Disease and conditions 

Melena is black, tarry stool indicative of upper GI bleeding, requiring careful assessment for life-threatening hemorrhage. Early recognition, monitoring, and management are crucial to prevent hypovolemic shock and complications.

McMurray’s sign is a clinical test for medial meniscus injury, identified by a palpable or audible click during tibial rotation on the femur. Positive findings, along with joint line tenderness and restricted motion, warrant orthopedic evaluation and imaging.

McBurney’s sign is tenderness at a specific point in the right lower quadrant, strongly suggestive of acute appendicitis. Prompt recognition and surgical evaluation are essential to prevent rupture and peritonitis.

Lymphadenopathy is an enlargement of lymph nodes due to infection, autoimmune disease, or malignancy, and can be localized or generalized. Thorough history, examination, and appropriate investigations are essential to identify the underlying cause and guide management.

Low birth weight (≤2,500 g) may result from prematurity or intrauterine growth restriction. Early recognition, respiratory support, thermal management, careful feeding, and infection surveillance are essential to improve survival and long-term outcomes.

Photopsias (light flashes) are warning signs of possible retinal detachment or other ocular/neurologic disorders. Any new or sudden flashes warrant urgent eye examination to prevent permanent vision loss.

Decreased Level of Consciousness (LOC) is a critical sign ranging from lethargy to coma, caused by neurologic, metabolic, infectious, toxic, or systemic conditions, and requires prompt assessment and intervention. Early recognition using the Glasgow Coma Scale and timely emergency management can prevent life-threatening complications and improve outcomes.

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.

Kernig’s sign is an early clinical indicator of meningeal irritation, commonly seen in meningitis and subarachnoid hemorrhage. Prompt recognition allows for immediate diagnostic evaluation and life-saving treatment.

Kehr’s sign is a referred left shoulder pain indicative of intraperitoneal hemorrhage, often from splenic rupture or ruptured ectopic pregnancy. It requires immediate evaluation, hemodynamic stabilization, and surgical intervention.

Jugular vein distention reflects elevated central venous pressure, often due to heart failure, cardiac tamponade, or fluid overload. Accurate assessment, monitoring, and prompt intervention are essential for preventing complications.

Jaw pain can arise from the maxilla, mandible, or TMJ and may reflect local, systemic, or life-threatening conditions such as MI or tetany. Diagnosis relies on careful history, examination, and targeted investigations, with management addressing the underlying cause and symptom relief.

Jaundice is yellow discoloration of skin, sclera, or mucous membranes due to elevated bilirubin from prehepatic, hepatic, or posthepatic causes. Diagnosis relies on history, physical examination, laboratory tests, and imaging, while management addresses the underlying cause, pruritus, and complications.

Intermittent claudication is exercise-induced limb pain relieved by short rest, commonly caused by arterial occlusive disease or neurogenic compression. Diagnosis relies on history, physical examination, pulse assessment, and imaging, with management focusing on risk factor modification, exercise, and, in severe cases, revascularization.

Insomnia is the inability to initiate or maintain sleep or achieve restful sleep, which may be acute or chronic, caused by physiologic, pathophysiologic, psychiatric, or drug-related factors. Comprehensive evaluation—including history, examination, and sleep studies—is essential for diagnosis and targeted management through behavioral, pharmacologic, and supportive interventions.

Impotence is the inability to achieve or maintain an erection sufficient for sexual intercourse and may have psychological, neurologic, hormonal, or vascular causes. Diagnosis involves a detailed psychosocial and medical history, physical examination, and targeted investigations to guide individualized therapy.

Hyperpnea is sustained deep or rapid breathing caused by metabolic, neurologic, or respiratory disorders and may be compensatory, as in Kussmaul’s respirations. Prompt evaluation is essential to identify underlying causes such as acidosis, hypoxemia, or brain injury and to prevent life-threatening complications.

Homans’ sign is elicited when abrupt dorsiflexion of the ankle causes deep calf pain, suggesting possible deep vein thrombosis or calf inflammation. However, it is an unreliable indicator and must be interpreted alongside clinical history, physical findings, and diagnostic tests.

Hoarseness is a rough or raspy voice caused by laryngeal inflammation, vocal cord lesions, nerve injury, systemic disorders, or external irritants. It can be acute or chronic, and persistent cases require evaluation for infections, reflux, malignancy, or airway obstruction.

Hepatomegaly is the abnormal enlargement of the liver caused by congestion, inflammation, infiltration, neoplasia, or metabolic disorders, often detected on physical examination or imaging. Its clinical significance depends on the underlying disease, ranging from reversible fatty liver to life-threatening cirrhosis, hepatitis, or malignancy.

Hemoptysis is the expectoration of blood from the lower respiratory tract, commonly caused by infections, chronic bronchitis, bronchiectasis, lung cancer, or pulmonary vascular disorders. Massive hemoptysis is life-threatening and requires urgent airway management, hemodynamic stabilization, and localization of the bleeding source.

