| Pneumonia, bronchopneumo | Signs of acute bronchitis. |
| Giardiasis | Distension and tenderness. |
| Typhoid | 2nd week. With tenderness. |
| Diabetes mellitus | Severe ketoacidosis in undiagnosed diabetes. |
| Peptic ulcer | The 'pointing sign' -- pain so localized the patient can indicate the site with 2 or 3 fingers. |
| Hyperthyroidism | Spontaneous. |
| SLE |
| Osteomyelitis | Paravertebral 'cold' abscess may form and track to the thigh, chest wall or neck, hip, knee, ankle, or wrist in tuberculous osteomyelitis. |
| Osteoarthritis | May be attributable to hyperaemia. |
| Acromegaly | Large hands, large feet. |
| Anaemia, haemolytic | Association to cold agglutination disease. |
| Atopic | Usually begins before age 6 months. |
| Sjogren's syndrome |
| SLE |
| Hyperprolactinaemia |
| Hypogonadism | Defective androgen receptors in target tissues. Testes may be found in groins. Pubic hair is absent. Patient may present with primary amenorrhea. |
| Rheumatoid |
| Anaemia, haemolytic | See general signs. Also a feature of lead poisoning but is not predominantly haemolytic. |
| Anaemia, iron deficiency | See general signs of anaemia. |
| Hypothyroid, atrophic | Iron deficient (premenopausal), normochromic, pernicious. |
| Leukaemia, Acute | Haemoglobin below 100 g/l. |
| Rheumatoid | Norocytic, normochromic. Does not respond to oral iron therapy. |
| Sjogren's syndrome | Leucopenia. |
| TB, miliary | Progressive. |
| Thalassaemia | Mild. |
| Hypothyroid, atrophic |
| Anaemia, iron deficiency |
| Candidosis | Especially in elderly. |
| Horner's syndrome | Loss of ssweating (on one side of the face). |
| Psoriatic |
| Hypogonadism | GnRH deficiency. Secondary. |
| Diabetes mellitus | Mental apathy or confusion. |
| Cranial arteritis | Thickened and tender temporal arteries. |
| Behcet's | Mono- or oligo-articular involving the kness, ankles, wrists, and elbows. |
| Reiter's | Triad. Affecting the large or small joints of the lower limbs. When arthritis alone follows sexual exposure or enteric infection then the term 'reactive arthritis' is used. |
| Acromegaly | Soft tissue changes. |
| Gout |
| Hypothyroid, atrophic | Rare but well recognized. |
| Hyperthyroidism | Exacerbation. |
| Acoustic neuroma |
| Multiple sclerosis |
| Hypothyroid, atrophic |
| Sjogren's syndrome | Primary. |
| Henoch-Schonlein |
| Cranial arteritis |
| Acromegaly | Growth of lower jaw (prognathism), skull growth (prominent supraorbital ridges with large frontal sinuses). |
| Paget's disease | Femur and tibia is characteristic predisposing to osteoarthritis of the hip or knee. |
| Paget's disease | Enlargement and deformity when condition is advanced. |
| Osteoporosis | Post-menopausal period: forearm fractures, back pain, crush vertebral fractures. Age related: loss of height, thoracic kyphosis, wedge fractures (Dowager's hump), and hip fractures. |
| Paget's disease | Spontaneously or after minor trauma. |
| Ankylosing spondylosis | tenderness over bony prominences such as the iliac crest, ischial tuberosity, greater trochanter. |
| Osteomalacia | Pain on pressure. |
| Paget's disease | On palpation (pelvis, femur, tibia, lumbar spine, skull). A bruit may be heard. |
| Cerebral tumour | Raised intracranial pressure. |
| Hypothyroid, atrophic | With low voltage complexes and ST-T wave abnormalities. |
| Typhoid | 1st week. |
| Quisy |
| Asthma | Wheezing, especially during night. |
