PATHOGNOMONIC SIGNS

Prepared By:

John Gil B. Ricafort, BSN, RN

Diseases and Pathognomonic Signs

A

Abdominal Aortic Aneurism

- pulsating abdominal mass

Abruptio Placenta

- painful bleeding, board-like abdomen

Acute Renal Failure

- azotemia, uremic frost on skin

Addison’s Disease- bronze pigmentation of skin

Angina Pectoris- pain upon exertion

Appendicitis- Mc Burney’s sign

Atrial Septal Defect- murmur heard high on chest

Autism- rocking, spinning, routines

B

Bacterial Vaginosis

- grayish white discharges

Basilar Fracture

- raccoon’s eye

Breech Birth

- meconium staining

Bulimia Nervosa

- Binge eating

CCarbon Monoxide Poisoning

- cherry pink flushed face, carbon in the secretions, non-productive cough

Carpal Tunnel Syndrome- Jack Hammer Syndrome (TINEL’s sign)

Cataract- cloudy vision

Celiac Disease- gluten sensitivity, foul smelling stool

Chicken Pox

- maculopopular rash

Cholera

- rice water stools

Colic

- pulling up of arms and legs, red-faced crying

COPD

- barrel chest, clubbing of fingers

Cushing’s Syndrome

- moon face, buffalo hump

CVA

- homonymous hemianopsia

Cystocele & Rectocele

- feeling of fullness at vagina

DDelirium

- recent and past memory defectDementia

- recall or learning memory impairmentDetached Retina

- flashes of light, shadow/ curtain across the vision

DM- polydipsia, polyuria, polyphagia

Diptheria

- pseudomembrane

Diverticular Disease

- cramping, colicky pain in left lower abdominal quadrant

Down Syndrome (Trisomy 21)

- saddle nose, brushfield’s spots

E

Ectopic pregnancy

- Cullen sign

Endometriosis

- premenstrual pain decreasing as menstrual flow decreases

F

Failure to Thrive (FTT)

- “Radar gaze”

G

GERD

- Barret esophagus

Glaucoma

- halos around the light, tunnel vision

Grave’s Disease

- exopthalmia

H

Hemophilia

- hemarthoses

Hepatic Disease

- asterixis, jaundice

Hirschprung’s Disease

- ribbon-like, foul smelling stool

H-mole

- grapelike growth, large abdomen

Hydrocephalus

- Setting sun eyes

Hypocalcemia

- Trousseau sign, Chvostek Sign, Hyperreflexia

I

Increased ICP

- high pitch cry

Increased IOP

- Doll’s eye

Intestinal Obstruction

- no passage of meconium

IDA

- activity intolerance

K

Kawasaki

- strawberry tongue

Kleibsiella Pneumonia

- red gelatinous sputum

L

Left-sided Heart Failure

- pulmonary manifestations

Low birth weight

- less than 2.5kg or 5 1/2lbs

Lyme Disease

- red-tinged circular rash (erythema chronicum migrans)

M

Malaria

- blackwater fever

Meniere’s Disease

- whirling vertigo, tinnitus

Meningitis

- Kernig’s sign, Brudzinski’s sign

Moniliasis

- white “cheesy” discharge

Multiple Sclerosis

- descending weakness, Charcot’s Sign (intention tremor, nystagmus, scanning speech)

Myasthenia Gravis

- nasal smile

Mycoplasmal Pneumonia

- nonproductive that progresses to mucoid sputum

Myocardial Infarction

- Levine sign, viselike or crushing pain radiating to shoulder, arms, jaw or back

O

Opthalmia Neonatorum

- purulent conjunctivitis

Oral Thrush

- white patches on tongue

Osteoporosis

- kyphosis

Otosclerosis

- ringing or buzzing, longer bone conduction than air conduction

P

Pancreatitis

- steatorrhea

PDA- machinery-type murmur throughout the heartbeat in the left 2nd or 3rd interspace

Parkinson’s Disease- pill rolling, bradykinesia, rigidity

Peritonitis- board-like abdomen

Pernicious Anemia- Beefy red tongue

Pertusis

- paroxysmal cough ending with a whoop

PID

- fever, vaginal discharges, lower abdominal cramping

Placenta Previa

- painless bright red bleeding

Pneumococcal Pneumonia

- purulent rusty sputum

Pneumothorax (Flail Chest)

- paradoxical respiration – loose chest segment moves inward during respiration and outward during expiration

