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DIGESTIVE SYSTEM AND ABDOMENDIGESTIVE SYSTEM
GI TRACT
Goodsall's Rule Softening of the vaginal part of the cervix during the first trimester
Chilaiditi
Syndrome
Rare condition when pain occurs due to transposition of a loop of large intestine (usually
transverse colon) in between the diaphragm and the liver, visible on plain abdominal X-ray or chest
X-ray
INTUSSUSCEPTION
Dance's Sign Empty RLQ (retracted right iliac fossa)
APPENDICITISAaron's Sign Epigastric pain with pressure on McBurney's point
Dunphy Sign Increase in abdominal pain on coughing
Markle Sign RLQ pain on dropping from standing on toes to heels
Mc BurneysPoint2/3 of the way lateral on a line from umbilicus to anterior superior iliac spine (corresponds to
junction of vermiform appendix and cecum)
Rosenstein's SignTenderness in the right lower quadrant increases when the patient moves from the supine position
to a recumbent posture on the left side
Rovsing's Sign Palpation of LLQ elicits pain in RLQ
Sherren's Triangle Area of hyperaesthesia over the right lower abdomen
Hampton's Line Line on barium meal indicating mucosal oedema associated with ulcer
ACCESSORY
LIVER
Councilman Body eosinophilic globules in liver
Mallory BodyAn inclusion found in the cytoplasm of liver cells.
Mallory bodies are damaged intermediate
filaments within the hepatocytes
BILIARY
Boas' Sign Dermal hyperaesthesia at inferior angle of R scapula
Courvoisier's Law Palpable gall bladder w/ painless jaundice unlikely to be cholelithiasis
Charcot's
Cholangitis Triad/
Reynolds' Pentad
Jaundice, fever and chills, RUQ pain
Charcot's triad + hypotension and altered mental state
CHOLECYSTITIS
Murphy's Sign Hesitation on inspiration while gall bladder is palpated
Lpine's SignPositive when effleurage (light percussion) with crooked third finger at the point of the gallbladder
projection to anterior abdominal wall (Kerr's point) elicits pain
Nardi Test Administration of morphine and neostigmine reproduces sharp LUQ pain; not in general use
ABDOMINO PELVICPERITONEU
M
Blumberg Sign Rebound tenderness
Rigler's Sign Gas outlines both mucosal and serosal surfaces of bowel
HERNIA
Howship
Romberg SignPain from an obturator hernia radiating to knee
Hannington-Kiff
SignAbsent thigh adductor reflex with positive patellar reflex
OTHERFothergill's Sign
Anterior abdominal mass which does not cross the midline and is still palpable when abdominal
wall muscles are tensed
Carnett's Sign Supine patient lifts head from bed;painabdominal wall ; pain intraperitoneal
ABDOMINAL
GENERAL
SPLEEN/LUQ
Ballance's Sign Percussive dullness left flank, LUQ, percussive resonance right flank
Traube's Sign Dull percussion sound over Traube's space
Castell's Sign
Placing the patient in the supine position. With the patient in full inspiration and then full expiration, percuss
the area of the lowest intercostal space (eighth or ninth) in the left anterior axillary line. If the note changes
from resonant on full expiration to dull on full inspiration, the sign is regarded as positive. The resonant note
heard upon full expiration is likely to be due to the air-filled stomach or splenic flexure of the colon. When the
patient inspires, the spleen moves inferiorly along the posterolateral abdominal wall. If the spleen is enlarged
enough that the inferior pole reaches the eighth or ninth intercostal space, a dull percussion note will be
appreciated, indicating splenomegaly.HEMORRHAGE
Cullen's Sign Ecchymosis around umbilicus predicts onset of acute pancreatitis
Grey Turner's Sign Flank ecchymosis
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CIRCULATORY SYSTEMHEART DISEASE
HEART
MURMUR
SYSTOLIC HEART MURMUR: BENIGN PAEDIATRIC HEART MURMUR
Still's murmur systolic ejection sound ; vibratory/musical; best heard at left lower sternal border
DIASTOLIC HEART MURMUR: PULMONIC REGURGITATION (
Graham Steell murmur) pulmonary regurgitation murmur in patients with pulmonary hypertension secondary to mitral stenosis
AORTIC INSUFFICIENCY
(Austin Flint murmur)
carey coombs murmurmid-diastolic rumble
MITRAL REGURGITATION
(Presystolic murmur)
AORTIC
INSUFFICIENCY