| Bronchitis | Wheeze. Rhonchi. |
| Pneumonia, pneumococcal | Bronchial sounds within two days. |
| Diabetes mellitus | Over the carotid or femoral arteries. |
| Stroke, subarachnoid | Over head or eyes if blleding is from an arteriovenous malformation. |
| Takayasu's disease | Vascular. |
| Gout |
| Heart failure | Cardiac cachexia caused by anorexia and impaired absorption. |
| Scleroderma | Calcinosis, Raynaud's, oEsophageal, Sclerodactyly, Telangiectasia (CREST). |
| HIV |
| anaemia |
| Polychondritis | Valvular disease. Conduction defects. |
| Acromegaly |
| Anaemia, sickle-cell | Increased susceptability. |
| Hypothyroid, atrophic |
| Thalassaemia | A later, frequently terminal event. |
| Scleroderma |
| Eosinophilic fascitis | May be an early feature with the onset following abnormal exercise. |
| Hypothyroid, atrophic | Compression of median nerve at the wrist. |
| Acromegaly | Soft tissue changes. |
| Pneumonia, pneumococcal | In the first 24-48 hours. Dimunision of respiratory movement. Slight impairment of percussion note. Pleural rub on the affected side. |
| Anaemia, haemolytic | Hereditary spherocytosis. |
| Anaemia, sickle-cell | Increased susceptability. |
| SLE |
| Toxoplasmosis | Adults. |
| Polyarteritis nodosa | Leg and jaw. |
| Takayasu's disease | Arm. |
| Cranial arteritis |
| Bronchial carcinoma | Hypertrophic Pulmonary OsteoArthropathy (HPOA). Usually gross. |
| Pneumonia, suppurative | Develops quickly (10-14 days). |
| Hypopituitary | May follow mild infection or injury. Lack of GH increases sensitivity to insulin; water intoxication due to lack of cortisol required for excretion; hypothermia (temp less than 32C) from hypothyroidism. |
| Anaemia, pernicious Addi | Yellow-tinted due to haemolysis. |
| Reiter's | Triad. |
| Whooping cough |
| Pneumonia, suppurative |
| Scleroderma | Tightening of skin over bony prominences. |
| Toxoplasmosis | Congenitally acquired. |
| Myasthenia gravis | May be to weak to unblock airways. |
| Pneumonia, bronchopneumo |
| Whooping cough | Paroxysmal: a succession of short, sharp coughs, gathering in speed and duration and ending in a deep inspiration (the characteristic whoop). Frequently ends with vomiting. |
| Heart failure | Inspiratory. Left heart failure. |
| Pneumonia, bronchopneumo |
| TB, miliary | Widespread. |
| Osteoarthritis | May be felt or heard. |
| Epilepsy |
| Pneumonia, bronchopneumo |
| Pneumonia, pneumococcal | In severe cases. |
| Dysentery |
| Neurosyhilis | Of grandeur; progressive dementia. |
| Anaemia, pernicious Addi |
| Hyperparathyroid |
| Hypothyroid, atrophic |
| Coeliac | Skin looks like colour of coffee patches. |
| Bronchial carcinoma |
| Acromegaly | Clinical diabetes mellitus, 10%. |
| SLE |
| Giardiasis |
| Cranial arteritis |
| Multiple sclerosis |
| Neurone, motor disease | Weakness of muscles of limbs. |
| Neurone, motor disease | Weakness of muscles in tongue face and palate. |
| Scleroderma | Calcinosis, Raynaud's, oEsophageal, Sclerodactyly, Telangiectasia (CREST). |
| Stroke, infarction |
| Heart failure | Left heart failure. |
| Nephritis |
| Hypothyroid, atrophic | Pericardial or pleural. |
| Pneumonia, pneumococcal | Stony dullness on percussion. |
| Rheumatoid |
| Trichinella |
| SLE |
| Bronchial carcinoma | Excesss ADH, ACTH, hypercalcaemia, gynaecomastia. |
| Horner's syndrome | The opposite of proptosis? |
