Atlas of Physical Signs.ppt

8/14/2019 Atlas of Physical Signs.ppt

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Preface

The aim of this atlas is to help the

medical students in the detection and

interpretation of the physical signs of

various medical diseases. I have no authority for any of these slides

but I had collected them from different

websites and added my notes.

(cont.)

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Preface

The title of the slide has been hidden forself assessment. To reveal the title click onthe slide.

Assist. prof. Safaa Ali

FICMS (med.)

College of Medicine / Kufa University

[email protected]
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Lid retraction

[Thyrotoxicosis]

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Lid lag

[Thyrotoxicosis]

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Exophthalmos

[Graves disease]

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Puffy apathetic face with coarse hair[Hypothyroidism, before and after treatment]

8


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Moon face with hirsutism

[Cushing syndrome]

9


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Coarse features of the face and bulky hands

[Acromegaly]

10


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Proganthism (protrusion of lower jaw)

[Acromegaly]

11


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Puffy eyes

[nephrotic syndrome, hypothyroidism]

12


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Xanthelasma

[hypercholesterolemia]

13


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e o rope ras(purple discoloration on the upper

eyelids)

[dermatomyositis]

14


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Pallor of conjunctiva

[anemia]

15


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Yellowish discoloration of the sclera and

skin

[jaundice]

16


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Kayser fleischer ring

[Wilsons disease]

17


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Kayser fleischer ring

[Wilsons disease]

18


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Red painful eye(anterior uveitis)[Behcet disease,Reiter's syndrome, IBD]

19


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Infiltration of lower eye lid

[Lymphoma]

20


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Discoid lupus lesion

[SLE]

21


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Saddle nose

[Wegner granulomatosis]

22


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Ulcer with rolled borders

[basal cell carcinoma]

23


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Hyperpigmented elevated lesion

[malignant melanoma]

24


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Papules, pustules and comedones

[Acne vulgaris]

(adolescence, steroid therapy)

25


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Whitehead and blackhead comedones

[Acne vulgaris]

(adolescence, steroid therapy)

26


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Melasma

(symmetric brown patches on the face)

[pregnancy, oral contraceptive]

27

h l h


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erythematous plaque over the nose

(butterfly rash)

[SLE]

28

P l t l d t l i t i


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Papules, pustules and telangiectasia

on erythematous plaque

[acne rosacea]

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Multiple angiofibroma

[tuberous sclerosis]

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Maculopapular rash

[measles, drug eruption]

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Maculopapular rash behind the ear

[measles]

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Erythema and edema of the face

[Erysipelas / streptococcal infection ]

33

P i bit l d


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Periorbital edema

[angioedema, hereditary or IgE

dependent]

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Unilateral ptosis

[Congenital, Myasthenia gravis]

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Bilateral ptosis


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Bilateral ptosis{before and after edrophonium (tensilon) test}

[Myasthenia gravis]

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Ptosis divergent squint and dilated pupil


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Ptosis, divergent squint and dilated pupil

[Oculomotor nerve palsy]

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Enophthalmos, ptosis and meiosis

[Horners syndrome]

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Inability to elevate the left eyebrow and


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Inability to elevate the left eyebrow andincomplete closure of left eye with Bells

phenomena.

Right side deviation of the mouth

[left LMN facial nerve palsy (Bells palsy)]

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Flat nasolabial fold and inability to show


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Flat nasolabial fold and inability to show

teeth in the right side

[right UMN facial nerve palsy]

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Chvostek'ssign

[hypoparathyroidism]

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ca ere emorr age, ye ow exu a es


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ca ere emorr age, ye ow exu a esand new vessels formation near optic

disc

[proliferative diabetic retinopathy]

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Scattered hemorrhage and cotton wool


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Scatteredhemorrhage and cotton wool

spots (retinal infarcts)

[hypertensive retinopathy]

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Massive retinal hemorrhage

[central retinal vein occlusion]

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Papilloedema

[raised intracranial pressure]

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Optic atrophy

[optic neuropathies]

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Pallor of the lips

[anemia]

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Bluish discoloration of the lips

[central cyanosis]

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Confluent vesicles on the lips

[Herpes simplex infection]

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Dark brown spots on the lips

[Peutz- Jeghers disease]

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Aphthous ulcer[idiopathic, Behcet disease,IBD, HIV infection]

51

Swelling of the lip


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Swelling of the lip


dependent]

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Gum hyperpigmentation

[Addisons disease]

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Gum hypertrophy


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Gum hypertrophy

[calcium channel blockers, Phenytoin

therapy and AML M5]

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Buccal hyperpigmentation

[Addisons disease]