Watson's water hammer
pulse/bounding forceful pulse elicited with postural manoeuvres
Corrigan pulse carotid pulsations with abrupt ascending and descending phases
De Musset's sign head nodding in time with heartbeat
Duroziez's sign double bruit heard over femoral artery when it is compressed distally (see Traube's sign)
Mller's sign visible pulsation or bobbing of uvula
Quincke's sign visible pulsation in ungual capillary bed
Austin Flint murmur mid-diastolic rumble heard at apex
Mayne's sign systolic blood pressure drop of >15mmHg on raising arm
ENDO-
PERICARIDUM
ENDOCARDITIS:
Roth's spot retinal haemorrhages with pale centres seen at fundoscopy
Osler's node painful red lesions on the pads of the fingers and plantar surfaces
Janeway lesion/ palmar or plantar erythematous or haemorrhagic papules
Bracht-Wachter bodies yellow-white spots in the myocardium
PERICARDIUM
CARDIAC TAMPONADE/PERICARDIAL EFFUSION:
Beck's triad hypotension, increased central venous pressure (JVP), distant heart sounds
Ewart's sign percussive dullness, aegophony and bronchial breath sounds at L scapular tip
OTHER
RHEUMATIC FEVER:
Anitschkow cell
Aschoff body foci of interstitial inflammatiuon in the myocardium and elsewhere
EKG
(Osborn wave) positive deflection at QRS-ST junction
ANGINA PECTORIS (
Levine's sign) patient clenches fist over chest when asked to describe pain
Gallavardin
phenomenondissociation of musical and noisy elements in ejection murmur
VASCULAR DISEASE
ARTERIAL
AORTIC ANEURYSM
(Cardarelli's sign, left displacement of trachea elicits palpable pulsation of same
Oliver's sign) caudal movement of trachea with systole
PULMONARY EMBOLISM
(McConnell's sign) echocardiography finding of akinesia of the mid-free wall of the right ventricle but normal motion of the apex
RADIAL ARTERY SUFFICIENCY
(Allen's test) tests for presence of palmar ulnar-radial anastomosis (palmar arch)
PSEUDOHYPERTENSION
(Osler's sign) falsely elevated bp reading due to incompressibility of calcified vessels
THROMBUS
(Lines of Zahn)
Adson's sign obliteration of radial pulse with manoeuvres
ARTERIOVENOUS FISTULA
(Nicoladoni sign)
VENOUS
Friedreich's sign collapse of distended neck veins in diastole
Caput medusae distended veins radiating from umbilicus
Kussmaul's sign increased jugular distension on inspiration
DVT
Bancroft's sign pain on anterior, but not lateral, compression of calf
Homans sign knee bent, ankle abruptly dorsiflexed, popliteal pain
Lisker's sign tenderness on percussion of antero-medial tibia
Louvel's sign increased pain along vein with valsalva; proximal pressure prevents this
Lowenberg's sign immediate pain on inflating blood pressure cuff around calf
Peabody's sign calf muscle spasm when raising the affected leg with the foot extended
Pratt's sign pain elicited by compression of posterior calf
Rose's sign Warm, stiff feeling of skin when affected leg is pinched
Trendelenburg test
SUPERIOR VENA CAVA SYNDROME
(Pemberton's sign) arms elevated over head elicits facial plethora, distended neck veins and inspiratory stridor
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ENDOCRINOLOGY, NUTRITION AND METABOLISMENDOCRINE DISEASE
HYPOGLYCEMIA Whipples triad
1.symptoms associated with hypoglycaemia
2. measured low serum glucose
3. relief of symptoms with administration of glucose p.o. or iv
GRAVES DISEASE/
GOITRE
EYELID
Abadie's sign of exophthalmic
goiterlevator palpebrae superioris spasm
Boston's sign spasmodic ptosis on downward gaze
Dalrymple's sign widened palpebral opening
Stellwag's sign infrequent and/or incomplete blinking, accompanied by Dalrymple's sign
LID LAG
Von Graefe's sign ' lid lag'; immobility of upper lid on downward gaze
Griffith's sign lid lag of the lower eyelid on upward eye movement
EXTRA OCULAR MUSCLES
Mbius sign inability to maintain convergence of eyes
HYPOTHYROIDISM Queen Annes sign
NUTRITIONVITAMIN B12DEFICIENCY
Schilling test affected areas of cervix fail to stain brown with iodine solution
RICKETS Harrisons groove rib deformity at the lower thorax
CARBOHYDRATE Benedict solution reagent for presence of monosaccharides
METABOLIC DISORDERS
HYPOCALCAEMIAChvostek sign tapping over facial nerve elicits abnormal muscle contraction(s)