| Cerebral tumour |
| Polyarteritis nodosa |
| SLE | Or other mild psychiatric disturbance. |
| Tapeworm | Starting in adult life. |
| Hyperthyroidism | Palmar. |
| TB, primary | Bluish-red, raised, tender, cutaneous lesions on the shins or thighs and is associated with pyrexia or polyarthralgia. Often the first clinical features of TB. |
| Thalassaemia | Mediterranian (beta); South East Asia (alpha - hydrops fetalis)). |
| Acoustic neuroma | Loss of corneal reflex. |
| Hyperthyroidism | Grave's disease only: lid lag, grittiness, excessive lacrimation, chemosis, exopthalmosis, corneal ulceration, opthalmoplegia, gdiplopia, papilloedema, loss of visual acuity. |
| SLE | Keratoconjuntivitis sicca, episclerosis, retinal vasculitis, soft exudates. |
| Hyperparathyroid | Ectopic calcification (band keratopathy). |
| Stroke, subarachnoid | Subhyaloid. |
| Thrombocytopenia | Optic fundal haemorrhage. |
| Stroke, subarachnoid | Optic disc. |
| Cerebral tumour | On the affected side. |
| Diabetes mellitus | Microaneurysms, haemorrhages, hard exudates, soft exudates, venous changes, neovascularisation, pre-retinal haemorrhage, vitreous haemorrhage, fibrosis. |
| Polychondritis |
| Hypothyroid, atrophic | Loss of hair from outer portions. |
| Multiple sclerosis | Optic atrophy, afferent pupillary defect, impaired colour vision. |
| Parkinson | Tapping the forehead causes repetitive blinking. Impaired upgaze and convergence. |
| Parkinson | Expressionless; greasy skin. |
| Mononucleosis |
| Hypogonadism | Defective androgen receptors in target tissues. Testes may be found in groins. Pubic hair is absent. Patient may present with primary amenorrhea. In 5-alpha-reductase deficiency (failure to convert testosterone to dihydrotestosterone) the patients are brouht up as females but phallus develops at puberty and some change themselves to males. |
| Nephritis |
| Pneumonia, bronchopneumo |
| Hyperthyroidism | Grave's disease only. |
| Scleroderma | Critical ischaemia leads to ulceration, infarction, pulp atrophy, and gangrene. |
| Anaemia, sickle-cell | Dactylitis in the infant during infarction crises. |
| Diabetes mellitus | Impalpable. |
| Leukaemia, myeloid chron | In cases of splenic infarction. |
| Parkinson | Slow to start walking; shortened stride; rapid small steps, tendency to run (festination); reduced arm swinging; impaired balance on turning. |
| SLE | Frequent but non-specific. |
| Mumps | Parotids. |
| Polychondritis | Proliferative. |
| Sjogren's syndrome |
| Anaemia, iron deficiency |
| Acromegaly | 25%. |
| Hyperthyroidism |
| Hyperthyroidism | Diffuse or nudular. Grave's disease: diffuse. May be a thrill or a bruit. |
| Hypothyroid, atrophic |
| Hypothyroid, goitrous | Hashimoto's thyroiditis (usually firm or rubbery); peroxidase antibodies may be present. |
| Hyperthyroidism |
| Hyperparathyroid |
| Mediterranean fever |
| Polycythaemia, stress | Haemocrit > 0.55. |
| TB, post-primary |
| Anaemia, haemolytic | Always indicates intravascular haemolysis. |
| Syringomyelia | Muscle wasting of the small hand muscles. |
| Hyperparathyroid | Soft tissues of the hands. |
| Thalassaemia |
| Ankylosing spondylosis | Aortic regurgitation. Aortitis with signs of a collapsing pulse. Diastolic murmur of aortic incompetence. |
| Reiter's | Aortic incompetence. Conduction defects. |
| Scleroderma | Aortic valve lesions. |
