An Insider’s Guide to Clinical Medicine Archith Boloor, Anudeep Padakanti
INDEX
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Abacavir 500
Abdomen 164f, 166, 175
four quadrants of 163f
pain in 151
regions of 163
shape of 162, 162f
Abdominal aorta 17, 165
bruit 165f
palpation of 17
Abdominal pain 142, 153
causes of 153, 154
Abducens nerve palsy 231
Abductor digiti minimi 263f
Abductor pollicis
brevis 257, 261f
longus 257
Abscess, splenic 153
Abulia 525
Acanthosis nigricans 468f
Acarbose 150
Acebutolol 479, 488
Acetaminophen 507
Acetazolamide 485
Acetylcysteine 463
Achilles tendon, examination of 349
Acid
ascorbic 51
ethacrynic 488
folic 51, 503
pantothenic 51
para-aminosalicylic 478
salicylic 51
Acquired immunodeficiency syndrome 321, 327
Acromegaly
clinical features of 386f
facies 386f, 471f
Acute coronary syndrome 107, 519
Acute respiratory distress syndrome 530
Addison's disease 161
oral pigmentation in 469f
Adductor femoris 263f
Adductor pollicis 257
Adenine 51
nucleotides 39
Adenoma sebaceum 202f, 468f
Adenosine 479, 480, 508
diphosphate receptor antagonists 481
reuptake inhibitors 482
Adie's tonic pupil 226
Adrenal insufficiency 154, 182
Adrenaline 486, 491
Adventitious sounds 62, 92, 92fc, 95
continuous 92
discontinuous 92
Aegophony 93
Aerophagia 147
Afferent pupillary defect 227, 227f
Agents, parentral hypoglycemic 495t
Ageusia 238
Agnosia 211, 525
types of 211
Agranulocytosis 484, 524
Agraphesthesia 528
Agraphia 526
Air bronchogram 442f
Airway
obstruction 19
partial obstruction of 72
responsiveness, reduces 487
Akathisia 305, 527
Akinesia 332
Akinetic mutism 525
Albumin gradient, serum-ascites 176
Albuminuria
moderately increased 523
severely increased 523
Alcohol
amount of 514t
complications of 514
units of 513
use 513
disorder 378
withdrawal, symptoms of 378
Alcoholism, sign of 159, 161
Alderman's gait 301
Alexia 526
Aliskiren 488
Alkaline phosphatase 37
Allergic alveolitis, extrinsic 71
Allergic rhinitis 479
seasonal 493
Allodynia 285, 528
Alloesthesia 528
Alopecia 158, 330, 340f, 355, 471f
areata 475f
Alpha-adrenergic antagonists 488
Alpha-motor neuron 267
Alveolar phase, absence of 91
Alveolitis, fibrosing 71
Amantadine 483
Ambu bag 454, 455
Amebiasis 150
Amikacin 477, 498
Amiloride 488
Aminoglycoside 498
antibiotics, common properties of 498b
Aminophylline 486
Amiodarone 331, 396, 479, 480, 509
Amitriptyline 331, 396
Amlodipine 481, 488
Amnesia 207, 525
anterograde 207
Amoss's sign 308, 308f
Amoxicillin 497
Amphotericin B 506
Ampicillin 497
Amyloidosis 330
Anal sphincter tone 197
Analgesia 285, 528
Analgesics 484
Anemia 34, 35, 159, 506, 517
aplastic 35
etiology of 34
hemolytic 35
megaloblastic 35
Anesthesia 255, 285, 528
Aneurysm
aortic 247
cardiac 399
Angina
abdominal 108
decubitus 107
equivalents 108
nocturnal 107
pectoris, grading of 534
sine dolore 108
types of 107
Angiotensin receptor antagonists blockers therapy 489
Angiotensin-converting enzyme inhibitors 488, 489
Angulation 431, 431f
Ankle 191
brachial index 23, 24f
measurement of 23f
clonus 273, 273f
joint, examination of 349, 349f
Ankylosing spondylosis 351
Anomalous lobe 169f
Anosognosia 211, 213, 529
Anterior horn cell 195, 322
disease 253
syndromes 322
Anterior spinal artery 319
syndrome 322
Anthropometry 53
Antianginal drugs
contraindications of 480t
indications of 480t
Antiarrhythmics drugs 479, 479t, 480
Antibiotics 496
Anticholinergic drugs 482, 487, 507
Anticholinergic effects 479
Anticholinergic symptoms 484
Anticitrullinated protein antibodies 353
Anticoagulant therapy
contraindications for 502b
indications for 501t
Anticoagulant, classification of 501t
Anticoagulation 501
Anticyclic citrullinated peptide antibodies 355
Antidepressants 483
atypical 484
tricyclic 484
types of 484t
Antidiabetic agents, profile of 495f
Antidotes, toxin-specific 507t
Antiencephalopathy 504
Antiepileptics drugs 478, 478t
Antifungal 505
Antihistamines 479
Antihypertensive
agents 488t, 489
therapy 489
Anti-inflammatory potency 492t
Anti-insulin antibodies 494
Antineutrophil cytoplasmic antibody 493
Antinuclear antibody 338, 355
Antiplatelets 480
Antipsychotic drugs 483, 483f
classification for 483
side effects of 378
Antiretroviral therapy 500t
site of action of 499f
Antirheumatic drugs, disease modifying 355, 503
Antisecretory agents 507
Antithyroid drugs 492
Antitubercular drugs, newer 478
Antiviral oseltamivir 499
Anton syndrome 316
Anuria 523
Aorta
coarctation of 18
descending 436
Aortic arch 437f
Aortic area 99
auscultation of 135, 135f
Aortic criteria 58
Aortic dissection 107
Aortic knuckle 436
Aortic pulsations 119
Aortic regurgitation 117, 119, 120, 123, 125, 126, 131–133, 141, 352
murmur of 133
Aortic root dilatation 58f
Aortic sinus of Valsalva, ruptured aneurysm of 136
Aortic stenosis 114, 117, 119, 120, 123, 125, 126, 131–133, 141
Aortitis 352
Apallesthesia 285
Apex
abnormalities of 117
beat 519
displacement of 118
pulse deficit 10, 10f
Aphasia 207–209, 209f, 210fc, 526
Aphonia 526
Apical impulse 79, 82, 116, 118
examination of 116
mechanism of normal 117
shift, implication of 82
Apixiban 502
Appendicitis 153
Apprehension test 344, 344f
Apraxia 211, 529
constructional 211, 529
ideomotor 211
types of 211
Arcuate fasciculus 209
Areflexia, distal 329
Argyll Robertson pupil 226, 226f
Arm span 54
measurement of 54
Arrhythmia 10
cardiac 109, 479, 480, 486
Arrhythmogenic right ventricular dysplasia 394
Arsenic intoxication 330
Arterial pulse
assessment of 9
normal 11
tracing 11f
Arterial system 316f
Arteriovenous fistula 117, 383f
Artery
peripheral 11
subclavian 123
Artesunate 476
Arthralgia 3, 338, 496
Arthranesthesia 285
Arthresthesia 285
Arthritis 338
acute gouty 350f, 473f
causes of 339
mutilans 346
Ascites 156, 157f, 175, 176
assessment for 179
causes of 176, 179
etiology of 176
grading systems of 176
malignant 176
massive 179
praecox 176
signs of 180, 180f
tense 179
Ascitic fluid, albumin level of 176
Ash leaf-shaped macule 202f, 468f
Aspartate aminotransferase 37
Aspergilloma 442f
Aspergillosis 506
Aspiration 65
Aspirin 150, 481
indication for low dose 481b
Astasia-abasia 301
Astemizole 396
Asterixis 160, 183, 527
causes of 160
Asterognosis 528
Asthma 493, 521
acute severe 71
bronchial 492
drugs for 486
Asynergia 290
Ataxia 193, 289, 295, 296, 529
telangiectasia 202
type of 295
vestibular 295
Atazanavir 500
Atelectasis, differential diagnosis of 439
Atenolol 481, 488
Athetosis 304, 527
Atopic dermatitis 493
Atrial appendage, left 437f
Atrial enlargement, left 437
Atrial fibrillation 10, 313, 390, 407, 480
Atrial flutter 391, 406
Atrial premature
beat 392
contractions 480
Atrial septal defect 114, 119, 125, 126, 141, 393, 446f
Atrioventricular impulse transmissions, normal 396f
Atrioventricular node 387
Atrophy 311, 531
Atropine 491, 508
infusion 491
Attention 207, 525
flexibility 207
Attitude 190, 252
Audiometric tests 242
Auditory agnosia 211
Auditory meatus, internal 238
Auricular nerve, greater 203f
Auscultation 90, 123, 123f, 165
areas of 116f
sequence of 124
Auscultatory gap 21
Auscultatory percussion 179
Guarino's method of 87, 88f
method 169, 169f
Austin flint murmur 134, 136
Autonomic dysfunction 187, 200, 197, 310, 310t, 332
Autonomic nervous system
signs of 192
testing 309
Autosomal dominant
disorder 511t
transmission 512f
Autosomal recessive
disorder 511t
transmission 512f
Autotopagnosia 211
Avellis’ syndrome 315
Avibactam 497
Axilla 123
Axillary area, percussion of 87f
Azathioprine 503, 504
Azilsartan 488
Azimilide 479
Azithromycin 477
B
Babesia microti 497
Babinski reflex 240
Babinski sign 274, 275, 311
Backache 198
Backcheck valve 460
Bacteriuria, asymptomatic 524
Bag valve mask 455
Balaclava helmet 235f
Balance test 366
Balanoposthitis 381f
Balint syndrome 295, 316
Ballotable 174
Balsalazide 504
Bambuterol 486
Baricitinib 505
Barognosis 285
Barre's sign 265
Bartonella 477
Basal ganglia, right 450
Basal skull fractures 241
Basilar artery syndrome 315
Bat wing appearance 438, 445f
Bazett's formula 396
Beaus lines 42
Beclomethasone 462
dipropionate 487
Bedford sign 437
Behçet's syndrome 161
Bekesy audiometry 242
Bell's palsy, bilateral 241
Bell's phenomenon 238–240, 241f
Benazepril 488
Bendopnea 70, 70f, 519
Benedict's syndrome 314
Benserazide 483
Benzathine penicillin 497
Benzodiazepines 481, 507
Benztropine 482
Bergara-Wartenberg sign 239
Bernheim effect 26
Beta-adrenergic antagonists 488
Beta-blockers 507
contraindications for 481, 481t
mechanism 481
uses of 481
Beta-galactosidofructose 504
Beta-lactam 496
antibiotics 497t
adverse effects of 496b
classification of 496f
Betaxolol 488
Biceps 259f
reflex 269f, 270f
supine position 269f
Bifidobacterium infantis 505
Biguanides 494
Bilirubin 459
conjugated 37
unconjugated 37
Bing's sign 275, 276f
Binocular diplopia 223
Binocular movements 222
Biot breathing 19
Biotin 51
Birmingham paradox 13
Bisoprolol 481, 488
Bladder 319
dysfunction 197
sensation 197
size of 197
Bleeding 496
gastrointestinal 147, 522