Trousseau sign of latent tetany in hypocalcaemia, occlusion of brachial artery induces carpal spasm
PKU Guthrie test
others Beutler test
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EYES AND EARSEYES
ADNEXA
LACRIMAL:
Schirmer's test quantifies lacrimal secretion
EYELID:
Abadie's sign of
exophthalmic goiterlevator palpebrae superioris spasm
Boston's sign spasmodic ptosis on downward gazeDalrymple's sign widened palpebral opening
Stellwag's sign
GLOBE
PUPIL:
Argyll Robertson
pupilsight-near dissociation
Adie pupil dilated pupil, poorly reactive but with normal near accommodation
Marcus Gunn pupil
IRIS:
Fleischer ring
Kayser-Fleischer ring ring of brownish copper deposit at corneo-scleral junction
Brushfield spots greyish-white spots at periphery of iris
Lisch nodule yellow brown hamartomata on iris
CONJUNCTIVA:
Bitot's spots spots of keratin deposition in the conjunctiva
Arlt's line
RETINA:
Hollenhorst plaque cholesterol embolus(i) of retinal artery(ies)
Roth's spot retinal haemorrhages with pale centres seen at fundoscopy
Fuchs spot
OTHERS:
Alexander's law describes nystagmus in vestibular lesions
Hirschberg test corneal reflection centred (-) or not centred (+) on pupil
Siegrist streaks hyperpigmented sreaks parallel to choroidal vesselsHudsonStahli line
EARSAUDITORY:
Rinne test comparison of air conduction to bone conduction differentiates sensorineural from conductive deafness
Weber test
VESTIBULAR:
DixHallpike test Elicitation of extreme vertigo upon lateral movement of a patient's head when lying in a supine position
Unterberger test patient walks in place with eyes closed;direction of rotation indicates vestibular lesion on that side
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HEMATOLOGYINCLUSION BODIES
ERYTHROCYTE
Cabot rings threadlike strands in erythrocytes
Howell-Jolly body
Pappenheimer bodies
Heinz body
NEUTROPHILDhle bodies basophilic inclusions in peripheral cytoplasm of neutrophils
PLASMA CELL
Russell bodies
MYELOBLAST
Auer rod cytoplasmic inclusions in myeloblasts
HISTIOCYTE
Birbeck granules
TESTSApt test
Coombs test
OTHERSArneth count lobulation of neutrophil nuclei
Mentzer index differentiates iron deficiency anaemia from beta thalassaemia
Virchow's triadHypercoagulability, Hemodynamic changes (stasis, turbulence) and
Endothelial injury/dysfunction
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INFECTIOUS DISEASEBACTERIAL DISEASE
SYPHILIS
Hutchinson's teeth small, widely spaced incisors with notched biting surfaces
Hutchinson's triad interstitial keratitis,nerve deafness, Hutchinson's teeth
Abelin reaction presence of arsenical anti-syphilitic;obsolete
Westphal's sign
Clutton's joints painless symmetrical hydrarthroses, particularly of the knees
Dennie-Marfansyndrome
VIRAL DISEASESMEASLES Koplik's spots
Warthin-Finkeldey cell
YELLOW FEVER Councilman body eosinophilic globules in liver
Tzanck test
INCLUSION
BODIES:
POXVIRUS
Downie bodies/A
Guarnieri bodies/B
RABIES
Negri bodies
Cowdry bodies
Liebermeister's rule
Faget sign
PARASITIC DISEASESCHAGAS DISEASE
Romana's sign painless unilateral periorbital swelling
AFRICAN TRYPANOSOMIASIS
Winterbottom's sign posterior cervical chain adenopathy
MALARIA
Schffner's dots
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INTEGUMENTARY SYSTEMSKIN
Asboe-Hansen Sign extension of a blister to adjacent unblistered skin when pressed
Auspitz's Sign punctate bleeding when scales are scraped
Borsari's Sign
Braverman's Sign
Crowe Sign axillary freckling
DennieMorgan Fold accentuated fold below the lower eyelidDarier's Sign dermatographia
Fitzpatrick's Sign
Florid Cutaneous
Papillomatosis
Gottron's Sign
Hutchinson's Sign lesion on tip of the nose which can presage ocular herpes zoster
Janeway Lesion palmar or plantar erythematous or haemorrhagic papules
Kerr's Sign
Koebner's Phenomenon
Koplik Spots
Leser-Trelat Sign sudden onset of multiple pruritic seborrheic keratoses
Nikolsky's Sign mild shear stress applied to skin causes bullae to form
Pastia's Sign lines of confluent petechiae in skin creases (associated with Scarlatiniform rash and strep pyogenes)