PIH

- edema, proteinuria, hypertension

Preterm infant

- 36 weeks or less

Prolapse Uterus

- pelvic heaviness

Pulmonary Embolism

- sudden dyspnea, sharp pleuritic pain

Pyloric Stenosis

- projectile vomiting, non bile stained vomitus,

R

Rabies

- hydrophobia

Retinoblastoma

- diminished vision, strabismus, retinal detachment, abnormal pupilary reflex

Right Ventricular Failure

- Systemic manifestation

Rocky-Mountain Spotted Fever

- rose colored macules

Rubella (German Measles)

- Foreschimer’s Spot (small red macules on soft palate)

Rubeola (Measles)

- Koplik spots

S

Schizophrenia

- Association, affect, ambivalence, autistic thinking

Sickle Cell Anemia

- “painful episodes” or “vaso-occlusive crisis”

Staphyloccocal Pneumonia

- yellow-blood streaked sputum

SIDS

- frothy, blood-tinged fluid fills mouth and nose

Syphilis

- chancre on genitalia, mouth, anus

SLE

- butterfly rash on face

TTetanus (lockjaw)

- spasmsTOF

- Pulmonary valve stenosis, RVH, Overriding of the Aorta, VSD

Thrombophlebitis- Homan’s sign

Tracheoesophageal Fistula- coughing, choking, cyanosis

Trichomoniasis

- malodorous thin yellow discharges

Typhoid fever

- rose-colored papules on the abdomen

Tuberculosis

- low grade fever, night sweats, hemoptysis

U

Ulcerative Colitis

- bloody, watery, purulent, mucoid stools

V

Varicosities

- tortous veins

VSD

- low, harsh murmur heard throughout systole

Common Laboratory Values

Albumin

3.5-5.0 g/100 ml

Ammonia

12-55 umol/L

Amylase

4-25 units/ml

AST, SGOT

Male: 8-46U/L

Female: 7-34U/L

Bilirubin

Total: up to 1.0mg/100ml

Bleeding Time

3-7 min

BUN

8-25mg/ml

Calcium

8.5-10.5mg/100ml

Carbon Dioxide

24-30mEq/L

Chloride

100-106mEq/L

Cholesterol

<200mg/dl

Creatinine Kinase (CK)

Male: 17-148U/L

Female: 10-79U/L

CPK

<150U/L

CPK-MB

0-5ng/ml

Creatinine

0.6-1.5mg/100ml

ESR

Male: 1-13mm/Hr

Female: 1-20mm/Hr

Fibrinogen

160-450mg/dl

Glucose

70-110mg/100ml

HCO3

22-26mmol/L

HDL

30-75mg/dl

Hemoglobin

Male: 13-18g/ 100ml

Female: 12-16g/ 100ml

Hematocrit

Male: 45-52%

Female: 37-48%

Iron

50-150u/100 ml

WBC

-10,000-15,000/mm3

LDH

70-180

Lipase

2 units/ml or less

Magnesium

1.5-2 mEq/l

pH

7.35-7.45

PO2

75-100mmHg

PCO2

35-45mmHg

Phosphorus

3.0-4.5mg/ 100ml

Platelets

150,000-400,000/mm3

Potassium

3.5-5mEq/l

Protein

6.0-8.4g/ 100ml

PT

10-12 sec

PTT

30-45 sec

RBC

Male: 4.6-6.2 million/ mm3

Female: 4.2-5.9 million/mm3

Sodium

135-145mEg/L

T3

75-195 ng/ 100ml

T4, total

4-12 u/ml

Thrombin Time

11-15 sec

Triglycerides

40-150mg/ 100ml

TSH

0.5-5U/ml

Urea Nitrogen

8-25mg/ 100ml

Uric Acid

Male: 4-9 mg/dl

Female: 3-6.6 mg/dl

DIAGNOSTIC TESTS &

PROCEDURESWag kalimutan…

Cardiovascular System Electrocardiography

- noninvasive test

- graphical representation of the heart’s electrical activity

- interpret EKG for changes

Holter Test Monitoring(Ambulatory EKG)

- noninvasive test

- records the heart’s electrical activity and cardiac events for 24 hours

- advise the patient on activity limitations while wearing monitor

Cardiac Catheterization- invasive, fluoroscopic procedure- examines intracardiac structure, pressure, oxygenation and cardiac output.- Note the patient’s allergies before testing- Report immediately if with chest pain

Echocardiography

- noninvasive test

- uses echoes from sound waves to visualize intracardiac structures and blood flow

- Determine the patient’s ability to lie still.