tendencies 492
Bleomycin 161
Blepharospasm 305
oromandibular dystonia 242
Blood pressure 19, 74, 156, 188, 200, 516
cuff, placement of 21f
diastolic 19
examination 20
mean arterial 138f
measurement of 21, 21f, 516t
monitoring, ambulatory 22
nocturnal 22f
systolic 19
Blood, clinical chemistry of 544
Boas tube 452
Bode index 535
Body hair 158
Body mass index 8, 56, 60, 98, 143, 188, 335, 535f
Body myositis 302
Body part, motion of 281
Body temperature 28
Bone marrow aspiration needle 458
contraindications 458
indications 458
sites 458
Bone marrow biopsy needle 459
Bone, infections of 197
Bony deformity 319
Bony structures 432, 432f
Bony tenderness 319
Borreliosis 241
Bouchard's node 346, 347f
Boutonniere deformity 346f, 471f
Bow string sign 346, 471f
Bowel disease, inflammatory 152, 154, 504
Bowel movement 319
Bowel obstruction 154
Bowel sounds 165
auscultation of 165f
Brachial artery 16
Brachial plexus 253
neuropathy, hereditary 332
Brachial pulse, palpation of 16, 16f
Brachioradialis 256, 259f
Bradycardia 9, 30, 37, 138, 389, 519
Bradykinesia 332
Bradykinin 39
Brainstem 231, 245
encephalitis 241
lesion 314
syndromes 314
Branham sign 16
Breast bud, palpation 158f
Breath sounds 61, 91, 94, 95
bronchovesicular 91
diminished intensity of 91
intensity, grading of 91
normal physiology of 90
Breathing 68
abnormal patterns of 19
advice 90
patterns, types of 19f
types of normal 91
unit, artificial manual 455
Breathlessness 70
acute severe 71b
scale 533
Bretylium 479
Broadbent's sign 81
Broca's area 209
Broken neck sign 249
Bronchial breath
sounds 91
types of 91
Bronchial disease 67
Bronchiectasis 68, 521
Bronchitis, chronic 65, 521
Bronchodilators 486
Bronchophony 93
Bronchorrhea 67
Brown's syndrome 341
Brown-Sequard syndrome 314, 321
Brudzinski's reflex 307
Brudzinski's sign 307, 308f
Brueghel's syndrome 242
Brugada syndrome 399
Bruit
hepatic 165, 165f
iliac 165, 166f
Brun's ataxia 211, 295
Buccinators 237
examination of 237f
Buck neurological reflex hammer 268
Bucket handle movement 83f
Budd-Chiari syndrome 161, 168, 169, 176
Budesonide 462
Buffalo hump 385f, 470f
Bulbar palsy 250
Bulge 95
flanks 176
sign 348, 349f
Bulla 531
Bullous lesions 330
Bumetanide 485, 488
Bundle branch blocks 397
Busulfan 161
Button-hole deformity 346
Butyrate 504
C
Cabot-Locke murmur 134
Cachexia 57
Café-au-lait macules 201, 201f, 468f
Calcium channel
antagonists 481, 488
blockers 481, 507
Calcium gluconate 508
Calf muscle, pseudohypertrophy of 253f
Caloric test 190, 242, 243f
Calot's triangle 174
Calprotectin 149
Calvarium, thickening of 386f
Campbell sign 82
Cancer, colorectal 154
Candesartan 488
Candidemia 505
Candidiasis
disseminated 505
esophageal 473f
Cannonball metastasis 445f
Cannula, intravenous 461
Caplan's syndrome 352
Capreomycin 477
Captopril 488
Carbamate 507
Carbamazepine 478
Carbapenems 497t
Carbidopa 483
levodopa formulations, efficacy of 482
Carbimazole 492
Carbone monoxide 507
Carbonic anhydrase inhibitors 485
Carcinoid syndrome 165
Carcinoma
bronchogenic 247
esophageal 151
Cardia 437f
Cardiac apex, types of 117f
Cardiac cycle 102, 102f–104f, 105t, 124, 124f
duration 124
events of 104f
Cardiac disease 121f
Cardiac events 103, 103f
Cardiac failure, congestive 43f
Cardiac impulse, location of 117f
Cardiac limb syndrome 114
Cardiac murmurs 103
timing of 103t
Cardiac sounds, characters of 123
Cardiac tamponade 27, 107
Cardiomyopathy
dilated 520
hypertrophic 399
Cardiopulmonary bypass machine 28
Cardiopulmonary disease 109, 148
Cardiovagal innervation 310
Cardiovascular diseases 140
Cardiovascular system 3, 62, 71, 97, 192, 352, 371
Carey Coombs murmur 134
Carina, splaying of 437
Carotid artery 123
internal 317
Carotid bruit 188, 313
Carotid pulse
palpation of 16, 16f
Carpal tunnel syndrome 345, 346
Carvedilol 488
Castell's method 171, 172f
Castell's point 171
Castell's sign 173f
Catacrotic pulse 12
Catatonia 205
Catecholamines 486
Catechol-O-methyl-transferase inhibitors 482, 483
Cauda equina syndrome 324
Caudal vermis syndrome 296
Caudate lobe 169
Causalgia 285
Cavernous sinus 231
syndrome 236
thrombosis 251
Cavity lesions, diagnosis of 440fc
Cefepime 497
Cefotaxime 497
Cefotetan 497
Cefoxitin 497
Ceftaroline 497
Ceftazidime 497
Ceftolozane 497
Ceftriaxone 497
Cefuroxime 497
Celecoxib 484
Celiac disease 150, 154, 295
Central cord syndrome 321
Central cyanosis 38, 38f, 159
oral mucosa suggestive of 38f
Central nervous system 3, 194, 200, 312, 371, 479
Cephalexin 497
Cephalosporins 497
Cerebellar artery
anterior inferior 316
posterior inferior 316
Cerebellar ataxia 296, 299
asymmetrical 296
causes of 296
symmetrical 296
Cerebellar disease 255
Cerebellar disorders, signs of 289
Cerebellar drift 192
Cerebellar examination 196
Cerebellar lesions, localization of 297
Cerebellar peduncle, superior 316
Cerebellar signs 191, 297
Cerebellar syndromes 296
Cerebellopontine angle 238
Cerebellum 289
anatomical areas of 296f
functional areas of 296f
Cerebral artery
anterior 314, 317
middle 314, 317
posterior 316, 317
Cerebral hemispheres 212f, 212t
Cerebral venous sinus thrombosis 311
Cerebrospinal fluid 321, 331, 460, 546, 546t
flow, blockage of 218
reabsorption, reduction in 219
Cerebrovascular accident 193, 311, 312, 399
Cerebrovascular disease 495
Cerebrovascular system 316f
Cerebrum 245
Cervical
cord lesion, high 314
lymph nodes 45
deep 46
examination of 46
lymphadenopathy 472f
pleura 74
rotation 308
signs, feature of 323
spinal lesion 234
spine 336
venous hum 34, 34f
Cetrizine 479
Chaddock's sign 276f
Charcot-Marie-Tooth disease 332
CHARGE syndrome 114
Cheek sign 307
Cheese reaction 21
Chest
asymmetry of 78
barrel-shaped 78, 78f
deformity 78, 116
diameters, measurement of 84
examination of 77
expansion 94, 95
examination of 85f
flat 78
high-resolution computed tomography of 450f
movements 84
normal 78, 78f
percussion of anterior 86f
pressure 72
rachitic 78
upper
anterior 82, 83f
posterior 83, 83f
wall abnormality 443
X-ray 58f, 428, 442f–444f
normal 65b
Chest pain 3, 59, 72, 97, 106, 106t
causes of 106, 106f, 107, 107t
central non-pleuritic 70
differential diagnosis of 106
Chiari malformation 138
Chicken heart 437
Chilaiditi syndrome 447f
Child-Turcotte-Pugh score 537
Chipmunk facies 36f
Chlamydophila pneumonia 497
Chloride diarrhea, congenital 150
Chloroquine 161, 216, 331, 396, 476
Chlorpheniramine 478
Chlorpromazine 396
Chlorthalidone 488
Cholangitis, acute 153
Cholecystitis, acute 153
Chondroectodermal dysplasia 114
Chorda tympani 239
Chorea 279, 304, 527
Choreiform gait 301
Choroidal artery, anterior 317
Churg-Strauss syndrome 76, 352
Chylous 176
Ciclesonide 487
Ciclosporin 487
Cimetidine 331, 506
Cirrhosis 146, 156, 472f, 523
cause of 157f
complications of 182, 182t
etiology of 160
Cisplatin 295, 331
Clarithromycin 477
Claude's syndrome 314
Claw hand 467f
Clevidipine 490
Clinical disease activity index 358, 358f
Clock drawing test 365
Clofazimine 161
Clonidine 488, 489
patch 488
Clopidogrel 482
Clostridium difficile infection 150
Clubbing 39, 39f, 113f, 159, 200, 466f
theories of 39
Cobalamin 51
Cochlear pathology 245
Cognition assessment tool 207
Cogwheel rigidity 527
Coin test 93, 94f
Colchicine 331
Cole-Cecil murmur 134
Colitis, infectious 153
Collapsing pulse 14, 15f
causes of 15
Colletsicard syndrome 251
Colloid 507
solutions 508
Color vision 216, 217f
Ishihara chart for 217f
Column disease, posterolateral 321
Coma 205, 525
Common bile duct 37
Complete cord transection 321
Complex motor activities 211
Comprehensive geriatric assessment 360, 363
components of 363f
Concentration 525
Conduction block, causes of 396
Conduction defects 245
Confusion 525
Conjunctiva 36
Conjunctivitis 341
Consciousness 205
altered state of 186, 194
Constipation 150, 154, 522
etiology of 150
functional 522
Constrictive pericarditis 12, 27, 27f, 28
Friederick's sign of 27
Conus medullaris syndrome 324
Conus-cauda equina syndrome 324f
Copper wiring 219f
Cor pulmonale
chronic 521
features of 75
Cord
involvement 322
lesion 323
Core body temperature 28
Corneal anesthesia, bilateral 236
Cornelia De Lange's syndrome 114
Cornell response 275
Coronary artery disease 126
Corrigan's pulse 14
Corrigan's sign 14
Cortical sensation 191, 280, 283
Corticobasal ganglionic degeneration 333
Corticospinal tract 316
Corticosteroids
inhaled 487
parenteral 487
systemic 487
Costophrenic angles 442f, 447f
obliteration of 444f
Costovertebral angle 175f
tenderness, causes of 175
Cotton wool spots 220f
Cough 3, 65, 520
acute 66
barking 66
bovine 66
chronic 65b, 66
classification of 66t
dry 66
duration of 65
habitual 65
hacking 66
otogenic 66
paroxysmal 66
production 65, 65f
productive 66
reflex 66fc
spluttering 66
subacute 66
types of 66t
variant asthma 65
Courvoisier's law 174
COVID 505
Coxalgic gait 301, 301f
Cranial nerve 189, 214, 215, 220, 232, 242, 246–249, 251, 316
branches of 247
disorders of 247
dysfunction 186, 194
examination 330
palsy 225f
multiple 251
site of 238
C-reactive protein 353, 491
Crepitations 93