| Acromegaly | Soft tissue changes. Increased heel pad thickness. |
| Stroke, infarction |
| Stroke, infarction |
| Stroke, infarction |
| SLE |
| Sjogren's syndrome | Chronic active. |
| Acromegaly |
| Anaemia, haemolytic | Sometimes in Warm autoimmune haemolytic anaemia. |
| Anaemia, sickle-cell |
| Heart failure | Right heart failure. |
| Leukaemia, Acute | Acute leukaemia. |
| Leukaemia, lymphocytic c | May be enlarged. |
| Leukaemia, myeloid chron | 50%. |
| Sjogren's syndrome |
| TB, miliary |
| Thalassaemia |
| Weil's disease |
| Pneumonia, pneumococcal | Is often present. |
| HIV |
| Scleroderma | With reflux eosophagitis. |
| Bronchial carcinoma | Carcinoma in the apex of the lungs. May also be pain in the shoulder and arm. |
| Tapeworm |
| Toxoplasmosis | Congenitally acquired. |
| Lymphoma, myeloma | A high fluid intake is required to manage a raised calcium. |
| Diabetes mellitus | Severe ketoacidosis in undiagnosed diabetes. Ketone bodies increase the osmality of plasma, and increasing H+ by withdrawl of water from cells. This stimulates thirst and 'air hunger'. |
| Acromegaly | 25%. |
| Cerebral tumour | Raised intracranial pressure. |
| Hyperparathyroid |
| Hypothyroid, atrophic |
| Polyarteritis nodosa | 40%. Renal disease 70%. |
| Scleroderma | Usual presentation (2 of 2) in diffuse type - Systemic Sclerosis. May be malignant. |
| Takayasu's disease |
| Anaemia, iron deficiency |
| Parkinson | Poor precision of repeditive movements; impaired fine movements, especially of fingers; slowness initiating movements. |
| Hypopituitary | Adrenocorticotrophic Hormone (ACTH) deficiency causing a resultant cortisol (required for normal water handling by the kidney) deficiency. |
| Diabetes mellitus |
| Pericardial tamponade |
| Toxic shock |
| Hypopituitary | Temperature less than 32C from hypothyroidism. |
| Hypothyroid, atrophic | Rare but well recognized. A paralysis or obstruction of the intestines resulting in the failure of contents to pass through properly. |
| Hyperprolactinaemia |
| Hyperthyroidism |
| Hypogonadism | Post-pubertal; early symptom. Loss of testosterone allows unopposed oestrogen causing(?) small oestrogen secreting tumours and gynaecomastia. Also caused by hyperprolactinaemia. Loss of FSH leads to failure of spermatogenesis. LH deficiency causes testosterone deficieny and hence poor spermatogenesis. |
| Polyarteritis nodosa |
| Takayasu's disease |
| Polyarteritis nodosa |
| Diabetes mellitus | Fungi (candida): flourish on skin and mucous membranes. |
| Leukaemia, Acute | Fever >38 for 1 hour in neutropenia indicates septicaemia. |
| Henoch-Schonlein | Disease frequently follows upper respiratory infection. |
| Anaemia, pernicious Addi | In young females. |
| Hyperthyroidism |
| Hypogonadism | No treatment for infertility from this source. |
| Henoch-Schonlein |
| Behcet's | Quad. |
| Reiter's | 10% of patients. Injection of the ciliary vessels around the cornea; constricted, irregular or unreactive pupil; cells in the anterior chamber on slit-lamp examination. |
| Stroke, subarachnoid |
| Anaemia, haemolytic | Mild. |
| Ankylosing spondylosis | Tender on percussion. |
| Neurosyhilis | Charcot joints. |
| Pericardial tamponade | Gross elevation especially during inhalation Kussmaul's sign). |
| Heart failure | Right heart failure. |
| Hyperparathyroid | Chondrocalcinosis due to deposition of calcium pyrophosphate crystals within articular cartilage -- typically affects the knees. |
