Tiredness or physical fatigue with no obvious cause is a very common complaint. It is normal to feel tired at times, e.g. after working long hours, unaccustomed exertion or sleepless nights. However, it is important to differentiate between tiredness due…
A sore throat is an extremely common symptom, especially in children and young adults. Persistent sore throat in an elderly patient is a cause for concern, as it may indicate the presence of neoplasia. Causes Infective ● Tonsillitis ( Fig.…
Thirst as a symptom, is usually associated with two other symptoms, i.e. drinking excessive amounts of water (polydipsia) and excessive urination (polyuria). Causes Inadequate fluid intake ● General debility/frailty ● Neurological disease ● Anorexia Excessive fluid loss ● Vomiting ●…
Syncope is the transient loss of consciousness due to impaired cerebral blood flow. Causes Cardiovascular ● Myocardial infarction (when complicated by arrhythmia or cardiogenic shock) ● Pulmonary embolism ● Aortic stenosis ● Carotid sinus hypersensitivity ● Hypertrophic obstructive cardiomyopathy Vasovagal…
Excessive sweating is often brought to the attention of the physician when it becomes socially unacceptable. The underlying cause ranging from trivial to serious. Causes Excessive sweating ● Primary hyperhidrosis ● Hypoglycaemia Infections ● Any systemic infection Malignancy ● Brain…
Stridor is a high-pitched inspiratory sound produced by upper airway obstruction. Causes Congenital ● Laryngomalacia (congenital flaccid larynx) Acquired ● Foreign body ● Infection ● Epiglottitis (green in countries without universal Hib vaccination) ● Retropharyngeal abscess ● Iatrogenic ● Post-tracheostomy…
Steatorrhoea refers to the passing of excessive amounts of fat in the faeces. Causes Lipase deficiency ● Impaired secretion – chronic pancreatitis ● Inactivation – excess gastric acid Bile deficiency ● Underproduction – liver disease ● Obstruction – obstructive jaundice…
The spleen must be enlarged to about three times its normal size before it becomes clinically palpable. The lower margin may feel notched on palpation. The spleen may become so massive in size that it is palpable in the right…
Shock is an abnormality of the circulation that results in inadequate organ perfusion and tissue oxygenation. Causes (all causes of shock require emergency assessment) Hypovolaemic ● Haemorrhage ● Burns ● Gastrointestinal losses Cardiogenic ● Myocardial infarction ● Acute valvular damage…
Scrotal swellings are a common presenting complaint in the outpatient clinic. It is also important to distinguish between those swellings that have underlying serious pathology (testicular tumour) and those that are simple and benign (epididymal cysts). Causes ● Sebaceous cyst…