mechanism of 92
Crisis, hypertensive 517
Crocodile tear syndrome 242
Crohn's disease 154, 493
Cross fluctuation sign 348, 349f
Cruveilhier-Baumgarten murmur 134, 165, 166f
Cryoglobulinemia 330
Cryptococcal meningitis 241
Crystalloids 507, 508, 508t
Cup deformity, pencil in 346
Curled hair 330
Cushing's habitus 385f
Cushing's syndrome 158, 163, 384
clinical features of 385f
Cyanide 507
Cyanosis 37, 38, 466f, 518
admixture 39
atypical presentation of 38
cardiac 39
clubbing 74
distributive 39
etiology of 37
hypoxic 39
peripheral 38
replacement 39
tardive 39
theories of 39
true 37
Cyclooxygenase inhibitors 481
Cyclophosphamide 161
Cycloserine 477
Cyclosporine 463
Cystic bronchiectasis 447f, 450f
Cystitis 153
Cytomegalovirus 150, 458
Cytoprotective agents 506
D
D'Espine sign 50
Dabigatran 502
Dactylitis 356
Daily living
basic activities of 361, 363
instrumental activities of 364
Dangling jaw 233
Danish pen 297
Dapsone 331
Darunavir 500
Datura 507
De Lange's syndrome 114
Decongestants 479
Decubitus position, lateral 177f
Defervescence 31f
nature of 31
Dejerine onion skin distribution 235f
Dejerine syndrome 315
Dejerine-Sottas
disease 330
neuropathy 332
Delirium 205, 525
Delta wave 394
Delusions 211
types of 211, 372
Dementia 333, 365, 525
causes of 365
vascular 365
Deoxyribonucleic acid, double-stranded 355
Depression 378
Depressor anguli oris 237
Dermatitis
contact 493
intertriginous 472f
Dexamethasone 493
Dextrocardia 392
Dextrose 508
Diabetes mellitus 241, 327, 331, 353, 380
Diabetic eye disease, advanced 219
Diabetic retinopathy 219
nonproliferative 219, 381f
preproliferative 220
proliferative 218f, 219, 381f
stages of 219
Diaphragm 434, 434f
flattening of 434f
normal height of 434f
Diaphragmatic movements 84
examination of 84f
Diarrhea 149, 152, 496, 507, 521
acute 149
causes of 149t
chronic 149
causes of 150t
fatty 150
inflammatory 149, 150
large-volume 149
mimics of 150
osmotic 149
overflow 150
small-volume 149
types of 149
watery 149, 150
Diazoxide 490
Diclofenac 484
Didanosine 331
DiGeorge syndrome 114
Digestive disorder 149
Digital index 41
Digitalis 216, 479
Digoxin 479, 507
Dihydroorotate dehydrogenase 504
Dihydropyridine 481
calcium antagonists 481
Diltiazem 479, 481, 488, 509
Dimethyl sulfide 160
Dipeptidyl peptidase-4 494
Diphenhydramine 396
Diplegia 194
Diplopia 223
assessment of 223
Dipyridamole 482
Disease activity score 357
Disopyramide 396, 479
Distraction 268
Disulfiram 331
Diuretics 485, 485t, 488, 521
Diverticulitis 153
Dizziness 197
Dobutamine 491
Doll's eye 245
Dopamine 491, 509
decarboxylase inhibitors, peripheral 483
facilitator 483
receptor agonists 483
Dorello's canal 231
Doripenem 497
Dorsal interossei 257, 262f
Dorsalis pedis artery 17
palpation of 17, 18f
Down syndrome 114, 115f, 161, 255
Doxazosin 488
Doxycycline 499
D-penicillamine 503
Dressing apraxia 211
Dronedarone 479
Dropped head syndrome 249
Drowsiness 205
Drug hypersensitivity 493
Dry pleurisy 72, 86
Dry powder inhalers 464
Duke's criteria, modified 539, 539t, 540
Dullness
lower border of 168f
shifting 177, 178f
Dupuytren's contracture 159, 159f, 472f
Dysarthria 208, 210, 289, 297, 526
cerebellar 290
clumsy hand 317
hyper-kinetic 210
types of 210
Dysdiadochokinesia 289, 290, 293, 293f
Dysesthesias 528
Dysgraphia 526
Dyskinesia 303
Dyslogia 526
Dysmetria 289, 290
Dyspepsia 150, 521
causes of 150t
functional 153
Dysphagia 151, 521
esophageal 151t
Dysphonia 526
Dyspnea 3, 59, 68, 70, 70f, 97, 109, 519, 535t
acute 71
causes of 71t
attacks of 69
chronic 71
causes of 71t
inspiratory 71
mechanism of 68
timing of 71
Dysrhythmias, cardiac 452
Dystonia 305, 527
E
Ebstein's anomaly 446f
Ecchymosis 163
Echolalia 526
Eclampsia, treatment of 490
Edema 42, 74, 220f, 496
drug-induced 43
examination of 42
idiopathic 43
variability of 110
Efavirenz 500
Egophony 94
Ehlers Danlos syndrome 114
EHRA score 537
Eight and a half syndrome 231
Ejection sounds 129
Ekbom's syndrome 305
Elbow 191
examination of 344
palpation of 344f
Electrocardiogram 104f
leads 388
anatomic groups of 389
waveforms and intervals 387
Electrolyte 401
disturbances 279
Electromyogram 331
Electronystagmography 242
Elfin facies 114
Ellis-van Creveld syndrome 114
Ellsberg phenomenon 195
Emesis, mechanism of initiation of 149
Emphysema 68, 521
bilateral 443f
severe 392
Enalapril 488
Enalaprilat 490
Encephalopathy, hepatic 182, 523, 538
Endocardial cushion defect 114
Endocarditis 352
diagnosis of infective 540
infective 113, 113f, 539t
Endocrine 54, 148, 156, 492
causes 150
changes 158
dysfunction 182
effects 484
Endotracheal tube 453
contraindications 454
indications 454
parts of 454
Enophthalmos 221, 228
Enoxaparin 509
Entacapone 483
Enthesitis 338
Eosinophilia, tropical 65
Epiconus 324
Epigastric pulsations 119, 120f
causes of 119
Epigastrium 123, 165f
right side of 166f
Epiglottitis 71
Epilepsy 529
Epinephrine 491, 509
Eplerenone 488
Epsilon wave 394
Erb's maneuver 119, 135f
Erb's neoaortic area 99
Erb's point 133
Erosion 531
Erotomanic delusions 211
Ertapenem 497
Erthropoietin 496
Erythema nodosum 341, 467f, 475f
Erythrocyte sedimentation rate 339, 353, 465
Erythrocytosis 517
Esmolol 479, 490
Esomeprazole 509
Esophagitis, infectious 151
Esophagus, perforated 107
Ethambutol 216, 331, 477
Ethionamide 477, 478
Etodolac 484
Etoricoxib 484
Ewald's tube 452
Excoriation 531
Exophthalmos 221, 384f, 470f
unilateral 221
Extensor carpi
radialis longus 256, 259f
ulnaris 256, 260f
Extensor digitorum
brevis 256, 257, 260f, 265f
longus 257, 265f
Extensor hallucis longus 257, 265f
Extensor pollicis
brevis 257
longus 257
Exteroceptive system 280
examination of 280
Extraocular movements 222f
Extraocular muscles 222, 384f
functions of 222
infiltration of 470f
Extrapyramidal disorders 247
Extrapyramidal syndromes 484
Eye
blink, reduced 332
changes 341
dryness of 341
examination of 339
fundus 217f, 218f
signs 384f, 470f
Eyeball 231
position of 221
Eyelids 220
F
Facial canal 238, 239
Facial edema 43
Facial hair 472f
diminished 160f
Facial involvement 469f
Facial motor function 240
Facial muscles 240
Facial nerve 189, 236, 240f
lesion 235
pathway 239f
temporal branches of 236
testing buccal branches of 236
zygomatic branches of 236
Facial nerve palsy 239, 240
bilateral 241
central 240
lower motor neuron type of 240
syndromes with 242
upper motor neuron type of 240
Facial nucleus 238
Facial numbness 236
Facial paralysis 210
infranuclear 242
peripheral 239
syndromes of 242
Facial weakness 240
Facioscapulohumeral dystrophy 249, 253f
Famotidine 506
Fasciculations 249, 250, 306, 311
causes of 306
Fasciculus, medial longitudinal 231
Fatigue 197
Febrile illness 74
Fecal incontinence 150, 522
Felodipine 481
Femoral artery, palpation of common 17
Femoral pulse, examination of 17f
Fenoldopam 490
Fenoterol 486
Fentanyl 509
Ferritin 39
Fetor hepaticus 160
Fever 29, 30, 59, 111, 200, 518
acute 29
aseptic 31
biphasic 32
chronic 29
clinical pattern of 30f
double quotidian 29
drug 31
glandular 32
intermittent 29
of unknown origin 518
patterns of 29
persistent 29
pontiac 32
pretibial 32
quartan 29
quotidian 29
rat bite 32
relapsing 29, 32
remittent 29
subacute 29
tertian 29
types of 29
typhoid 31f
uveoparotid 242
valley 32
Fiber neuropathy, small 328
Fibrinolytic agents, use of 503b
Fibromyalgia
syndrome 356
trigger points in 356f
Filariasis 43f, 467f
Finger
flexion reflex 272f
flexion test 269
flicking percussion 179
nose test 292, 292f
rubbing 242
spindling of 346
Finger-to-nose test 290
Fistula
coronary arteriovenous 136
intercostal arteriovenous 136
Fitz-Hugh-Curtis syndrome 153, 166
Flabby tongue 250
Flaccid 210
paraplegia, causes of 195, 323
Flail chest 78
Flanks
fullness of 176
indicates, fullness of 162
Flecainide 396, 479
Flesche test 350, 350f
Flexion 190
Flexor carpi
radialis 257, 260f
ulnaris 257, 260f
Flexor digiti minimi 257
Flexor digitorum
longus 257, 265f
profundus 257, 262f
sublimis 257, 262f
Flexor pollicis longus 257
Flexor spasm 311, 319
Floating nail sign 41
Floppy head syndrome 249
Fluconazole 505
Fluent aphasias 209
Fluid
intravenous 507
thrill 179f
Fluoroquinolones 477
Fluticasone 462
Foleys catheter 456
Food allergy 149
Foot
drop 298
pat test 294
position of 290
small muscles of 191
tapping 294, 294f
test 266
Forearm rolling test 266, 266f
Formeterol 462, 486
Fosinopril 488
Fosphenytoin 510
Foster-Kennedy syndrome 215
Fothergill's disease tic douloureux 235
Foul smelling sputum 67
Four finger technique 346
Foville's syndrome 242, 315
Frailty cycle, core of 364
Frailty syndrome 364
Framingham heart failure 537
Framycetin 498
Free fluid, examination of 175
French paradox 13
Frey's syndrome 236, 242
Friction fremitus 86
Friederick's sign 27, 90
Frog's sign 108
Frusemide 509
Fungus 150
Furosemide 485, 488
G
Gabapentin 478
Gaenslen maneuver 351
Gaenslen test 351f
Gaertner's method 27
Gag reflex 246
components of 246
examination of 246f
testing of 246
Gait 192, 290, 298
abnormalities 187, 196, 298, 301
antalgic 301
apraxia 211, 295