Russell's Sign scarring of the dorsum of one hand (contact with incisors when purging)
Wickham Striae white or greyish lines on the lichen planus lesions
Wolf's Isotopic
Response
NAILSAldrich-Mees' Lines
Beau's Lines transverse ridges on nails
Muehrcke's Lines paired transverse white lines on nail bed
Terry's Nails white 'ground glass' nails;absence of lunula
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MUSCLES AND SOFT TISSUENEUROMUSCULAR/ SOFT TISSUE
SUPERIOR GLUTEAL
NERVE WEAKNESS
Trendelenburg
Gait
Trendelenburg's
Signpelvic tilt contralateral to 'stance leg'
THORACIC OUTLETSYNDROME
Adson's Sign obliteration of radial pulse with manoeuvres
Wright'sManeuver
Gowers' Sign
COLLAGEN
EHLERS-DANLOS
SYNDROMEGorlin Sign
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NERVOUS SYSTEMCNS
HEAD, GENERAL
Battle's sign mastoid ecchymosis
Broca aphasia expressive aphasia
Kernig's sign hip and knee fully flexed, extension of knee elicits pain and/or opisthotonus
Macewen's sign
Myerson's sign inability to resist blinking when glabella is percussedStroop test reaction times for incongruent stimuli (e.g., word red printed in blue)
Wada test short acting barbiturate injected in internal carotid; lateralizes language function
Dix-Hallpike testElicitation of extreme vertigo upon lateral movement of a patient's head when
lying in a supine position
Hirano body
MULTIPLE SCLEROSIS
Dawson's fingers characteristic fingerlike appearance of lateral ventricle on mri, ct, or at autopsy
Lhermitte's sign electrical sensation down the back and into limbs with neck flexion or extension
Charcot's neurologic triad
Uhthoff's phenomenon in neurological symptoms with exercise or other increase in body temperature
OTHER
Romberg's test nability to maintain posture with eyes closed
INCREASED
INTRACRANIAL
PRESSURE
Cushing's triadelevated systolic bp, bradycardia, irregular respiration
Miller Fisher testImprovement in cognitive function after withdrawal of CSF during lumbar
puncture used to confirm diagnosis
PNS
REFLEXES OF
EXTREMITIES/CORTICOSPINAL
TRACT
COMBINATION
Jendrassik maneuver compares patellar reflex w/ and w/o distraction
LOWER LIMB
Babinski sign
dorsiflexion of the hallux with fanning of the remaining phalanges upon soft
stimulation of the lateral plantar surface of the foot
Chaddock reflex extension of big toe with stimulation of skin over lateral malleolus
Oppenheim's sign irritation downward of the medial tibia causes dorsiflexion of big toe
Westphal's sign
UPPER LIMB
Hoffmann's sign tapping distal phalanx of 3rd or 4th finger elicits flexion of same in thumb
OTHER
TORSO/LIMBS
UPPER LIMB
Froment's signpatient required to hold paper between thumb and palm (against attempt to
withdraw);ability to do so is assessed
carpal
tunnel
syndrome
Tinel sign 'DTP'distal tingling on percussion
Phalen maneuver 3060 seconds of full forced flexion of wrist elicits symptoms
LOWER LIMB
Abadie's sign of tabes dorsalis absence of pain on Achilles tendon pressure
Gowers' sign
Hoover's sign differentiates organic from non-organic etiology
Lasgue's sign better known as straight leg raise test
Trendelenburg's sign pelvic tilt contralateral to 'stance leg'
TORSO
Beevor's sign caudal movement of navel on cervical flexion
GENERAL
Todd's paresis focal weakness for as much as 48 hours after seizure
Jolly's test electromyography test using repeated stimuli to show fatiguability in myasthenia
MENTAL/ BEHAVIOURAL
Russell's sign scarring of the dorsum of one hand (contact with incisors when purging)
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ONCOLOGYHEMATOLOGICAL MALIGNANCY
Russell bodies
Auer rod cytoplasmic inclusions in myeloblasts
Bence Jones protein
LYMPH NODESVirchow's node ( Troisier's
sign )Enlargement of the left supraclavicular lymph node (=Virchow's node)
Sister Mary Joseph nodule palpable lymph node in the umbilicus
Lund's node
OTHERCall-Exner bodies
LeserTrlat sign sudden onset of multiple pruritic seborrheic keratoses
Trousseau sign of
malignancyspontaneous thrombosis of multiple veins, including portal circulation
Courvoisier's law palpable gall bladder w/ painless jaundice unlikely to be cholelithiasis
Schiller-Duval body
