Disease and conditions 

Duchenne’s sign is an inward movement of the epigastrium during inspiration, which may indicate diaphragmatic paralysis or pericardial effusion.

Gum bleeding (gingival bleeding) can result from dental disorders, systemic diseases, blood disorders, or certain drugs, ranging from mild oozing to life-threatening hemorrhage. Evaluation includes history, oral examination, and addressing underlying causes, with emergency care for profuse bleeding.

Oligomenorrhea is abnormally infrequent menstrual bleeding, usually occurring at intervals greater than 36 days, and may signal hormonal, ovarian, pituitary, thyroid, metabolic, or stress-related disorders. It is often associated with anovulation, infertility, or underlying systemic conditions and requires thorough evaluation of history, physical signs, and relevant laboratory tests.

Dysuria is painful or difficult urination often accompanied by urinary frequency, urgency, or hesitancy, usually resulting from lower urinary tract irritation or infection. Its timing, associated symptoms, and patient history help identify underlying causes such as cystitis, prostatitis, urinary obstruction, or chemical irritation.

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.

A positive psoas sign is increased abdominal pain with leg movement against resistance, usually indicating appendicitis or a localized abscess. Evaluation focuses on prompt recognition, monitoring for complications, and preparing the patient for surgery or further diagnostic testing.

Hypotension is a condition where blood pressure drops below normal, leading to inadequate perfusion of vital organs. It can result from dehydration, blood loss, sepsis, or heart failure, and requires prompt identification and treatment to prevent shock and organ damage.

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.

Anisocoria is unequal pupil size (0.5–2 mm) is normal in ~2% of people, but fixed dilation/constriction or abnormal light response suggests neurologic or ocular disease.

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.

Photophobia is abnormal light sensitivity, often caused by ocular disorders, trauma, systemic disease, or certain drugs. Assessment involves history-taking and careful eye examination, with management aimed at treating the underlying cause and relieving discomfort.

Leg pain can signal minor musculoskeletal issues or severe vascular/neurologic emergencies. Prompt evaluation of neurovascular status, mobility, and systemic signs is essential for proper management.

Maisonneuve’s sign is hyperextension of the wrist seen in Colles’ fracture. It occurs due to posterior displacement of the distal radius fragment.

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.

Hill’s sign is a markedly higher femoral systolic pulse pressure (60–100 mmHg) in the right leg compared to the right arm. It indicates severe aortic insufficiency.

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.

Rectal pain is discomfort in the anorectal area, often caused by conditions such as anal fissures, hemorrhoids, perirectal abscesses, or anorectal fistulas. Evaluation includes inspection, history, and possibly anoscopic or endoscopic examination, with management focused on treating the underlying cause, relieving pain, and preventing complications.

Fan sign is a component of Babinski’s reflex, characterized by the spreading of the toes after firm stroking of the sole, indicating corticospinal tract dysfunction.

Dorendorf’s sign is a fullness or prominence in the supraclavicular groove, suggestive of an aortic arch aneurysm.

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.

Paroxysmal nocturnal dyspnea is sudden nighttime shortness of breath that awakens a patient, usually due to left-sided heart failure and pulmonary congestion. Relief comes with sitting or standing, and management includes evaluating cardiac status, giving oxygen, and treating the underlying heart failure.

A lumbosacral hair tuft is an abnormal patch of hair over the lower spine, sometimes with skin depression or discoloration. It may indicate underlying spina bifida occulta or spina bifida cystica.

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.

Exophthalmos is the abnormal protrusion of one or both eyeballs caused by orbital inflammation, tumors, infection, or autoimmune disorders. Prompt diagnosis, identification of the underlying cause, and timely management are essential to prevent vision loss and complications.

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.

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.

Dalrymple’s sign is an abnormally wide palpebral fissures due to upper eyelid retraction, commonly seen in thyrotoxicosis.

Asynergy is a loss of coordinated function among muscles or organs that normally act together, typically resulting from basal ganglia or cerebellar disorders.

Echolalia is a repetition of another person’s words or phrases without comprehension in adults, commonly seen in schizophrenia and frontal lobe disorders; in children, it may appear as imitation of sounds or words produced by others.

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.

Subungual hemorrhage is a bleeding beneath the nail plate, appearing as splinter-like lines or larger hemorrhagic areas. It may indicate subacute bacterial endocarditis, trichinosis, or direct nail bed trauma.

Demianoff’s sign is a lumbar pain elicited by stretching the sacrolumbalis muscle; raising the extended leg in a supine patient causes pain that limits elevation, indicative of lumbago.

Bradycardia is a slower-than-normal heart rate (below 60 bpm) that can be physiological or indicate serious underlying conditions requiring prompt evaluation. Symptoms like dizziness, chest pain, or syncope alongside bradycardia necessitate urgent medical assessment and treatment.

Cruveilhier’s sign is a swelling in the groin indicative of an inguinal hernia, detected by palpating the inguinal canal during patient coughing.

Lasègue’s sign is pain triggered by specific leg movements that helps differentiate hip joint disease from sciatica. Pain on hip flexion with the knee bent suggests hip pathology, while pain on knee extension with the hip flexed indicates sciatic nerve irritation.

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.

Pulsus paradoxus is an exaggerated drop in systolic blood pressure (>10 mm Hg) during inspiration, often signaling cardiac tamponade, severe asthma, or chronic obstructive pulmonary disease. Accurate detection requires careful blood pressure measurement or arterial pulse monitoring and prompts further cardiac or pulmonary evaluation.

Amoss’ sign is a maneuver in which a patient uses their hands for support when rising from supine to sitting to avoid spinal pain, indicating possible vertebral or spinal pathology. It is often observed in conditions causing back pain or restricted spinal mobility.

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.

Polydipsia is excessive thirst often caused by endocrine, renal, or drug-related disorders, and may be accompanied by polyuria, nocturia, and signs of dehydration. Management involves identifying the underlying cause, monitoring fluid balance, and educating patients on hydration and lifestyle adjustments.