apraxic 299
ataxia 297
ataxic 299, 299f
broad-based 299
cerebellar 299f
circumduction 298f
cycle, normal 298, 298f
equinus 301
extrapyramidal 300
festinant 300
gluteus medius 299
high stepping 298, 299f
hyperkinetic 301
Galinstan 28
Gallbladder
examination of 174
palpable 37
Gamma motor neuron 267
Ganglion, geniculate 238, 239
Ganglionic disorders 310
Garland's triangle 90, 90f
Gastric lavage tube 452
complications 453
contraindications 452
indications 452
Gastric ulcer 68, 506
Gastritis 68, 153
Gastroenterology 156
Gastroesophageal reflux disease 72, 153
Gastrointestinal bleeding
causes of upper 148f
lower 148, 148f
occult 522
Gastrointestinal disease 161
Gastrointestinal system 3, 62, 100, 142, 192, 352, 371
Gastrointestinal tract 137, 493
Gastrointestinal ulcers, Forrest grading of 541
Gastroparesis 153
Gastropathy 153
Gaze
apraxia 211
palsies 229
Gel phenomenon 338
Geniculocalcarine tract 216
Genitourinary system 353
Gentamicin 498
Genu valgus 350f
Genu varus 350f
Gerhardt's sign 90
Gerstmann syndrome 316
Giant axonal neuropathy 330
Giant cell arteritis 493
Giardia lamblia 150
Gibson's area 123
Gibson's murmur 134
Gilles de La Tourette syndrome 305
Glabellar tap 277, 278f
Glasgow coma scale 206, 537
Glass slide method 157f
Glenohumeral joint, examination of 344
Glomerulonephritis 353
Glossopharyngeal nerve 190, 246
Glucagon 509
Glucocorticoids 492
adverse effects of 493t
doses of 492, 492t
Glutamic acid decarboxylase 296
Gluteus
maximus 257, 264f
medius 257, 263f
minimus 257, 263f
Glyceryl trinitrate 480
Goiter, enlarged nodular 384f, 470f
Goldenhar syndrome 242
Gonadal dysfunction 182
Goodpasture's syndrome 352, 353
Gordon's sign 275
Gordon's technique 276f
Gradenigo's syndrome 236
Graham-Steell murmur 134, 136
Grandiose delusions 211
Granulomas 439
Graphesthesia 283, 284f
Grasp reflex 278, 279f
Great arteries, transposition of 125
Guanabenz 488
Guarino's method 87, 88f
Guedel pattern airway 454
Guillain-Barré syndrome 187, 219, 241, 242, 247, 249, 327, 331, 331t
Gunn phenomenon, reversed 236
Gynecomastia 158, 158f, 472f, 532
causes of 158
male 116
H
Hackett's grading system 170, 170f
Hair, loss of 158
Hallucinations 211, 212, 373
hypnagogic 211
hypnopompic 211
Hallux valgus 350f, 471f
Hallux varus deformity 350f
Haloperidol 396, 509
Hamartomas 439
Hamman's mediastinal crunch 94
Hammer toes 471f
Hand
asterixis in 160f
deformities of 346
examination of 339
grip 191
hygiene 4
muscle wasting, causes of 253
small muscle wasting of 253f
squeeze test of 345f
ulnar deviation of 347f
Handedness 205, 371
Hansen's disease 241
Harvey's sign 180, 180f
Haverhill fever 32
Head to toe signs 143
Headache 187, 313, 495, 496
cluster 21
post-spinal 459
Head-up tilt-table testing 310
Heart
base of 119
conduction system of 387, 387f
murmurs 136
palpation of 115
topographical areas of 123
Heart block
complete 395
first degree 395
second degree 395
third degree 395
Heart border 61, 122f
determination of 121
Heart disease
acquired 101
congenital 101, 114
cyanotic 37
congenital 15
valvular 313
Heart failure 520
congestive 70
diuretics for 521
symptoms of 111
Heart rate 389
calculation of 389f
Heart sound 118f, 124, 124f, 126f
auscultation of 129
fourth 127
frequency
high 120, 123
low 120, 123
palpable 119
second 125, 126
third 126
Heat loss 31
Heatstroke 31, 519
Heberden's nodes 346, 347f
Heel knee test 290, 291f
Heel-to-shin test 290
Heerfordt's disease 242
Helicobacter pylori infection, treatment of 506t, 507t
Hematemesis 68t, 147, 522
Hematochezia 147, 182, 522
Hematology 542
Hematoma
acute left extradural 450f
acute right subdural 450f
Hematuria 523
Hemiballismus 304, 317, 527
Hemichorea 317
Hemidiaphragm
bilateral 447f
left 436
right 436
Hemifacial atrophy, progressive 242
Hemiparesis 265f
ataxic 317
Hemiplegia 240, 252
causes of 195
localization of 314f
stuttering 312
Hemisensory loss 196
Hemispheric syndrome 297
Hemithorax
circumference 85f
dimension 95
expansion 85
measurement 85
white homogeneous opacity, causes of 441
Hemochromatosis 156
Hemocytometer 457
Hemoglobin 456
levels 518t
Hemoglobinuria 476
Hemolytic anemia, warm autoimmune 493
Hemoptysis 3, 67, 68t
causes of 67t
clinical clues of 67t
true 68t
Hemorrhage
acute 541
intraparenchymal 450f
pontine tegmental 241
subarachnoid 311
subconjunctival 113f
Hemorrhagic spots 474f
Henoch-Schönlein purpura 340f
Heparin 507, 510
unfractionated 502
Hepatic encephalopathy 182, 523, 538
clinical grade of 182
clinical stages of 538t
types of 182, 183f
Hepatic friction rub 166
Hepatitis
acute 153
viral 157f
Hepatobiliary system 156
Hepatojugular reflux 27
Hepatomegaly
causes of 169, 169f
painless 168
Hepatopulmonary syndrome 157, 159, 182
Hepatorenal syndrome 182–184
types of 183
Hepatosplenomegaly, causes of 173, 173f
Hernia
inguinal 138
umbilical 163, 164f
Herpes simplex 241
virus 311
Herpes zoster 469f
ophthalmicus 469f
Hidradenitis suppurativa 477
Hilar mass, differential diagnosis of 440
Hilar shadows, bilateral 443f
Hilum 433, 433f, 435
Himalayan P waves 393
Hip 191
circumference 57
joint 350
deformities 350f
examination of 348
Hitchhiker's thumb 346, 347f
Hodgkin's disease 247
Hoehn and Yahr staging system 193
Hoffman's reflex 277, 277f
Holmes-Adie syndrome 279
Holt-Oram syndrome 114
Homunculus 285
Hooking maneuver 171
Horn cell, anterior 195, 322
Horner's syndrome 228, 228f, 230f
causes of 229
left 474f
Horseshoe dullness 176, 176f
Hot potato voice 210
House-Brackmann grading system 239
Hudsons mask 462
Human erythropoietin, recombinant 496
Human immunodeficiency virus 312, 327
infection 332
Human T-cell lymphotropic virus 321
Hutchinson's
index 78
pupil 228
Hydralazine 331, 488, 490, 509
Hydrochlorothiazide 485, 488
Hydrocortisone 493, 510
Hydroflumethiazide 488
Hydropneumothorax 444f
right 89f
Hydroxychloroquine 503
Hyperalgesia 285, 528
Hypercalcemia 396, 401
Hyperesthesia 285
zone of 319
Hyperestrogenism
causes of 158
effects of 158
Hyperglycemia 158
Hyperinflation 443f
Hyperkalemia 392, 401
Hypermagnesemia 255, 401
Hyperoxia test 39
Hyperpathia 285, 528
Hyperpigmentation 330
Hyperplasia
benign prostatic 489
gingival 473f
Hyperpyrexia 30, 31, 518
Hyperreflexia, generalized 234
Hypersomnia 376
Hypersplenism 524
Hypertension 22, 119, 381, 496, 516
capillary 438
extrahepatic portal 176
intrahepatic portal 176
labile 21
malignant 517
masked 21, 517
nocturnal 22
paradoxical 22
paroxysmal 21
portal 181
pseudoresistant 517
pulmonary artery 123, 438
refractory 517
renovascular 21
resistant 517
secondary 517
systemic 119, 125, 126
thrombotic paradox of 13
white coat 21, 517
Hypertensive emergency 490t, 517
Hypertensive retinopathy
fundus image of 382f
stages of 219
Hyperthermia 31, 518
malignant 31
Hyperthyroidism 306, 383, 384f, 470f
Hypertonia 255
causes of 255
Hypertrophic obstructive cardiomyopathy 114, 117, 126, 130, 133
Hypertrophy 397
gum 161
true 252
Hyperventilation 68
Hypoalgesia 285
Hypocalcemia 401
Hypoesthesia 285
Hypogeusia 238
Hypoglossal muscle, weakness of left 250f
Hypoglossal nerve 190, 249
location of 249f
Hypoglycemia 21, 493
Hypokalemia 401
Hypomagnesemia 401
Hypomastia, female 116
Hypotension 22, 482, 484
causes of 22
orthostatic 22, 109
postprandial 22
postural 22
Hypothermia 31, 399
causes of 31
Hypothyroidism 255, 383
treatment of 492
Hypotonia 255, 289
Hypoxia 74
I
Ibuprofen 484
Ice pack test 221, 221f
Ichthyosis 330
Icterus 36, 36f, 74, 200, 466f
dark yellow 37f
Idarucizumab 502
Idioglossia 526
Iliopsoas 263f
Immune
system 493
thrombocytopenia 493
Immunoglobulin G 321
Impingement test 344, 344f
Incontinence, type of 197
Indapamide 488
Indinavir 500
Infarction, acute 316
Infection 477
acute 173
bacterial 149
chronic 173
gastrointestinal 187
parasitic 149
prophylaxis 477
viral 149, 241
Inflammatory demyelinating
polyneuropathy, chronic 311, 327
polyradiculoneuropathy, chronic 295
Inflammatory disease 148, 338
Inhaler
devices 462
metered dose 463, 464
Inhibitors, post-attachment 501
Insomnia 376, 525
Inspiration, tracheal descent on 82
Inspiratory film 430, 430f
Inspiratory intercostal retraction 81, 81f
Inspiratory wheeze, sequential 92
Insulin 457, 493
analogs 493t
regular 510
resistance 494
secretagogues 494
syringe 457
therapy, indications for 493t
Integrase strand transfer inhibitor 501
Intellectual ability 374
Intellectual disability
grading of 378
stigmata of 371
Intercostal space 119, 120, 123
Interlobar fissure, left major 77f
Internal capsule, blood supply of 317f
Interoceptive system 280
Interphalangeal joint 353, 353f
assessment 346
distal 41f
examination of 346f
proximal 353
Interstitial lung disease 41
Intertrigo 381f, 472f
Intracerebral disorders 148
Intracranial pressure 218, 316
Ipratropium 462
bromide 487
Irbesartan 488
Iridocyclitis 341
Iris nodules 201f
Iritis 341
Iron
deficiency anemia 34
deplete cyanosis 39
replete cyanosis 39
Irradiation, abdominal 148
Irritable bowel syndrome 154
Ischemia 399
Ischemic neurological deficit, reversible 312
Isomazid 507
Isoniazid 331, 477