| Osteoarthritis |
| Measles | Day 2+. Mucous membrane of mouth (small white spots surrounded by a narrow zone of inflammation). |
| Acromegaly |
| Osteomyelitis | Tubercular osteomyelitis can lead to destruction of spinal bone. |
| HIV | Oral-hairy type. |
| Hyperprolactinaemia | Loss. |
| Parkinson | Rigidity: upper limbs cogwheel type; lower limbs plastic (lead pipe) type. |
| Leg ulcer, venous | Fibrosis of the dermis and subcutis (inverted champagne bottle). |
| Tapeworm | Right lobe. |
| Hepatitis C |
| Ankylosing spondylosis | Failure to obliterate the lumbar lordosis on forward flexion. |
| SLE | Impairment of ventilation and diffusion. |
| Lymphoma, Hodgkin's | Enlargement of one group of superficial lymph nodes. The cervical nodes are often the first. They are often painless, discrete, and rubbery. Pressure by node masses may cause a variety of problems. |
| Leukaemia, lymphocytic c | Cervical, axillary, and inguinal regions. |
| Quisy | Enlarged. |
| Hyperthyroidism |
| Lymphoma, non-Hodgkin's | More widespread node involvement than noticed by the patient. |
| Mononucleosis |
| Sjogren's syndrome |
| SLE |
| Leukaemia, Acute | Secondary to pharangeal sepsis but enlarged lymph nodes are a common feature. |
| HIV | Asymmetrical lymphadenopathy suggest lymphoma or tuberculosis, instead of HIV. |
| Anaemia, sickle-cell |
| Thalassaemia |
| Sjogren's syndrome | Lymphoreticular. |
| Hyperprolactinaemia |
| Horner's syndrome | Constriction of the pupil. |
| Candidosis | White curd-like patches which can be scraped away leaving a bleeding base. |
| Thrush | White curd-like patches which can be scraped away leaving a bleeding base. |
| Epilepsy | Limb stiffening, jerking, automatisms. |
| Anaemia, pernicious Addi | Pale. |
| anaemia |
| Osteoarthritis | As the disease progresses. |
| Neurone, motor disease | Wasting and fasciculation of muscles. |
| Typhoid | 1st week. |
| Bronchial carcinoma |
| Sjogren's syndrome |
| Chickenpox | Usually aduts or immunosuppressed. |
| Rheumatoid |
| Trichinella |
| Weil's disease | Suggested by tachycardia, fall in blood pressure, arrhythmias, and cardiac failure. |
| Acromegaly | Soft tissue changes. |
| Hyperparathyroid |
| Hyperthyroidism | Bulbar or proximal. |
| Sjogren's syndrome |
| Hypothyroid, atrophic |
| Hyperthyroidism | Pre-tibial. |
| Hypothyroid, atrophic | Most marked on the skin of the hands, feet, and eyelids causing periorbital puffiness. |
| Hyperthyroidism |
| Rheumatoid | Necrotising vasculitis. |
| Psoriatic | Subungual hyperkeratosis. |
| Candidosis | Start at base, forming ridges often accompanied by paronychia. |
| Dermatomyositis | Nail fold infarcts are common. |
| Acoustic neuroma | Initially on looking away from the lesion, later when looking towards the lesion. |
| Toxoplasmosis | Congenitally acquired. |
| Multiple sclerosis |
| Stroke, infarction | Lateral medula. |
| Bronchial carcinoma |
| Polyarteritis nodosa | Symmetrical. Neuropathy 50%. |
| Bronchial carcinoma | Polyneuropathy, myelopathy, cerebellar degeneration. |
| Multiple sclerosis | Upper motor neurone signs. |
| Sjogren's syndrome |
| Rheumatoid |
| SLE |
| Reiter's |
| SLE |
| Hyperparathyroid |
| TB, extra-pulmonary | Cervical node involvement is most common. Sinus formation is common. |
| Scarlet fever | Tender enlargement of the tonsillar nodes. |
