportive care, and preparing for interventions such as diuretics, shunting, or surgery.

Simple partial seizures are brief focal seizures without loss of consciousness, producing motor, sensory, or autonomic symptoms depending on the brain focus. Management includes documenting seizure features, treating underlying causes, using antiepileptic drugs, and advising safety and medical identification.

Generalized tonic-clonic seizures cause sudden loss of consciousness with stiffening and jerking of muscles. Care focuses on airway protection, seizure observation, and postictal support.

Complex partial seizures are focal seizures, usually originating in the temporal lobe, causing altered consciousness, automatisms, and postictal confusion. Management involves ensuring patient safety, diagnosing with EEG or imaging, anticonvulsant therapy, and educating patients and families on seizure precautions.

Absence seizures are brief, benign generalized seizures causing sudden staring and inattention, often in children aged 4–12. Diagnosis involves observation, EEG, and imaging, with management focusing on anticonvulsants, safety, and patient education.

Scrotal swelling is an enlargement of the scrotum from various causes, ranging from painless cysts to painful emergencies like testicular torsion. Evaluation includes history, physical exam, and diagnostics, with management based on the underlying cause.

A scotoma is a partial or complete blind spot within the visual field, caused by retinal, choroidal, or optic nerve disorders such as macular degeneration, optic neuritis, or retinal pigmentary degeneration. Detection involves visual field testing, ophthalmoscopy, and assessment of visual acuity, with patient counseling focused on monitoring progression, using assistive devices, and regular eye exams.

Rhonchi are low-pitched, continuous breath sounds caused by airflow through narrowed large airways due to secretions, tumors, or bronchospasm. They indicate underlying pulmonary disorders like asthma, bronchitis, bronchiectasis, or pneumonia and require assessment, airway management, and treatments to relieve obstruction and improve oxygenation.