preventive therapy 477
Isoproterenol 491
Isosorbide
dinitrate 480
mononitrate 480
Isosthenuria 465
Isradipine 488
Itching 493
Ivabradine 480, 481
J
J wave 394
Jaccoud's syndrome 251
Jack in box tongue 304
Jackson's syndrome 315
Jacobson's neuralgia 247
Jamshidi needle 459
Jaundice 36, 37, 142, 147, 156, 518
cholestatic 484
hepatic 476
types of 37
Jaw
enlargement of 386f
jerk 234
examination of 234f
winking
inverse 236
phenomenon 236
Jendrassik maneuver 268, 268f
Jerk nystagmus 231
Jervell-Lange-Nielsen syndrome 396
Joints 352
affection 338
disease, slowly progressive 355
examination of 338
involvement, pattern of 355f, 471f
motion 281
number of 337
range of movement of 342, 343f
sense, examination of 281f
swelling 3
twenty-eight 357
Jones criteria, revised 539
Jug handle appearance 446f
Jugular foramen, lesions of 247
Jugular vein, internal 24
Jugular venous
pulse 23, 26f, 143, 189
system 23
wave pattern 27f
Jugular venous pressure 74, 143, 189, 200, 517
estimation 27
height of 25f
Kussmaul sign of 28
square root sign of 28
timing of 103t
waveforms of 25, 27f, 103
Juxta-articular new bone formation 356
K
Kala-azar, diagnosis of 166
Kanamycin 477, 498
Kartageners syndrome 76
Katz-Wachtel phenomenon 398
Keith-Wagener-Barker classification 219
Keratitis 342f
Kernig's sign 307, 307f
Ketoacidosis 154
Key-Hodgkin murmur 134
Kidney 175
disease, chronic 200, 327, 382, 382f, 523
enlargement 174
examination of 174
injury, acute 183, 523
palpation of right 174, 174f
Kinesia paradoxa 13, 300
Kinesthesia 528
Kirby's method 374
Klinefelter's syndrome 158
Knee 160f, 191
jerk 271f
sitting position 271f
joint 350
deformities 350f
examination of 348
palpation of 348f
Knuckle pigmentation 36f
Koilonychia 35f, 42
Korotkoff sounds 20
character of 20
Korsakoff's psychosis 207
Kronig's isthmus 88, 88f
Kussmaul sign 28
L
Labetalol 488, 490
Labyrinthine disease 148
Lacrimation hyperacusis 190
Lactate dehydrogenase 37
Lactobacilli 505
Lactoferrin 149
Lactose intolerance 154
Lactulose therapy 504
Lacunar stroke 529
signs of 317t
symptoms of 317t
Lamivudine 500
Language
and brain 208f
domains of 209
Laryngeal fixation 82
Laryngeal nerve, superior 246
Laryngoscope 453
contraindications 453
indications 453
Lateral medullary syndrome 315
Latissimus dorsi 256, 259f
Laugier-Hunziker syndrome 161
Leflunomide 503, 504
Left atrium 119
Left bundle branch block 125, 126, 397
Left heart border 121, 122f, 436
straightening of 437
Left kidney 175
palpation of 174f
Left upper quadrant, causes of 153
Left ventricular hypertrophy 114, 117, 397, 398f, 399
causes of 397
criteria of 397
types of 398
Left-rotated film 431, 431f
Leg
asterixis of 160
deformities of 350
Legionella pneumophila 497
Leminiscus, medial 316
Leonine facies 469f
Leopard syndrome 114
Lepromatous leprosy, lesions of 469f
Leprosy 241, 330, 477
Lesion 195
intramedullary 235, 320
location 238
longitudinal 195
nodular 469f
noncompressive 195
peripheral 249
purpuric 531
site of 196, 197, 209, 304, 313
trigeminal 234
Lethargy 205
Leukemia 241
Leukonychia 159f
Leukotriene modifiers 487
Levator anguli oris 237
examination of 237f
Levetiracetam 478
Levodopa 482
Levosalbutamol 486
Lewy bodies 333
Lhermitte's syndrome 231
Lichenification 531
Lid retraction 221
Lidocaine 479
Ligament of Treitz 182
Light reflex 224
pathway 225f
Light's criteria 540
Limb
ataxia 191, 297
hyperreflexia 234
stiffness of 187, 196
Linea nigra 163
Linezolid 497
Lingua plicata 242
Lipid profile 545
Lips, predominantly of 242
Lisch nodules 201f
Lisinopril 488
Lithium 331
Livedo reticularis 330, 341f
Liver 175
abscess 153
cell failure 143
cirrhosis of 156, 157f, 458, 523
examination of 166
hooking method of 167
failure, acute 522
palm 157
palpation of 167f, 168f
span 167, 168f
Liver biopsy
complications of 458
contraindications for 458
indications for 458
Liver disease 146
alcoholic 371
chronic 200
signs of 156
Liver dullness 121f, 122f
lower 168
Lobar disease 438
Lobe, right 169f
Local allergic reactions 493
Locomotor system examination 335
Loop diuretics 485
Loperamide 507
Lopinavir 500
Loratadine 396
Lorazepam 509
Losartan 488
Low cardiac output, symptoms of 111
Lower anterior chest 83
respiratory movements of 83f
Lower limb 192, 252, 257
examination of 348
reflexes, reinforcement of 268f
Lower motor neuron 193, 240, 241, 311, 314, 320
disease 255, 311
signs of 311t
facial palsy
causes of 239
signs in 239
palsy, bilateral 241
Lower posterior chest 83
respiratory movements of 84f
Lower respiratory tract 60, 76, 81, 86, 90
demarcation of 76
Low-molecular weight heparins 502
Ludwig's angina 108
Lumbar cord, feature of 324
Lumbar puncture
complications of 459
contraindications for 459
indications for 459
needle 459
Lumbricals 257
Lung
abscess 68, 442f
cancer 68
carcinoma 439
disease of 67
unilateral 70
fields 435
fissures, surface marking of 76f, 77f
function 487
hidden areas of 441, 441f
lower margin of 77f
lymphatic drainage of 74
pulmonary disease, chronic 392
resonance 87
segments of 435
sounds 520
classification of common 520t
topographical percussion of 88
tumor 70
zones of 436
Lutz syndrome 231
Lymph nodes 45, 47, 48f
axillary group of 48
epitrochlear group of 50
groups of 45, 45f, 46f
inguinal 50
jugulodigastric 46f
jugulo-omohyoid 46f
left
anterior group 49f
apical group 49f
central group 49f
lateral group 50f
posterior group 49f
mediastinal 50
mesenteric 50
occipital 47f
palpation of epitrochlear 50f
postauricular 47f
posterior triangle 47f
preauricular 46f
right
anterior group 48f
apical group 48f
axillary 48
lateral group 49f
posterior group 49f
scalene 48f
submandibular 46f
superficial cervical 45
supraclavicular 47, 47f
Lymphadenopathy 43, 44, 74, 156, 200, 443f, 524
axillary 466f
generalized 43, 44, 524
Lymphatic drainage 75f
Lymphomas 247
M
M2 stroke 314
MacLeod's syndrome 443
Macrolide 396, 477, 497
Macruz index 393
Macula 216
Maculopathy, diabetic 219
Magnesium 479
Malabsorption syndromes 150
Malar rash 340f, 471f
Malaria, treatment of severe 476t
Malena 522
Marcus-Gunn
phenomenon 236
pupil 227, 227f
Marfan's syndrome 58, 58f, 114
Marin-Amat sign 236
Masking symptoms 363
Mass, visible 164
Masseter muscle 233f
Massive ascites 175, 180
Massive hemoptysis 68, 520
causes of 68b
Massive pulmonary embolism 71
Massive splenomegaly 524
Mastoid process 245f
May's sign 27
May-Thurner syndrome 43
Mechanical derangement 197
Medial medullary syndrome 315
Mediastinal cyst 448f
Mediastinal mass
differential diagnosis of 440, 440f
superior 448f
Mediastinal pleura 74
Mediastinum 95, 433
Medium vessel vasculitis 340f
Mee's lines 330
Meige syndrome 242
Melena 147, 182, 522
Melkersson-Rosenthal syndrome 242
Memory 206, 373, 525
classification of 206
declarative 206
episodic 207, 374
explicit 206
implicit 206
semantic 207, 374
systems, Budson and Price concept of 207
types of 206
Meningeal irritation 313
signs of 192, 307
Meningeal signs 197, 307
Meningeal stiffness 307
Meningism 308
Meningitis 187
types of 460
Menstrual history 335
Mental function, higher 186, 189, 194, 205
Mental state and cognition 186, 194
Mental status examination 367
Meropenem 497
Mesalamine 504
Mesalazine 504
Mesencephalic nuclei 232
Mesothelioma 444
Metabolic acidosis 71
Metabolic causes 150
Metabolic disease 148
Metabolic syndrome 56, 160, 484, 530
Metacarpophalangeal joint 283f, 345f, 353, 353f
Metal tracheostomy tube 453
indications 453
Metallic mitral valve prosthesis 445f
Metastatic lesions 439
Metatarsophalangeal joint 350f, 353, 473f
examination of 349, 349f
Metformin, contraindications for 494b
Methimazole 492
Methotrexate 503
Methoxamine 133
Methyclothiazide 488
Methyldopa 488
Methyldopate 490
Methylprednisolone 493
Methylxanthines 486
Metolazone 485, 488
Metoprolol 479, 481, 488
Metronidazole 331
Mexiletine 479
Mid-arm circumference 56, 57, 57f
Midclavicular line 168f
Middleton's maneuver 171
percussion 172f
Migraine
classical 188
headaches 21
Milkmaid grip 304
Mill wheel murmur 134
Millard-Gubler syndrome 242, 315
Miller-Fisher syndrome 241, 295
Minimal hepatic encephalopathy, diagnosis of 183
Minimally conscious state 205
Mini-mental state examination 365
Minocycline 503
Minoxidil 489
Miosis 224, 474f
Mirizzi syndrome 174
Mirror movements 305
Misnomer 12
Mitral area, auscultation of 134f
Mitral regurgitation 117, 119, 120, 123, 125, 126, 130–133, 141
Mitral stenosis 120, 125, 126, 128, 131–133, 141, 247
auscultation for 134
mid-diastolic murmur of 134f
murmur of 133
Mitral valve
disease 446f
metallic prosthesis 446f
prolapse 133
Möbius syndrome 241, 242
Modern geriatric giants 364f
Moexipril 488
Mogigraphia 305
Molluscum contagiosum 473f
Moniz’ sign 275, 276f
Monkey fever 32
Monoamine oxidase 482
Monoarthritis
acute 339
chronic 339
Monocular diplopia 223
Mononeuritis multiplex 326, 331
causes of 326
Mononeuropathy 326, 331
causes of 326
multiple 326
Mononucleosis 241
Monoplegia affecting
lower limb, causes of 195
upper limb, causes of 195
Montelukast 487
Montreal cognitive assessment 365