| Neurosyhilis | Impairment of pin-prick sensation over the nose, perineum, and distal lower limbs. |
| anaemia |
| Henoch-Schonlein |
| Heart failure | Right heart failure. |
| Heart failure | Left heart failure. |
| Hyperprolactinaemia |
| Heart failure | Poor renal perfusion. |
| Psoriatic |
| Optic atrophy | Appears pale white or grey. |
| Optic neuritis | Oedema. |
| Mumps | 25% in males who develop mumps after puberty. |
| Heart failure | Left heart failure. |
| Lymphoma, myeloma | Osteoclasts are stimulated. |
| Rheumatoid |
| Peptic ulcer | Pain often relieved by eating. |
| Stroke, infarction | Impairment. Spinothalmic tract. Contralateral to lesion. |
| TB, post-primary | Not associted with an acute illness. |
| Polyarteritis nodosa |
| Bronchial carcinoma | And ankles. HPOA. |
| Bronchial carcinoma | And shins. HPOA. |
| Stroke, infarction | Brainstem. |
| Quisy |
| anaemia | Skin, mucous membranes, palms of hands, conjunctivae. |
| hand | Chronic liver disease or hyperthyroid. |
| Hyperthyroidism |
| Stroke, infarction | Brainstem. |
| Hyperparathyroid | Acute. |
| Acoustic neuroma |
| Cerebral tumour | Raised intracranial pressure. May be accompanied by haemorrhages in the optic disc. |
| Anaemia, pernicious Addi | May be sub-acute degeneration. |
| Polyneuropathy, chronic | Feet and, later, the hands. Progresses up the limbs. |
| Hyperthyroidism | Period in orientals. |
| Toxoplasmosis | Congenitally acquired. |
| Rheumatoid |
| Scleroderma |
| SLE |
| Tapeworm | Changes. |
| Stroke, subarachnoid |
| Leg ulcer, venous | Haemosiderin and ivory-coloured scarring. |
| SLE |
| Chickenpox | Usually aduts or immunosuppressed. |
| TB, post-primary | Spontaneous. |
| Dermatomyositis | Mild, inflammatory. |
| Hyperparathyroid |
| Bronchial carcinoma |
| Sjogren's syndrome |
| Hyperparathyroid |
| Multiple sclerosis | Impaired peripheral position sense. |
| Parkinson | Flexed. |
| Mediterranean fever |
| Nephritis |
| Polychondritis |
| Scleroderma | Usual presentation (1 of 2) in diffuse type - Systemic Sclerosis. |
| SLE |
| Hyperparathyroid |
| Hyperthyroidism |
| Hypothyroid, atrophic | Rare but well-recognized. |
| Cranial arteritis |
| Horner's syndrome |
| Myasthenia gravis | One of the first signs. |
| Hypogonadism | Often positive family history and short stature. Other causes of delayed puberty include systemic disease, androgen receptor defect, 5alpha-reductase deficiency, anorexia nervosa, emotional deprivation, and excessive exercise. |
| Scleroderma | Occurs in the majority of patients. |
| Takayasu's disease | Absent or diminished. Upper limbs more than lower. |
| Pneumonia, pneumococcal |
| Pericardial tamponade | Fall in blood pressure during inhalation when the pulse may be impalpbale. |
| Neurosyhilis | Small and irregular; react to convergence but not directly to light. |
| Optic neuritis | Direct light reflex is impaired. |
| Henoch-Schonlein | Characteristically over buttocks and lower legs. |
| Rheumatoid | Necrotising vasculitis. |
| Sjogren's syndrome | Hyperglobulinaemic. |
| Rheumatoid | Vasculitis. |
| Pneumonia, pneumococcal | Recurrent or persistent. |
| Pneumonia, suppurative | High, remittent. |
| TB, miliary | High. |
| Dyshydrotic | Provoked by heat or emotional upset. Vesticles or bullae affecting the palms, fingers, and soles. |
| Leg ulcer, venous | Venous eczema. |
| Mononucleosis | Petechial rash on palate. Maculo-papular rash. |