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OBSTETRICSPREGNANCY
Abderhalden reaction serum reaction;obsolete
Chadwick sign cyanosis of vulva, vagina and cervix
Goodell's sign softening of the vaginal part of the cervix during the first trimester
Hegar's sign softening of cervical isthmus appearin between 4th and 6th weeks (usually)
Ladin's sign softening of uterus; similar to Hegar's sign
Piskacek's sign palpable lateral bulge at tubal-uterine junction; present at 78 weeksVon Braun-Fernwald's sign softening of the uterine fundus at the site of implantation at 45 weeks gestation
OTHERApgar score assess health of newborn
Braxton Hicks contractions "false labour". sporadic contractions beginning as early as mid 1st trimester
hydrops fetalis (Hemoglobin Barts)
ectopic pregnancy (Spiegelberg
criteria)
fetal death (Spalding's sign)
Leopold's maneuvers determination of fetal lie
Naegele's rule method of estimating due date
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REPRODUCTIVE SYSTEMFEMALE
ENDOMETRIUM:Arias-Stella's
phenomenon
Canga's bead symptom
MALE
PENIS John Thomassign
penile shadow points at affected hip (+) or unaffected hip (-) (2)
TESTICLE Prehn's sign
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RESPIRATORY SYSTEMRESPIRATORY SYSTEM
OBSTRU
CTIVE
LUNG
DISEASE
COPD
Hoover's sign inward movement of lower ribs during inspiration
ASTHMA
Curschmann's spirals spiral mucus plugs found in sputum
CharcotLeyden
crystalsCHRONIC BRONCHITIS
Reid index
RESTRIC
TIVE
LUNG
DISEASE
SARCOIDOSIS
Kveim test intradermal injection of lymphatic extract from known sufferer; obsolete
DYSPNE
A
Biot's respirationquick shallow respirations followed by period of
apnea
CheyneStokes
respirationfluctuation between apnoea and tachypnoea
Kussmaul breathing laboured deep breathing with normal or reduced frequency
OTHER/
GENERA
L
CLUBBING
Schamroth's window
testidentifies clubbing of distal phalanges
Hippocratic fingers clubbing of distal phalanges
PULMONARY EMBOLISM
Hampton hump wedge shaped consolidation at periphery with base on the pleura
Westermark sign Area of oligaemia on chest x-ray
PULMONARY EDEMA
Kerley lines
Hamman's sign crepitus in sync w/ heartbeat but not respiration
Golden S sign
REFERREDSPLEEN
Kehr's sign referred pain to L shoulder
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SKELETAL SYSTEM AND JOINTSJOINTS
ARTHROPATHY
OSTEOARTHRITIS
(Bouchard's
nodes/bony outgrowths on dorsa of proximal interphalangeal joints
Heberden's
node)same as bouchard's nodes, but over dip joints
DERMATOMYOSITIS(Gottron's
papules)Scaling, erythematous eruption or dusky red patches over the knuckles, elbows and knees
DEQUERVAIN'S SYNDROME
(Finkelstein's
test)
ANTERIOR SHOULDER INSTABILITY
(Jobe's test)
HIP DYSPLASIA
Barlow's
maneuverdislocation on adduction of hip
Ortolani test palpable clunk on moving hip
LOW BACK PAINWaddell's
signs)identify non-organic sources of low back pain
DORSOPATHY
LOW BACK FLEXIBILITY
Ott test
Schober test quantifies lumbar flexion
SACROILIITIS
(Larrey's sign) pain in sacroiliac area on sitting down on hard chair
TRAUMA/
ORTHOPEDICS
KNEE:
LIGAMENT
Lachman test) modified anterior drawer test with knee in less flexion
MENISCUSApley grind test manoeuvres to elicit knee pain
McMurray test knee extended, valgus stress applied, leg rotated produces palpable or audible click
LIGAMENT AND MENISCUS
O'Donoghue's
triadcoincidence of anterior cruciate injury,medial collateral injury and meniscal tear
ANKLE:
TENDON
Simmonds' test squeezing of calf fails to produce plantar flexion
SHOULDER:
ROTATOR CUFF
Hawkins-Kennedy test
LIGAMENT
Neer
impingement
sign
Jobe's test
Watson's test
SKELETAL/BONEBONE TUMOR
Codman triangle) triangular subperiosteal growth
OSTEOCHONDRITIS DISSECANS
Wilson test)
TEETHHutchinson's teeth small, widely spaced incisors with notched biting surfaces
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URINARY SYSTEMURINARY SYSTEM
Addis Count quantitative cells and casts in 24hr. urine
Brewer Infarcts dark red wedge shaped areas on kidney section resembling infarcts
Murphy's Punch Sign punch tenderness at the costovertebral angle
Lloyd's Sign
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