Mood 373
and affect 373
Mood disorders 376
classification of 376
spectrum of 376f
Mood disturbance 376
Moon facies 385f, 470
Moricizine 479
Morphine 509
Morris index 393
Motivation enhancement therapy 379
Motor 189, 247
Motor behavior, abnormal 372
Motor component, testing of 233
Motor deficit 320, 324
Motor dysfunction 186, 194, 235
Motor fibers, arrangement of 320f
Motor function 247
examination of 236
Motor impersistence 304
Motor neuron diseases 306
Motor neuropathy, distal hereditary 332
Motor power 256
Motor system 190
examination 252
Motor tics 305
Mouth, deviation of angle of 240f
Movement disorders 303, 303fc, 306
categorization of 303fc
Movement fluidity 302
Movement syndromes 484
Mucosa, esophageal 151
Mucosal ulcers 340f
Muddy sclera 36
Muehrcke's nails 159
Multifocal motor neuropathy 327
Multiple lentigines syndrome 114
Multiple system atrophy 296, 333
Multisystem disorder 332
Murmur 120, 129
changing 135
configuration of 132, 132f
continuous 131
crescendo-decrescendo 132
diastolic 131, 534
docks 134
early diastolic 131, 133, 141
early systolic 130
ejection systolic 130, 141
grading of 131
heart 136
innocent 134
late diastolic 131
late systolic 130
maximum intensity of 133
mid-diastolic 131, 132, 134f, 141
mid-systolic 130
palpable 119
pansystolic 123, 130
presystolic 131
production of 130
radiation of 132f
timing of 130f
Murphy's eye 454
Murphy's kidney punch 175
Murphy's sign 174
Muscarine-containing mushroom poisoning 491
Muscle 190
abdominal 257, 263f
accessory 18
bilateral weakness of 233
bulk 252
loss of 187, 196
disease 253
affecting 195
during examination, state of 256
fiber, innervation of 267f
hypertrophy, causes for 252
relaxants 255
swelling, localized 252
tone 254
wasting
causes of 253
proximal 253f
Musculoskeletal system 342
Myalgia 3, 495
Myasthenia gravis 221, 249
Myasthenic dysarthria 210
Mycoplasma pneumonia 497
infection 241
Mydriasis 224
Myelopathy, noncompressive 319, 320
Myerson's sign 277, 332
Myocardial infarction 399
acute 31, 153
inferior 392
Myoclonus 305, 527
negative 160f
Myoedema 256
Myokymia 305, 527
Myoneural junction, diseases affecting 195
Myopathic gait 299
Myopathy 495
inflammatory 249
Myositis 338, 495
Myotactic reflex scale 534
Myotonia 255, 256f
Myxedema 43f, 383f
N
Nadolol 488
Nafcillin 497
Nail
black 42
blue 42
changes 42, 159, 341, 341f
diagnosis of 341
red 42
white 42, 159f
Naloxone 509
Naproxen 484
Nasal cannula 462
Nasal discharge 76
Nasogastric lavage 522
Nasogastric tube 455
Natural colloids 508
Nausea 142, 148, 152, 482, 496, 521
causes of 148t
Near vision, Jaeger's chart for 215f
Nebivolol 488
Nebulizers 464
Neck
circumference 57
extensor of 256, 258f
flexion of 256, 257f
greater auricular nerve of 203f
muscle of 196, 256
pain 197
stiffness, examination of 307f
veins, engorged 25f
Negro's sign 239
Neologism 207, 526
Neomycin 498
Neoplasms
benign 458
malignant 458
Nephrolithiasis 153
Nephrotic syndrome 474f, 492, 524
Nerve
dysfunction, causes of eighth 245
fibers 326f
infiltrations 204
lesion, peripheral 238, 253
optic 215, 216
palsy 222
bilateral 241
trochlear 231
peroneal 203f
root 253
diseases affecting 195
sheath 204
supraorbital 203f
thickening 202, 330
trunk 245
tumors of 204
ulnar 203f
vestibular 245
vestibulocochlear 190, 242
Nervous system 62, 100, 137, 186, 193, 200
diseases stratification of 311fc
examination 189, 205
Netilmicin 498
Neubauer chamber 457
Neuralgia
postherpetic 235
trigeminal 235
Neuraminidase inhibitors 499
Neurocardiogenic syncope 109
Neurocutaneous syndromes 200
Neurodeficit, pattern of 319
Neurofibromas 200f
Neurofibromatosis 200, 201, 330, 468f, 475f
diagnostic criteria for 201
Neurogenic
bladder, causes of 197t
edema 43
ptosis 220f
Neuroleptic malignant syndrome 31
Neurological diseases 311
pathology of 194
Neurological disorder 332
Neurological examination 361
Neurological symptoms, common 187
Neuromuscular junction 311
Neuron, inhibitory 267
Neuronal shock, state of 255
Neuronopathy 310, 326, 331
motor 326
sensory 326
Neuropathic disorders 328
pathologic classification of 326
Neuropathy 193, 330, 332
autonomic 331
axonal 326
classification of 327f
clinical types of 326
diabetic 331b
hereditary 327, 332
large fiber 328
medications causing 331
of diabetes, treatment-induced 331
patterns of 329
peripheral 310, 326, 328
Neurotoxic snake bite 249
Neurovascular syncope 109
Neutropenia 482, 524
febrile 524
Nevirapine 500
Niacin 51
Nicardipine 481, 488, 490
Nicoladoni-Israel-Branham sign 16
Nicorandil 480
Nifedipine 481, 488
Night sweats 30
Nihilistic delusions 211
Nisoldipine 488
Nitrates 480
Nitrofurantoin 498
Nitroglycerin 490, 510
Nitroprusside 510
Nitrous oxide 331
Nixon's method 172f
landmarks for 173f
percussion by 173
Nizatidine 506
Nocturia 523
Nodular opacities, multiple rounded 445f
Nodule 531
differential diagnosis of 439
Noisy
breathing 72
restrictive dyspnoea, causes of 71
Nonalcoholic steatohepatitis 156
Non-dihydropyridine calcium antagonists 481
Nondominant hemisphere, lesions of 212
Nonfluent aphasias 209
Non-homogeneous opacity 442f
Noninflammatory disease 338
Non-nystagmus oscillations 231
Nonpitting pedal edema 383f, 467f
Non-rebreather mask 462
Non-ST-elevation myocardial infarction 401
Nonsteroidal anti-inflammatory drugs 76, 150, 484
doses of 152
Nonsulfonylureas 494
Noonan's syndrome 114
Noradrenaline 491
Nose 76
Nose-finger nose test 292, 292f
Nothnagel syndrome 315
Novel oral anticoagulants 502
advantages of 503t
disadvantages of 503t
Nuchal rigidity 307
Nuclear and infranuclear processes 247
Nuclear lesion 247, 238
Nuclei and functions 232
Numb cheek syndrome 236
Numb chin syndrome 236
Nutrition 252, 513
Nutritional assessment 51
Nutritional deficiency 51
signs of 200
NYHA breathlessness 533
Nystagmus 231, 242, 289
central 232
convergence retraction 231
degrees of 231
down beat 231
gaze-evoked 297
grading of 231
peripheral 232
types of 231
O
Obesity 385f, 470f
hypoventilation syndrome 74
Obscure gastrointestinal bleeding 522
Obsession 373
themes of 373
Obsessive, diagnostic criteria for 377
Obstetric history 335
Obstipation 150
Obstructing disorders 148
Obstructive expiratory dyspnoea, causes of 71
Obstructive pulmonary disease
chronic 117, 380, 393, 520
assessment test 536
Occipitofrontalis, frontal belly of 236
Octreotide 510
Ocular bobbing 232
Ocular dipping 232
Ocular flutter 231
Ocular movement testing 222
method 223f, 224f
Oculocephalic reflex 245
Oculogyric reflex, palpebral 238
Oculomotor
dysfunction 290
nerve 222f
palsy 231
Oculosympathetic palsy 228
Oddi dysfunction, sphincter of 153
Odor 67
Odynophagia 151
causes of 151t
Olfactory nerve 214
examination of 214f
Olfactory pathway 214
Oliguria 523
Oliver's sign 82, 82f, 121, 121f
Olmesartan 488
Olsalazine 504
One and half syndrome 231
Openheim's and plantar strike 277f
Openheim's technique 276f
Ophthalmoplegia 224f, 229
external 229
infranuclear 229, 231
internal 229
internuclear 229–231, 315
painful 231
third nerve 222
Opioids 463
Opponens pollicis 257, 261f
Opsoclonus 231
Optic ataxia 295
Optic atrophy, causes of 220
Optic chiasma 216
Optic tract 216
Optokinetic nystagmus 231
Oral candidiasis 473f
Oral cavity examination 74, 161
buccal mucosa 161
gums 161
lips 161
palate 161
pharynx 161
teeth 161
tongue 161
Oral contraceptives 161
Oral corticosteroids 487
Oral fluconazole 505
Oral hypoglycemic agents 494
Oral mucosa, pigmentation of 161
Oral ulcer 352, 355
causes of 161
Orbicularis oculi 236
examination of 237f
reflex 238
weakness of 241f
Orbicularis oris 237
reflex 238
Orbit 231
Orbital apex syndrome 251
Orofacial cervical dystonia 242
Orofacial edema 242
Orogastric lavage, technique of performing 452, 452t
Oromandibular dystonia 305
Oropharyngeal airway 454
Oropharyngeal dysphagia, causes of 151t
Oropharynx 76
Orphenadrine 482
Orthocyanosis 38
Orthodeoxia 519
Orthopnea 3, 69, 519
pathophysiology of 69
Osborn wave 394
Oseltamivir 499
Osler's nodes 113f
Osler-Weber-Rendu syndrome 157
Osmotic diuretics 485
Osteoarthritis 347f, 355, 355f, 484
Osteosclerotic myeloma 330
Oxacillin 497
Oxcarbazepine 478
Oxygen
mask 461
saturation 69
P
P pulmonale 393
Pacemaker, artificial 392
Pachyderma 41
Pachydermoperiostosis 41
Paclitaxel 331
Pain 280
abdominal 142, 153
acute 151
low back 198
assessment
model 32f
scales 33
back 3
central 285
chest 3, 59, 72, 97, 106, 106t
chronic 151
description of 151
disorders of 285
epigastric abdominal 153
funicular 320
ischemic
cardiac 106
noncardiac 106
pressure 283
radicular 320
root 319
site of 153
types of 32
Palatal myoclonus 247
Palatal tremor 297
Palate, high-arched 58f
Palilalia 526
Pallanesthesia 285
Pallesthesia 282, 528
Palliation 152
Pallor 34, 34f, 74, 200, 466f
grading of 34
over conjunctiva 34f
Palm
hyperpigmentation of 36f
pigmentation of 469f
Palmar erythema 157, 472f
Palmar interossei 257, 262f
card test for 262f
Palpable nerves
clinical landmarks of 202t
sites of 203f
Palpation 81, 99, 143, 166, 249, 259
Palpitations 97, 108, 519