| Scarlet fever | First behind the ears, rapidly becoming a punctate erythema. Most intense in flextures of arms and legs. Face not affected (but is usually flushed). Region around mouth is pale. |
| Rheumatoid |
| Scleroderma | Calcinosis, Raynaud's, oEsophageal, Sclerodactyly, Telangiectasia (CREST). |
| SLE |
| Anaemia, haemolytic | Association to cold agglutination disease. |
| Hypothyroid, atrophic | Delayed relaxation of tendon reflexes. |
| Diabetes mellitus | Depression or loss of tendon reflexes at the ankles. |
| Hyperthyroidism | Hyper-. |
| Neurone, motor disease | Exaggerated; extensor plantar responses. |
| Syringomyelia | Loss of one or more arm reflexes. |
| Henoch-Schonlein | Involvement in more severe cases. |
| Sjogren's syndrome |
| Polyarteritis nodosa |
| Whooping cough |
| Rosacea |
| Pneumonia, suppurative | Common. |
| Psoriatic |
| Sjogren's syndrome | Enlargement. |
| Epilepsy |
| Cranial arteritis |
| Polyarteritis nodosa |
| Scleroderma | Calcinosis, Raynaud's, oEsophageal, Sclerodactyly, Telangiectasia (CREST). |
| Acromegaly | Soft tissue changes. |
| Stroke, infarction | Impairment. Spinothalmic tract. Contralateral to lesion. |
| Candidosis | Commonest where the skin is moist and in contact with itself. |
| Polycythaemia, primary p | With suffused conjunctivae. |
| Behcet's | Quad. |
| TB, primary | Brownish after pressing with glass slide. Most likely on hands and neck. See erythema nodosum. See skin, nodules. |
| Acromegaly | Soft tissue changes. |
| Anaemia, sickle-cell |
| Paget's disease | Frontal bossing. |
| Sjogren's syndrome |
| Pericardial tamponade | Soft heart sounds with an early third heart sound. |
| Neurone, motor disease |
| Parkinson | Soft, rapid, indistinct. |
| Hypogonadism | Klinefelter's syndrome may cause a mild reduction in verbal skills. |
| Hypothyroid, atrophic | Due to an enlarged tongue. |
| Mononucleosis |
| SLE |
| Ankylosing spondylosis | Restriction of movement of lumbar spine in all directions. |
| Anaemia, haemolytic | Hereditary spherocytosis - often but not always palpably enlarged. Warm autoimmune haemolytic anaemia. |
| Anaemia, iron deficiency | Uncommon unless anaemia is severe and may reflect portal hypertension. |
| Anaemia, pernicious Addi | May be palpable. |
| Anaemia, sickle-cell |
| HIV |
| Leukaemia, Acute | Acute leukaemia. |
| Leukaemia, hairy cell | 90%. Lymph node enlargement is unusual. |
| Leukaemia, lymphocytic c | Usually palpable. |
| Leukaemia, myeloid chron | Principal finding (90%). |
| Myelofibrosis | Rarely absent. |
| Polycythaemia, primary p | 75% of patients at diagnosis. |
| Rheumatoid | Felty's syndrome is associated with spenomegaly and neutropenia with rheumatoid arthris. |
| TB, miliary |
| Thalassaemia | Early and prominent feature. |
| Typhoid | 2nd week. |
| Weil's disease |
| Pneumonia, bronchopneumo | Purulent. |
| Giardiasis | Malabsorption of xylose and vitamin B12; lactose intolerant (partial villous atropy -- DD coeliac or Crohn's). |
| Roundworm | Blockage of bile. |
| Hyperthyroidism |
| Behcet's | Quad. |
| Hyperparathyroid |
| Nephritis |
| Polyarteritis nodosa |
| Acromegaly | Soft tissue changes. |
| Takayasu's disease |
| Anaemia, haemolytic | Association to cold agglutination disease in children (paroxysmal cold haemoglobinuria). |
| anaemia |
| Diabetes mellitus |
| Diphtheria | Blood pressure may be low. |