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Multiple aphthous ulcers[idiopathic, Behcet disease,IBD, HIV infection]

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Whit t h f l


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White patches of oral mucosa

[Candida albicans infection]

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T ill l t


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Tonsillar enlargement

[Tonsillar abscess]

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D t


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Dry tongue

[dehydration]

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Swelling of the tongue


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Swelling of the tongue


dependent]

60

At hi l iti


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Atrophic glossitis

[B12and iron deficiency]

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H l iti


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Herpes glossitis

[Herpes simplex infection]

62

Whit t h th t


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White patches on the tongue

[Candida albicans infection]

63

Whit l th t


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White plaques on the tongue

[Leukoplakia /Epstein Barr virus infection]

64

High arched palate


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High arched palate

[Marfan syndrome]

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Unequal lower teeth


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Unequal lower teeth

[fracture mandible]

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Left parotid enlargement


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Left parotid enlargement

[Sjogrens syndrome]

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Right parotid enlargement


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Right parotid enlargement

[mumps]

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Cervical lymph node enlargement


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Cervical lymph node enlargement

[lymphoma]

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Supraclavicular lymph node enlargement


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p y p g

(Virchow's node)

[gastric cancer]

70

Multinodular goiter


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Multinodular goiter

[simple multinodular goiter]

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Multinodular goiter


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Multinodular goiter

[simple multinodular goiter]

72

Clubbing and cyanosis


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Clubbing and cyanosis

[cyanotic congenital heart diseases]

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Clubbing


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Clubbing

[bronchogenic cancer]

74

Koilonychia (spooning of nail)


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Koilonychia (spooning of nail)

[iron deficiency anemia]

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Beaus lines


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Beau s lines

[chemotherapy, transient medical illness]

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Central nail canal


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Central nail canal

[peripheral vascular disease]

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Nail beading


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Nail beading

[DM, endocrine disorders]

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Nail pitting


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Nail pitting

[psoriasis]

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Leukonychia (white nail)


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Leukonychia (white nail)

[liver cirrhosis, CRF]

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Splinter hemorrhage


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Splinter hemorrhage

[trauma, vasculitis, bacterial endocarditis]

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Paronychia


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Paronychia

[bacterial or fungal infection]

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Swelling of the right hand


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dependent]

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Fingers cyanosis


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Fingers cyanosis

[Raynauds phenomena]

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Digital infarction


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Digital infarction

[DIC, vasculitis, sever Raynauds disease]

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Palmar erythema


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Palmar erythema

[liver disease, thyrotoxicosis, pregnancy and fever]

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Depigmentation of skin[vitiligo with possible associated autoimmune


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[vitiligo with possible associated autoimmune

diseases]

88

Palmar xanthoma


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Palmar xanthoma

[familial hypercholesterolemia]

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Tendon xanthoma of thumb


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e do a t o a o t u b


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Tuberous xanthoma


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Carpal spasm


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p p

[hypocalcemia]

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Trousseau's signs


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g

[hypocalcemia]

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Thick tight skin


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g

[scleroderma]

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Flexion contractures


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[scleroderma]

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Limited extension of fingers


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g

[scleroderma, DM]

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Dupuytren's contracture

[alcoholic liver disease DM idiopathic


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[alcoholic liver disease, DM, idiopathic

fibrosis]

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Hypermobility of the joints


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yp y j

[Ehlers - Danlos syndrome]

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Long fingers (arachnodactyly)


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g g ( y y)

[Marfan syndrome]

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Long arm span


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[Marfan syndrome]

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Heberden's nodes


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[osteoarthritis]

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Swan neck deformity


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[rheumatoid arthritis]

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Boutonniere deformity


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Z-deformity of the thumb


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Rheumatoid nodule


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Warts


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[Papillomavirus infection]

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Extradactyly and syndactyly


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[LaurenceMoon- Biedl syndrome]

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Short fourth metacarpal bone


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[Pseudohypoparathyroidism]

108

Erythematous plaques with adherent

silvery scale


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silvery scale.