anxiety related 109
causes of 108, 108t
duration of 108
extrasystolic 109
frequency of 108
types of 109
Palsy
horizontal gaze 230
infranuclear 231
vertical gaze 229
Pancerebellar syndrome 297
Pancreaticobiliary disorders 151
Pancreatitis
acute 153
chronic 153
Panic disorders 21
Panniculitis, type of 341
Panretinal photocoagulation 218f
Paper money skin 157
Papilledema 218, 218f
causes of 218
Papillopathy, diabetic 220
Papule 530
Para-aortic lymphadenopathy 50
Paradoxical respiration 13
Parageusia 238
Paralysis 529
agitans 332
palatal 210
Paramedian pontine reticular formation 231
Paraneoplastic disorders 295
Paraphasia 207
Paraplegia 322
causes of 195
Parasitic infestations 173
Parasternal heave
examination of 118f, 119f
grading of 119
Paratonia 255
Paratracheal stripe, right 436
Paresis 529
Paresthesia 285, 528
Parietal drift 192
Parietal pleura 72, 74
Parinaud syndrome 315
Parkinson's disease 193, 302, 332
idiopathic 332
nonmotor symptoms of 332t
stage of 333t
Parkinson's facies 472f
Parkinson's gait, stages of 300f
Parkinson's hand tremors 472f
Parkinson's plus syndromes 193, 333t
Parkinsonism
causes of secondary 333t
dementia complex 333
Parkinsonsian disorder, classification of 333fc
Paromomycin 498
Parotid enlargement 160f, 472f
Paroxysmal nocturnal dyspnea 3, 69, 69t, 519
mechanism of 69f
Parry-Romberg syndrome 242
Patch 530
Patellar clonus 273
left 273f
right 273f
Patellar tap test 348
Patent ductus
arteriosus 117, 119, 120, 123, 130, 131
artery 141
Pathognomonic sign 128
Pathologic valvular regurgitation, diagnosis of 539t
Patrick's test 351, 351f
Peak flow meter 465
Pectoralis major 256, 259f
Pectus
carinatum 79f, 116
excavatum 78, 79f, 116
Pedal edema 42f, 97, 110, 110fc, 142, 156, 200
nonpitting type of 43f
pitting type of 43f
Pedigree analysis 511
Pel-Ebstein's fever 29
Pendular nystagmus 231
Penicillins 497
Pentaplegia 194
Peptic ulcer 68, 492
disease 153
Perceptual abnormalities 373
Percheron stroke, artery of 315
Percussion
abnormal types of 88
rules of 87
types of 87
Perianal sensation 197
Pericardial effusion 445f, 446f
Pericardial rub 128
Pericarditis 107, 352
acute 399
Perihepatitis 153
Perindopril 488
Peripheral nerves, diseases affecting 195
Peristalsis, visible 164
Peritonitis
dialysis-related 154
granulomatous 176
Per-rectal examination 182
Persecutory delusions 211
Personality disorders, classification of 378
Pes
cavus 302
planus 302
Petechiae 113f
Petrous apex 231
gradenigo syndrome 251
Peutz-Jeghers syndrome 161
PHACE syndrome 202
Phakomatoses 200
Phantom limb pain 285
Pharyngeal branch 246
Phentolamine 490
Phenylalkylamines 481
Phenylephrine 133, 491
Phenytoin 331, 478, 479
Pheochromocytoma 21
Phonation 207
Phonic tics 305
Phonogram 104f
Phthinoid chest 78
Piano-playing movements 304
Pickwikian syndrome 74
Pierre-Marie-Foix syndrome 315
Pigmented striae 385f
Pill-induced injury 151
Pillow orthopnea 69
Pin head method 158f
Pin prick sensation, examination of 280f
Pindolol 488
Pinful gait 301
Piperacillin 497
Pitting edema 466f
grading of 42, 42f
Pityriasis versicolor 467f
Plantar reflex 274, 275f, 322
reinforcement of 275
Plantar response, variants of 275
Plaque 531
Plasmodia 476
Plasmodium ovale 476
Platelet abnormality 355
Platypnea 70, 519
causes 70
Platysma 237, 256, 257f
examination of 237f
sign of Babinski 239
Pleura
diaphragmatic 74
lymphatic drainage of 74
parts of 75f
Pleural opacities, differential diagnosis of 439
Pleural rub 93
Pleuritic chest pain 70, 72
Pleximeter finger, placement of 122f
Plummer nails 42
Plummer-Vinson syndrome 151
Pneumoconiosis 41, 71
Pneumocystis carinii pneumonia 438
Pneumonectomy 441f
Pneumonia 74, 505
atypical 442f
bilateral 442f
lobe
right middle 442f
right upper 442f
severe 71
Pneumoperitoneum 447f
Pneumothorax 107
bilateral 443
right-sided 443f
Poisoning, organophosphorus 306
compound 249
Poland syndrome 443
Polyarthritis
acute 339
chronic 339
Polycythemia 74, 517
Polymyositis 249
Polyneuropathy 326, 327, 331
acute inflammatory demyelinating 193, 311
causes of 326
types of 330f
Polyradiculopathy 331
Polyuria 523
Polyvinylchloride 454
Pontain's murmur 34, 134
Pontine gliomas 241
Popliteal artery 17
palpation of 17, 17f
Popliteal lymphadenopathy 50
Portal hypertension 523
classification of 184, 184f
Portal vein thrombosis 153, 181
Portosystemic anastomosis, sites of 184
Posaconazole 506
Posterior column
sensations, disorders of 285
syndrome 321
Postganglionic disorders 310
Postspinal artery syndrome 322
Post-tussive
crepitations 93
suction 93
prerequisites for 93
Postural changes 332
Potassium-sparing diuretics 485
Prader's orchidometer 158, 159f
Prasugrel 482
Prayer sign 345, 345f
Prazosin 488
Precordial bulge, causes of 116
Preganglionic autonomic failure 310
Premature ventricular
complexes 392
contraction 126, 133, 480
Pressure hydrocephalus, normal 295, 302
Primaquine 476
Probiotics 505
Procainamide 396, 479
Profile sign 40f
Prognathism 449f
Promyelocytic leukemia 311
Pronator drift 265
positive 266
Propafenone 479
Prophylaxis, primary 477
Propionate 504
Propranolol 479, 481, 488
Proprioception 281
Proprioceptive system 280
examination of 281
Propylthiouracil 492
Prosody 213
Prosopagnosia 211
Prostaglandins 39
Protease inhibitors 500
Proton pump 506
inhibitors, indications for 506
Proverb test 374
Proximal lower limb 196
pelvic 196
thigh 196
Proximal upper limb 195
arm 195
shoulder 195
Pseudoathetosis 283, 283f
Pseudobulbar palsy 250
Pseudocyanosis 38
Pseudodiarrhea 150
Pseudo-Foster-Kennedy syndrome 215
Pseudogynecomastia 158
Pseudohallucination 211, 373
Pseudohypertension 22, 517
Pseudohypertrophy 252
Pseudopolymelia 211
Pseudosyncope, causes of 110, 110b
Pseudotumor cerebri 219
Psoriasis 341f, 467f
evidence of 356
nail changes in 341
Psoriatic arthritis 347f, 356
classification for 356
Psoriatic nail 347f
dystrophy 356
Psychiatric disorders
diagnosis of 375
groups of 375
management of 378
Psychiatric illness 148
Psychological management 379
Psychomotor
activity 372
agitation 376
Psychotic disorders 375
feature of 374
Psychotic symptoms 378
Pterygoid muscle 233f
Ptosis 220, 221, 474f
acquired 220
bilateral 221
causes of 220
congenital 220
mechanical 220, 220f
partial 228
reverse 221, 221f, 228
unilateral 221
upside-down 228
Puddle sign 179
Pulmonary artery 28, 114, 123
prominent 446f
Pulmonary communication 131
Pulmonary cyanosis 39
Pulmonary edema 71, 445f
Pulmonary embolism 72, 107, 399
Pulmonary emphysema 443
Pulmonary hypertension 119, 125, 126, 520
symptoms of 111
Pulmonary oligemia 446f
Pulmonary overinflation 443
Pulmonary plethora 446
Pulmonary pulsations 119
Pulmonary stenosis 114, 119, 120, 125, 133, 141
Pulmonary venous hypertension 438
Pulsatile liver 137
examination of 137
Pulsatile liver, palpation of 137f
Pulse 9, 200, 516
absence of 15, 313
character of 10, 12
deficit 10
grading of 10, 535
normal contour of 11
palpation of 115f
peripheral 16, 16f
rate 9
spike and dome 12
volume of 10
wave
components of 11f
speed of 11
waveform 13f
individual components of 11
Pulsus alternans 12, 14, 14f
elicitation of 14
types of 14
Pulsus anacroticus 12
Pulsus bisferiens 12, 15, 15f
Pulsus dicroticus 12
Pulsus paradoxus 12, 13f
mechanism of 13
reverse 12
Pulsus parvus et tardus 12
Pump handle movement 83f
Pupil 206, 224
large 221, 224
reactivity score 206
size 221
small 221, 224
Pupillary abnormalities 226, 227f, 228f
Pupillary size, normal 221
Pure sensory 317
Pure tone audiometry 242
Purpura 163, 330
over lower legs, palpable 340f
Pursed lip breathing 19, 81f
Pursuits 222
Pyelonephritis 153
Pyoderma gangrenosum 355
Pyramidal drift 192
Pyramidal gait 298
Pyramidal tract 322
Pyrazinamide 477
Pyrexia of unknown origin 30
Pyridoxine 51, 331
Q
Q waves 394
QRS
complex 394
low voltage 394
qSOFA 540
QT interval 396
Quadriceps
femoris 257, 264f
gait 301
Quadriplegia, causes of 195, 195t, 323
Quadruple therapy 507
Queen square neurological reflex hammer 268
Quetiapine 396
Quinapril 488
Quinidine 396, 479
Quinine 396
Quinolones 499
R
Racecadotril 507
Radial artery, palpation of 9, 9f
Radio-femoral delay 18, 18f
Radio-radial delay 18
Raeder's paratrigeminal syndrome 236
Ramipril 488
Ramsay-Hunt syndrome 242
Ramus
externus 248
internus 248
Ranitidine 506
Rapid finger tapping test 266
Rauchfuss-Grocco triangle 90f
Raymond Ceston syndrome 315
Rebound phenomenon 293, 293f
Rectus
diastasis of 164
divarication of 164, 164f
Recurrent laryngeal nerve 246
palsy 247
Referred pain, common sites for 154f
Reflex 189, 191, 222, 234, 238, 267, 269, 320
abdominal 274f
accommodation 225
anal 197, 274
ankle 271f, 272f
bulbocavernosus 197, 274, 274f
causes of altered 279
conjunctival 234, 235f
corneal 234, 235f, 238, 240
cremasteric 274f
generation, mechanism of 267
grading of 267
inverted 279
mandibular 234
mass 322
palmomental 238, 278f
pathway, accommodation of 226f
pectoral 272f
perverted 279
pout 278, 278f
primitive 191, 277
rooting 278, 278f
sneeze 234
snout 238, 278
superficial 191, 274