| Hyperthyroidism | Sinus. Common. |
| TB, miliary |
| Pneumonia, pneumococcal | Rapid breathing: 30-40 adults, 50-60 children, and is shallow when pleural pain is present. |
| Anaemia, sickle-cell |
| Hepatitis C |
| Scleroderma | Calcinosis, Raynaud's, oEsophageal, Sclerodactyly, Telangiectasia (CREST). |
| Nephritis | Renal angle and lumbar region. |
| Polymyalgia | Acromio-clavicular or sterno-clavicular joints. |
| Ankylosing spondylosis |
| Gout |
| Osteomalacia | Carpopedal spasm and facial twitching. |
| Polychondritis |
| Leukaemia, Acute | Coagulation abnormalities occur. |
| Sjogren's syndrome |
| Rheumatoid | A feature of active systemic inflammation. |
| Sjogren's syndrome |
| Cranial arteritis |
| Anaemia, pernicious Addi | Smooth, but sometimes red and inflammed. |
| Acromegaly | Lips and nose, too. |
| Scarlet fever | Showing prominent red papillae. |
| Mononucleosis | Exudative. |
| Diphtheria | Membranous tonsillitis (greyish-green membrane with a well-defined edge). |
| Scarlet fever | May be covered with a follicular exudate. Easily wiped off. Yellow in appearance. (As opposed to diptheria). |
| Gout | Frequently found in the cartilage of the ear, bursae, and tendon sheaths. |
| Parkinson | Usually first in fingers/thumb; supination/pronation of forearm; may affect arms, legs, feet, jaw, tongue; present at rest, diminishing on action. Postural: less obvious, faster, finer amplitude; present on action or posture, persists with movement. |
| Toxoplasmosis | Congenitally acquired. |
| Mumps | Clenching of the jaw muscles. |
| TB, miliary | May be visible on ophthalmoscopy but are rarely present in the elderly. |
| Behcet's | Quad. |
| Neurosyhilis | Loss of pain sensation. |
| Rheumatoid | Necrotising vasculitis. |
| Hyperparathyroid |
| Polycythaemia, primary p | Common. |
| Pneumonia, suppurative |
| Heart failure | Poor renal perfusion. |
| Hyperparathyroid |
| Reiter's | Triad. Dysuria and a clear, sterile discharge. |
| Nephritis | Cloudy; due to associated cystitis. Leucocyte positive. |
| Anaemia, haemolytic | Increased. |
| Ankylosing spondylosis |
| Toxoplasmosis | Adults. |
| Quisy |
| Candidosis | Intense pruritis and a thick creamy discharge. |
| Polychondritis |
| Sjogren's syndrome |
| Rheumatoid | Large areas of skin necrosis or digital gangrene have more serious clinical significance and may herald the onset of malignant rheumatoid disease. Such patients are often febrile with severe systemic disturbance and multiple extra-articular manifestations. A larger vessel arteritis, histologically resembling polyarteritis nodosa, may result in catestrophic mesenteric, renal, cerebrovascular or coronary occlusion. Such patients frequently have evidence of circulating immune complexes, hypergammaglobulinaemia, cryoglobulins, and hypocomplementaemia. |
| Polycythaemia, primary p | Engorgement. |
| Diabetes mellitus | Impaired distally in the legs. |
| Multiple sclerosis | Loss of peripheral vibration sensation. |
| Acromegaly | Soft tissue changes. Heart, thyroid, liver. |
| Hyperprolactinaemia | Defects. |
| Hypogonadism | Pituitary tumour causing secondary hypogonadism. |
| Hyperthyroidism | Grave's disease only. |
| Hypothyroid, atrophic |
| Diabetes mellitus | Severe ketoacidosis in undiagnosed diabetes. |
| HIV |
| Pneumonia, suppurative | If not adequately treated. |
| Hypothyroid, atrophic |