Disease and conditions 

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.

Ballet’s sign is a paralysis of the external ocular muscles causing loss of voluntary eye movement, while reflexive eye movements and pupillary light reflexes remain intact; indicative of thyrotoxicosis.

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.

Argyll Robertson pupil is a small, irregular pupil that reacts to near accommodation but not (or poorly) to light, classically linked to neurosyphilis, especially chronic syphilitic meningitis.

Catatonia is a severe motor inhibition or excitation seen in psychotic disorders, manifesting as stupor (extreme immobility) or excitement (extreme agitation).

Cullen’s sign is a bluish periumbilical discoloration indicating retroperitoneal or intra-abdominal hemorrhage, commonly seen in ruptured ectopic pregnancy or hemorrhagic pancreatitis.

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.

Disorientation is an inability to accurately perceive time, place, or personal identity, commonly seen in organic brain disorders, cerebral anoxia, intoxication, or after severe stress.

Keen’s sign is an increased ankle circumference, typically seen in Pott’s fracture of the fibula. It’s detected by measuring and comparing the circumferences of both ankles at the malleoli.

Barlow’s sign is a clinical test for congenital hip dislocation in infants, elicited by flexing the hips and knees to 90°, applying posterior and lateral pressure on the femur, and detecting a “click” as the femoral head dislocates posteriorly.

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.

A pleural friction rub is a coarse, grating lung sound caused by inflamed pleural surfaces rubbing together, often from pneumonia, pleurisy, pulmonary embolism, or trauma. Assessment includes auscultation, history-taking, and monitoring respiratory status, with management directed at treating the underlying cause and relieving symptoms.

Polyuria is the excessive production of urine, typically more than 3 L/day, and may result from endocrine, renal, neurologic, or psychological disorders, as well as certain drugs. Evaluation focuses on fluid balance, identifying underlying causes, monitoring vital signs and electrolytes, and providing guidance on fluid intake and disease management.

Pallor is abnormal paleness of the skin or mucous membranes caused by anemia, arterial occlusion, shock, or peripheral vasoconstriction. Its evaluation requires careful history, physical examination, and sometimes laboratory or imaging studies to identify systemic or localized causes.

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.

Marcus Gunn’s phenomenon is a reflexive elevation of a ptotic upper eyelid on one side, linked to jaw movement. It occurs in misdirectional syndrome involving cranial nerves III and V and is elicited by jaw opening and lateral movements.

Broadbent’s sign is a visible retraction of the left posterior chest wall near the 11th and 12th ribs during systole, indicative of extensive adhesive pericarditis.

Anuria is defined as urine output less than 100 mL in 24 hours, commonly caused by urinary tract obstruction or acute renal failure. Prompt diagnosis and intervention—such as catheterization and addressing underlying causes—are critical to prevent severe complications like uremia.

Nausea is a common symptom reflecting gastrointestinal, metabolic, infectious, neurological, or drug-related disturbances. Accurate evaluation, supportive care, and treatment of the underlying cause are critical to prevent complications such as dehydration, electrolyte imbalance, and aspiration.

Arm pain can arise from the bones, joints, muscles, tendons, ligaments, nerves or skin, or be referred from the neck or the heart. Assessment separates local musculoskeletal causes from red flags such as acute coronary syndrome, fracture, infection or vascular compromise, which need urgent management.

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.

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.

Autistic behavior is a self-centered, unresponsive behavior with repetitive, nonmeaningful actions and speech, sometimes seen in children or adults with schizophrenia.

Nasal flaring is an early and vital indicator of respiratory distress, caused by increased work of breathing from obstructive, parenchymal, or cardiopulmonary disorders. Prompt evaluation, airway management, and treatment of underlying causes are essential to prevent life-threatening complications.

Guilland’s sign is a quick, forceful flexion of the hip and knee when the opposite quadriceps is pinched, indicating meningeal irritation.

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.

The infective process of endocardial layer of the heart can involve native or prosthetic valve and congenital defects/shunts.

Eye pain can range from mild discomfort to severe, vision-threatening pain caused by ocular or systemic disorders. Prompt assessment, accurate diagnosis, and emergency interventions when needed are essential for preserving vision and ocular health.

Atrophy is a reduction in size or wasting of tissue or an organ due to decreased cell size or number, which may be physiologic (e.g., brain or ovary) or pathologic (e.g., neurologic or endocrine disorders).

Asterixis is a clinical sign of negative myoclonus characterized by brief lapses in muscle tone, often seen as a flapping tremor during sustained posture. It commonly indicates metabolic encephalopathies such as hepatic, uremic, or hypercapnic conditions.

Asthenocoria (Arroyo’s sign): Abnormally slow dilation or constriction of the pupils in response to light, sometimes accompanied by photophobia, commonly associated with adrenal insufficiency.

Bradykinesia is a slowness of voluntary movements and speech due to reduced dopaminergic activity, commonly seen in Parkinson’s disease and other extrapyramidal or cerebellar disorders. It may also result from certain medications and is often accompanied by tremor and rigidity.

A pleural friction rub is a coarse, grating lung sound caused by inflammation of the pleura, often associated with pleurisy, pneumonia, pulmonary embolism, or lung disease. It is best heard over the lower lung fields with the patient upright and may indicate serious respiratory pathology.

Psychotic behavior is a severe mental disturbance marked by delusions, hallucinations, bizarre language, and impaired reality perception, often resulting from psychiatric, neurologic, organic, or drug-induced causes. Management focuses on patient safety, reality orientation, structured activities, psychiatric evaluation, and appropriate pharmacologic therapy.

Bezold’s sign is a swelling and tenderness of the mastoid region due to an abscess beneath the sternocleidomastoid muscle, indicative of mastoiditis.

Muscle weakness is a reduction in the force-generating capacity of muscles caused by neurologic, metabolic, musculoskeletal, or systemic disorders. Early recognition, careful assessment, and targeted therapy with assistive devices are essential to maintain function and prevent complications.

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.

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.

Rebound tenderness, or Blumberg’s sign, is severe abdominal pain elicited when pressure on the abdomen is quickly released, indicating peritoneal inflammation or peritonitis. It requires prompt assessment, supportive care, diagnostic evaluation, and preparation for potential surgical intervention.

Attention span decrease is a reduced ability to concentrate on a task while ignoring distractions, often caused by anxiety, emotional stress, or central nervous system dysfunction.