July 1, 2012

Signs and syndromes in the emergency department

This guy surely did beat the feeling You remember the ad "you can't beat the feeling"? What they didn't know is that there actually is one thing that does beat the feeling of a fresh Cola can - eliciting a sign you've learned in medical school, glued to your cortex years ago and finally making sense! Just like fresh blood on a CT can't lie about subarachnoid hemorrhage, a positive sign can verify a diagnosis you're having in mind. And that is indeed a feeling of excitement and victory. Even drugged Dr House can't hide his wide nostrils of joy as he's hit the nail on the head.

Therefore I decided to learn more signs and even syndromes I might encounter in my emergency department. And it has already made wonders - recently I learned about Rovsing sign and what do you know - next patient coming in with ambulance was a comatose elderly man having fluctuating, horizontal eye movements caused by uremia, a positive Rovsing sign... HOWZAT!

But that's what wise masters have been telling us all the time, doctors or not - what you go looking for, you will find. It's an universal law - and a Russian proverb!.

So I decided to make a list of signs and syndromes I could expect to encounter in my emergency department. In the spirit of social media I want to share this list with you, in hope that it will also increase your skills of diagnosis and pattern recognition. As most of my notes in Google Docs (now Drive) the list is a dynamic one which I am constantly editing to make better. Please feel free to use the comments for feedback or additions if you have some favorite sign or syndrome that has helped you in the ED.

To complement this list I also have a special collection in my Picasa web album where I collect medical images representing signs or diagnostic clues in the same manner as a picture says 1000 words.

In case you are interesting in more of these there are even more detailed lists on the Internet although I find many of the entries there not so relevant to the ED;


Finally, credit must be given to some sources I have used extensively to make the list;
  • Wikipedia
  • Whonamedit.com
  • fpnotebook.com
  • gpnotebook.com
  • and others who I haven’t been able to identify (just old notes from med-school)