Stress Testing- noninvasive test- study of the heart’s electrical activity and ischemic events during levels of exercise.- Light breakfast before the test - STOP the test if patient develops cardiopulmonary symptoms

Respiratory System Bronchoscopy

- invasive test

- allows for visualization of the trachea and bronchial tree

- Check cough and gag reflex AFTER procedure

Pulmonary Angiography

- invasive test involving injection of radiopaque dye

- allows for radiographic examination of pulmonary circulation

-NOTE allergies to iodine, seafoods, and radiopaque dyes BEFORE test

Thoracentesis

- invasive procedure using needle aspiration

- allows removal of pleural fluid and specimen examination

- PLACE the patient in proper position

Pulmonary Function Tests (PFTs)

- noninvasive test

- measures lung capacity

- Document bronchodilators or narcotics used before testing

Arterial Blood Gas analysis (ABG)

- blood test

- arterial blood measurements of tissue oxygenation, ventilation and acid-base balance.

- APPLY pressure to the site 5 minutes after procedure

Lung Biopsy

- invasive test

- removal of a small amount of lung tissue for histologic evaluation

- OBSERVE for signs of pneumothorax and air embolism after procedure

Nervous System Electroencephalography (EEG)

- noninvasive test

- graphic representation of the brain’s electrical activity

- WITHHOLD medications and caffeine 8 hours before the procedure

Cerebral Angiogram

- invasive procedure using a radiopaque dye

- allows examination for the cerebral arteries

- NOTE patient’s allergies before the procedure

Lumbar Puncture

- invasive test

- collection of CSF for analysis

- CONTRAINDICATED in the presence of increased ICP

Gastrointestinal System Upper GI Series (Barium Swallow)

- allows for examination of the esophagus, stomach, duodenum and other portions of the small bowel after swallowing

- BEFORE procedure, administer fluids, cathartics, and enema, as prescribed

Lower GI Series (Barium Enema)

- Allows for examination of the large intestine after administration of a barium enema

- BEFORE procedure, withhold food

Endoscopy

- procedure using an endoscope for visualization

- WITHHOLD food and fluids 6 to 12 hours before the test

Fecal Occult Blood Test

- laboratory test using a reagent

- analysis of stool for blood

- ADVISE the patient to AVOID red meat, iron and high fiber for 1 to 3 days prior to the procedure

Fecal Fat Test

- laboratory test using a stain

- analysis of stool for fat

- ADVISE the patient to restrict alcohol intake and maintain a high-fat diet for 72 hours before examination

Cholangiography

- invasive procedure using an injection of a radiopaque dye through a catheter

- allows for examination of the biliary duct system

- BEFORE the procedure, note the patient’s allergies

Liver Scan

- invasive procedure using an IV injection of a radioisotope

- provides an image of blood flow in the liver

- Assess the patient for allergic reaction after the procedure

Gastric Analysis

- aspiration of the contents of the stomach through an NG tube

- measures the acidity of gastric secretions

- Instruct NOT TO SMOKE for 8 to 12 hours before the test

Ultrasonography

- noninvasive procedure that uses echoes from sound waves

- provides visualization of body organs

- WITHHOLD food and fluids for 8 to 12 hours before the procedure

Liver Biopsy

- invasive procedure using needle for the percutaneous removal of a small amount of liver tissue

- Before the test, assess clotting studies

- During the test, hold the breath

- After the test, Right lateral position

Urinary System Urinalysis

- laboratory test for urine

- examines the color, appearance, pH, specific gravity, protein, glucose, ketones, RBCs, WBCs and casts

- OBTAIN first morning urine specimen

Urine Culture and Sensitivity

- laboratory test for urine

- detects bacteria

- Collect midstream sample in sterile container

24-hour Urine Collection

- laboratory test for urine

- samples collected over 24 hours to determine kidney function

- instruct the patient to void and note time

- discard the first urine collected

Blood Chemistry

- laboratory test of blood sample

- analysis for potassium, sodium, calcium, phosphorus, glucose, bicarbonate, BUN, creatinine, protein, albumin, and osmolality

- check the site for bleeding

Cystoscopy

- procedure using cystoscope to visualize the bladder

- Check the patient’s urine for blood clots after the procedure

Renal Angiography

- procedure using injection of radiopaque dye through a catheter

- examination of the renal arterial supply

- NOTE the patient’s allergies before the procedure

Hematopoietic System Bone Marrow Examination

- percutaneous removal of bone marrow

- examines erythrocytes, leukocytes, thrombocytes, and precursor cells

- GIVE analgesics or anxiolytics, as ordered.

Schilling Test

- administration of oral radioactive cyanocobalamin and I.M. cyanocobalamin

-microscopic examination of 24-hour urine sample of cyanocobalamin

- WITHHOLD food and fluids post HS