Famous Signs and Symptoms
HIigh-Yield Knowledge
Neurological Symptoms
- Kernig’s sign: Position the patients supine with their hips flexed to 90°. Test is positive if there is pain on passive extension of the knee.
- Brudzinski’s sign: Position the patient supine and passively flex their neck. Test is positive if it causes reflex flexion of the hip and knee.
- Charcot’s Triad: Dysphagia, Nystagmus, and intentional tremors.
- Descending Muscle Weakness. Again, Descending, Descending, Descending. PERMANENT
- Chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle → weakness of muscles. Affects the voluntary muscles of the body, the eyes, mouth, throat and limbs.
- Ascending muscle weakness NOT PERMANENT
- Watch for respiratory depression/weakness/decreased vital capacity. The NCLEX answer is almost breathing!
- Immune disorder that often occurs after a viral illness
- The client had an untreated sore throat? Think Guillain Barre Syndrome
- Pill-rolling tremors of the hand
Cushing’s sTriad: Hypertension, bradypnea, and bradycardia.
Famous Respiratory Symptoms
- Low-grade afternoon fever and night sweats
- Rusty Sputum
- Bronchial breath sounds at bases of lungs. Pay attention to image and location of normal breath sounds.
- Wheezing on EXPIRATION. Read it again, EXPIRATION
- Asthma attack? Priority is to Give that albuterol (beta adrenergic agonist)
- Barrel-shaped chest
- These are the clients that need to do purse-lip breathing and have a history of SMOKING!
Dyspnea and chest pain. Petechiae on chest. Turn Client to the left side.
Decreased or absent breath sounds at the location of the pneumothorax
Barking or seal-like cough
Tripod D’s
- Drooling
- Dysphonia (voice change)
- Dysphagia (Swallowing difficulty)
The drooling client is a priority client: AIRWAY
Inspiratory Stridor. INSPIRATORY.
Diagnosed when babies are born: salty skin, meconium ileus, and poor weight gain.
Cardiovascular Symptoms
Bruit sound in the abdomen and pulsating mass around umbilicus.
Back pain and symptoms of shock
Hypotension, jugular venous distension, and muffled heart sounds
Beck’s triad: Hypotension, JVD and muffled or distant heart sounds.
Crushing stabbing chest pain relieved by nitroglycerin
Crushing stabbing chest pain that radiates to the left shoulder, neck, left arm or jaw and it is not relieved by nitroglycerin.
Hypotension, Tachypnea, and Tachycardia
Homan’s Sign
GI Symptoms
- Red Beefy Tongue. There is a lack intrinsic factor and vitamin B12 is not absorbed.
- Think Gastrectomies or any thing related to the stomach.
- These clients must have injectable Vitamin B12.
- Cannot have oral Vitamin B12 because they have no intrinsic factor to absorb Vitamin B12.
- Schilling test to confirm diagnosis.
- Chipmunk face: One of the telltale signs of bulimia is the appearance of swollen cheeks – colloquially known as “chipmunk cheeks” – on the sides of the face. Caused by the enlargement of the parotid glands (one of the salivary glands)
- Bulimia Knuckles: lesions on knuckles caused by the teeth when making themselves vomit
RLQ pain (Mcburney’s point) with rebound tenderness.
Olive-like mass, projectile vomiting after feeding (nonbilious)
Foul, smelly, bilious vomiting and ribbon stools
Spider-like varices
Cullen’s sign (bluish discoloration around umbilicus) and Grey Turner’s spot (the appearance of purplish-bluish skin discoloration (ecchymosis) on the flanks due to internal bleeding)
Blood diarrhea
Sausage-shaped mass, jelly-like stools and pain.
Dance sign: Abdominal mass in RUQ and empty RLQ. Stool stuck in the RUQ and does not pass to RLQ
Flapping tremors
Other Symptoms
Koplik’s spots (also Koplik’s sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself. They are characterized as clustered, white lesions on the buccal mucosa (opposite the lower 1st & 2nd molars) and are pathognomonic for measles (Rubeola).
- Painless, progressive enlargement of spleen & lymph tissues.
- The presence of Reed Stenberg cells
- Hodgkin’s = Reed Sternberg cells
- Sore throat, cervical lymph adenopathy (swollen lymph nodes), and fever
Weight Gain. Cold intolerance.
Morning stiffness. Asymmetrical Joint stiffness. Finger joints often affected.
Severe great toe pain
Fluid Retention and hyponatremia
Encephalopathy and Liver Failure
Shivering and Hyperthermia
Moon Face and Buffalo Hump
Bronze-like pigmentation
Everything is low except potassium: hyponatremia, hypoglycemia, hypotension, but hyperkalemia
Butterfly rash
Kussmaul respirations and fruity breath.
Trousseau’s and Chvostek’s sign