Hemianopsia is a visual field defect characterized by loss of vision in one-half of the normal visual field of one or both eyes. Complete homonymous hemianopsia, in which the same half of the visual field is lost in both eyes, usually indicates a lesion of the optic tract or optic radiation, whereas incomplete defects affecting less than half the field in both eyes suggest an occipital lobe lesion. Lesions of the optic chiasm, tract, or radiation often impair color vision and visual perception.

Hematuria is the presence of blood in urine, ranging from microscopic to gross, and may indicate renal, urinary tract, or systemic disorders. Evaluation involves history, physical examination, urine testing, and imaging to identify underlying causes and guide management.

Hematochezia, the passage of blood per rectum, often indicates lower GI bleeding but may arise from rapid upper GI hemorrhage. Prompt evaluation and stabilization are crucial, with causes ranging from anal fissures and colitis to malignancy and vascular lesions.

Hematemesis, or vomiting of blood, indicates upper GI bleeding and may be life-threatening depending on the source, amount, and speed of bleeding. Prompt evaluation, stabilization, and management are essential, with causes ranging from peptic ulcers and varices to coagulopathies and malignancies.

Heat intolerance is the inability to tolerate elevated temperatures, often causing persistent overheating and profuse sweating. It commonly results from thyroid dysfunction, menopause, hypothalamic disorders, or certain medications.

Hearing loss affects millions worldwide and may be temporary or permanent, partial or complete, involving low-, middle-, or high-frequency tones. Early identification is critical for optimal patient outcomes, especially in children and older adults.

Halo vision is the perception of colored rings around lights due to scattering of light in ocular media, commonly linked to cataracts, corneal edema, or glaucoma. Its presence, especially with pain or headache, may indicate acute angle-closure glaucoma, requiring urgent evaluation.

Halo vision is the perception of rainbow-colored rings around lights, caused by light scattering through abnormal cornea, lens, or tear film. It most commonly indicates cataracts or glaucoma, with acute painful halos suggesting angle-closure glaucoma, an ophthalmic emergency.

Gynecomastia is the benign enlargement of male breast tissue caused by hormonal imbalances, drugs, systemic diseases, or tumors, often presenting with tenderness or, rarely, nipple discharge. Evaluation involves a thorough history, physical exam, hormonal assessment, and imaging, with management ranging from observation and pharmacologic therapy to surgery in severe or persistent cases.

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.

Male genital lesions may present as warts, ulcers, vesicles, or scaly patches and arise from infections, neoplasms, parasites, allergies, or drugs. Proper diagnosis, including STD screening, patient counseling, and early intervention, is critical to prevent complications and ensure sexual health.

A ventricular (S3) gallop is a low-pitched early diastolic heart sound caused by rapid ventricular filling, often indicating volume overload or impaired myocardial contractility. It is a key sign of heart failure, cardiomyopathy, or valvular disorders and may form a summation gallop when coexisting with S4.

An atrial (S4) gallop is a presystolic heart sound caused by atrial contraction against a stiff ventricle, often indicating diastolic dysfunction. It is associated with hypertension, ischemic heart disease, valvular disorders, and cardiomyopathies and can be a key diagnostic clue in angina or heart failure.

Waddling gait is a ducklike walk caused by weakness of the pelvic girdle muscles, leading to trunk lean toward the stance leg, exaggerated lumbar lordosis, and abdominal protrusion. It is commonly seen in muscular dystrophies, spinal muscle atrophies, and congenital hip disorders.

Steppage gait is a compensatory walking pattern caused by footdrop, usually from lower motor neuron lesions, characterized by exaggerated hip and knee flexion to prevent the toes from dragging. It can be unilateral or bilateral, permanent or transient, depending on the underlying neural damage.

Spastic (hemiplegic) gait is a stiff, foot-dragging walk caused by unilateral corticospinal tract damage, often following flaccidity, with compensatory pelvic tilt and circumduction of the affected leg. Its presence signals underlying neurologic disorders such as stroke, brain tumor, multiple sclerosis, or cerebral palsy, and requires careful assessment and targeted rehabilitation.

In scissors gait, careful history taking and physical examination identify the underlying neurologic lesion, differentiate between congenital, hereditary, or acquired causes, and guide targeted interventions like physical therapy, spasticity management, or orthopedic correction.

Propulsive (festinating) gait is a stooped, rigid, forward-leaning gait with short, rapid, shuffling steps, commonly seen in advanced Parkinson’s disease due to basal ganglia degeneration. It can also result from drug-induced extrapyramidal effects, carbon monoxide or manganese toxicity, and rare pediatric neurodegenerative disorders.

A bizarre gait is a non-organic, theatrical walking disturbance seen in conversion disorder, malingering, or somatization, often inconsistent with neurological patterns.
It requires careful differentiation from true gait disorders, emphasizing supportive care and psychiatric referral when appropriate.