[psoriasis]

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Pathergy test


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[Behcets disease]

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Lipodystrophy


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[insulin therapy]

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Hyperpigmented lesions

[di b i d h ]


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[diabetic dermopathy]

113

Purpura[thrombocytopenia, Henoch-Schnlein


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[thrombocytopenia, Henoch Schnlein

purpura]

114

Erythema nodosum[ TB streptococcal infection IBD sarcoidosis


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[ TB, streptococcal infection, IBD, sarcoidosis,

OC]

115

Erythema ab igne

[l l h t ff t]


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[local heat effect]

116

Necrobiosis lipoidica diabeticorum

[DM]


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[DM]

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Pyoderma gangrenosum[idiopathic, IBD, chronic active hepatitis, RA,


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[idiopathic, IBD, chronic active hepatitis, RA,

CML]

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Swelling and redness of the left leg

[ t i DVT]


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[extensive DVT]

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Hoffmans sign

[ac te DVT]


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[acute DVT]

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Swelling and redness of the leg

[cellulitis]


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[cellulitis]

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Bilateral leg edema[heart failure nephrotic syndrome liver cirrhosis]


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[heart failure, nephrotic syndrome, liver cirrhosis]

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Unilateral leg edema

[lymphatic obstruction]


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[lymphatic obstruction]

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Swelling behind the right knee

[Baker cyst /RA]


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[Baker cyst /RA]

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Varicose veins[primary or secondary to deep venous insufficiency ]


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[primary or secondary to deep venous insufficiency ]

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Swelling and redness of the varicose vein

[superficial thrombophlebitis]


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[superficial thrombophlebitis]

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Stasis dermatitis with ulcer

[chronic venous insufficiency]


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[chronic venous insufficiency]

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Foot ulcer and amputation of toes

[DM]


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[DM]

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Blisters and ulcer of the foot

[DM]


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[DM]

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Dry gangrene

[DM]


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[DM]

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Bony abnormality and nail infection

[DM]


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[DM]

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Interdigital infection

[DM]


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[DM]

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Swelling and redness of 1stMP joint

[acute gouty arthritis]


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[acute gouty arthritis]

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Skin hyperpigmentation

[Addison's disease]


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[Addison s disease]

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Achilles tendon xanthoma



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Pes cavus (high arched foot)

[Friedreich's Ataxia, Charcot-Marie-Tooth


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[

neuropathy, muscular dystrophy]

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Spider nevi

[chronic liver disease]


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[chronic liver disease]

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Purplish striae

[Cushing syndrome recent weight gain]


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[Cushing syndrome, recent weight gain]

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Velvety hyperpigmentation of axilla(Acanthosis nigricans)

[obesity, acromegaly, insulin resistance, GI


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[ y, g y, ,

malignancy]

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Gynecomastia[puberty, liver disease, drugs like cimetidine,

di i d i l t ]


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digoxin and spironolactone]

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oss o ma e a r s r u on[hypogonadism: hypothalamic-pituitary

disorders, testicular disease, liver


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disorders, testicular disease, liver

cirrhosis]

143

Dilated superficial veins

[superior vena cava obstruction]


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[superior vena cava obstruction]

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Pectus carinatum

[congenital, Marfan syndrome]


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Barrel chest

[chronic obstructive lung diseases]


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[ g ]

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Scoliosis



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[ g , y ]

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Ascites[liver cirrhosis, nephrotic syndrome, heart

failure TB peritonitis malignancy]


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failure, TB peritonitis, malignancy]

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Caput medusa(dilated peri-umbilicalveins)

[li i h i ith t l h t i ]


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[liver cirrhosis with portal hypertension]

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Dilated superficial veins with upwards flow

[inferior vena cava obstruction]


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[ ]

151


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Maculopapular rash[viral infections like measles, drug

allergy]


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allergy]

153

vesicular eruption of variable stages

[Varicella (chicken pox)]


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[ ( p )]

154

Unilateral vesicular eruption

[Herpes zoster(shingles)]


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[ p ( g )]

155

Urticaria[drug allergy, physical urticaria,

hereditary urticaria and vasculitis ]


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hereditary urticaria and vasculitis ]

156

Blisters over the abdomen

[Bullous pemphigoid ]


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157

Erythema multiformi[drug allergy, herpes and Mycoplasma

infection ]


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infection ]

158

Scaly lesion with central healing andperipheral inflammation

[Tinea (ring worm) /fungal infection]


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[Tinea (ring worm) /fungal infection]

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Erythematous papules in the trunk

[cherry hemangioma]


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160

Neurofibromas and caf au lait spots[neurofibromatosis type 1]

(Von Recklinghausen's disease)


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(Von Recklinghausen s disease)

161

Lipoatrophy

[local complication of insulin injection]


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Wasting of face and neck muscles/frontalbaldness

[myotonic dystrophy]


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[myotonic dystrophy]

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Gowers sign

[Duchenne muscular dystrophy]


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A

B

C

D

Muscle wasting and contracture

[Duchenne muscular dystrophy]


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Short stature and obesity

[Cushing syndrome in children]


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Dwarfism

[achondroplasia]


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Gigantism

[GH excess before puberty]


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Atlas of Physical Signs.ppt

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