supinator 270f
types of 267
Reflux
abdominojugular 27, 27f
esophagitis, severe 151
Refractory angina 108
Refsum's disease 330
Regurgitation 521
Rehabilitation 379
Reinforcement maneuvers 268
Reinke's dysphonia 72
Reitan's number-connection test 183, 183f
Remdesivir 505
Renal angle 175
Renal artery bruit 165, 165f
Renal failure 353
acute 476
Renin inhibitor, direct 488
Reserpine 489
Respiration 18
assessing type of 19f
movement with 164
muscles of 18
types of 19
Respiratory diseases 74, 82
signs of 76
Respiratory failure, features of 75
Respiratory movements 61, 80, 83f, 84f
examination of 82
Respiratory muscle function, impaired 68
Respiratory rate 18, 18f, 74, 188
Respiratory system 3, 71, 74, 137, 192, 352, 371
abnormal signs in 80
examination of 59, 76
Restless leg syndrome 305, 527
Retching 521
Retrograde amnesia 207
Rhabdomyolysis 495
Rheumatic carditis 539t
Rheumatic diseases, inflammatory 484
Rheumatic fever, signs of 113
Rheumatoid arthritis 353, 353f, 355, 471f
extra-articular manifestations of 354f
Rheumatoid factor 338, 353
Rheumatological diseases 353
Rheumatological disorders, systems in 352
Rheumatology 334
skin changes in 339
Rhinocerebral mucormycosis 473f
Rhomberg's sign 283f
Rhomboids 256
Rhonchi, classification of 92
Rhythm 9
causes 10
dissociated 231
Rib crowding, examination of 86f
Ribavirin 463
Riboflavin 51
Riedel's lobe 169
Rifampicin 477
indications of 477
Rifaximin 505
Right ankle clonus 273f
Right atrium 437f
connection 131
Right bundle branch block 125, 126, 397
Right heart
border 121, 122f, 436
connection 131
failure 168
Right upper quadrant, causes of 153
Right ventricular
dilatation 75
failure 75
hypertrophy 119, 397
Right-rotated film 431
Rigidity 255, 332, 526
Rinne's and Weber's test 243
Rinne's test 190, 242, 243, 244f, 245f
Ritonavir 500
Rivaroxaban 502
Rivero-Carvallo sign 133
Rofecoxib 484
Roger's area 123
Roger's murmur 134
Roger's sign 236
Roller clamp 460
Romano-Ward syndrome 396
Romberg's sign 283, 295f
Romberg's test 191, 295
Rostral vermis syndrome 296
Rotational test 242
Rotch sign 123
Roth spots 113f
Roussy Levy syndrome 330
Rubella syndrome 114
Ryles tube 455
complications 455
contraindications 455
indications 455
position of 455
Rytand's murmur 134
S
Saccades 222
Saccadic dysmetria 297
Saccharomyces boulardii 505
Sacral cord, feature of 324
Sacral sensation 320
Sacroiliac joint 336, 351
Sahli's hemoglobinometer 456
Salbutamol 462, 486
Salmeterol 486
Samter's triad 76
Sarcoidosis 41, 71, 241, 443f
Sarcopenia 366
Scabies 467f
Scars 120, 163, 531
visible 81
Schamroth's sign 40f
Schirmer's test 238
Schober's test 351, 351f
modified 351, 351f
Scissor technique 345
Scissoring gait 300, 300f
Sclera, blue 35f
Scleroderma facies 472f
Scleromalacia perforans 341
Sclerosis
amyotrophic lateral 247, 249, 306
multiple 493
systemic 340f
Scoliosis
acquired 80
causes of 80
congenital 80
Scorbutic rosary 78
Scratch sign 94
Scratch test 169
Scrivener's palsy 305
Secretory function 238
Sedation 484
Seesaw nystagmus 231
Seizure 188, 486
epileptic 529
Sella turcica 449f
Sellar enlargement 386f
Semilong cases 380
Sensation, primary 191
Sense, position 282
Sensorimotor
functions, altered 148
mixed 317
Sensorium 75
Sensory 247
and motor component 232
ataxia 295, 300, 301f
component, testing of 232
deficit 320
dermatomes 286
dysfunction 187, 196, 235
clinical patterns of 288f
homunculus 285f
motor neuropathy, syndrome of subacute 329
nucleus, principle 232, 235
pathway 285, 285f
problems 332
Sensory loss 196, 285, 329
ascending 196
dissociative 196
global 328
pattern of 196
symmetric 329
upper level of 319
Sensory system 191, 280
examination of 237, 280
Sepsis 530
Septicemia 492
Sequential therapy 506
Serratus anterior 256
Serum
bilirubin levels 36
enzymes 37
Sexual behavior, high-risk 3
Shaeffer's sign 275
Shaeffer's technique 276f
Shagreen patch 202f, 468f
Shallow injection 493
Sherrington classification 280
Shock 492
anaphylactic 491
stage, lesion in 195
Short stature 53
causes of 54
Shoulder 190
drooping of 79, 79f
examination of 344
joint 344f
Shuffling gait 300
Sildenafil 216
Silent ischemia 108
Silent restrictive expiratory dyspnea, causes of 71
Silhouette sign 436, 436f, 442f
positive 436
Similarity test 374
Sims position 182
Simultanagnosia 211
Sinoatrial node 387
Sinus 81, 163
bradycardia 390
pause 390
rhythm 390
tachycardia 390
visible 81
Sisomicin 498
Sjogren's syndrome 295, 341
Skeletal abnormality 443
Skin 493
examination of 339
hypopigmentation 330
over abdomen 163
segment innervation 286f, 287f
Skinfold
calipers, types of 55f
thickness 55
triceps 56, 56f
Skull
and spine 192
examination of 309
lateral X-ray of 449f
radiograph 202
Slapping gait 298
Sleep disorders 332
Slurred speech 208
Smoking 515
index 515
Snellen's chart 215f
Sodium
bicarbonate 509
glucose cotransporter 2 inhibitors 494
nitroprusside 490
Soft neurological signs 192
Soft tissue 432, 432f
density 444
Sokolow index 394
Solitary pulmonary nodule 445f
Somatic delusions 211
Sotalol 396, 479
Sound
nonejection 129
production, mechanism of 90
protodiastolic 126
requires, production of 210
ventricular 126
Spastic paraplegia, causes of 195t, 323
Spasticity 255
Spectrum 497
Speech 207, 372
ataxic 210
genesis of 208f
scanning 210, 289
Sphincter dysfunction 324
Spider nevus 157, 157f, 158f
Spinal accessory nerve
anatomy of 248f
testing 248
Spinal artery 319
anterior 319
posterior 319
Spinal cord 195
anatomy 318
disease 193, 318
bladder involvement in 320f
patterns of 321
types of 319fc
involvement of 318
level 318
syndromes 322f
tracts of 318f
vascular supply of 319, 319f
Spinal joints, arthritis of 197
Spinal nucleus 232, 235
Spinal pain, types of 324
Spinal part 248
Spine 182
deformities 80f, 352, 352f
examination of 79, 309, 336, 350
extensors of 257, 263f
involvement 355
movements of 309f, 336
thoracolumbar 336
Spino-acromion distance, examination of 85, 85f
Spino-scapular distance, examination of 85, 85f
Spinothalamic tract 280
Spironolactone 488
Spleen 175
examination of 170
palpation 171f
percussion sign 171
surface marking of 170f
Splenic percussion 172f
Splenic rub 166
Splenic rupture 153
Splenomegaly
causes of 173
grading of 170f
palpable 170, 170f
Split hand sign 253
Sputum 3, 66
Square wave jerks 297
Squeeze test 345
Squint 223
types of 223
ST segment
depression, causes of 399
elevation, causes of 399
Staccato speech 210, 289
Stag's antler sign 446f
Stamping gait 300
Stapedius muscle 239
Staphylococcus spp. 477
Statins 495
Status anginosus 108
Stavudine 500
Stereognosis 284, 284f
Sternoclavicular joint, examination of 352, 352f
Sternoclavicular pulsations 119
Sternocleidomastoid muscle 79f, 256, 257f, 316
examination of 248f
Sternutatory 234
Steroids
common indications of 492
contraindications of 492t
indications of 492t
Stevens-Johnson syndrome 475f
Stiff tongue 250
Stiffness 338
Still's disease, adult onset 357
Still's murmur 134
Stimulus
site of 275
strength of 275
Stools
fatty 149
red-colored 182
Storage disorders 168
Strabismus 223
Straight back syndrome 116
Straight leg raising test 351, 351f
Straight line walking 294f
Streptomycin 477, 498
Stress
acute sympathetic 399
echocardiography 491
incontinence 366
Stretched shiny skin 163
Stridor 93
Stroke 312, 529
complete 312
embolic 313t
hemorrhagic 313t
ischemic 495
lateral side downwards 349f
localization of 313
onset of 313
progressing 312
risk factor for 312t
thrombotic 313t
types of 312
Strongyloides stercoralis 150
Strongyloidiasis 150
Strümpell's phenomenon 275
Stupor 205, 524
Sturge-Weber
disease 236
syndrome 201, 202f
Subarachnoid space 231
Subcutaneous emphysema 444f
detection of 86
Subcutaneous nodules 341
Substance dependence syndrome 377
Succussion splash 93, 94f, 166
Sucking reflex 238, 278, 278f
Sucralfate 506
Suction catheter 455, 456
indications 456
Sulfasalazine 503, 504
Sulfonylureas 494
Superior orbital fissure 231
syndrome 236, 251
Suppurative diseases 41
Supranuclear involvement 249
Supranuclear lesion 238, 247
Supranuclear ophthalmoplegia 229, 231
Supranuclear palsy, progressive 230f, 333
Suprapatellar pouch 348f, 349f
Suprasegmental component 267
Supraspinatus 258f
Suramin 331
Suzman's sign 120
Swan-Neck deformity 346, 471f, 346f
Swelling 349
abdominal 147
over Achilles tendon, examination of 349f
Swyer-James syndrome 443
Symphyseal sign 307, 308f
Syncope 97, 109, 530
Syndromic lymphadenopathy 44
Synkinesis movements 305
Synovitis 338
Syphilis 150, 241
Syringobulbia 235f
Systemic diseases 306
Systemic inflammatory response syndrome 530
Systemic lupus erythematosus 353, 340f, 471f
clinical features of 355f
Systole 102, 102f
Systolic murmur 130, 131, 534
configuration of 132f
Freeman and Levine grading of 534
T
T wave 394
inversion
asymmetrical 394
causes of 394
tall 394
Tabes dorsalis 295
Tachycardia 9, 389, 519
palpitations 109
paroxysmal supraventricular 480
supraventricular 138, 391
types of supraventricular 391
ventricular 391
Tachypnea 94
Tactile extinction 284, 284f
Tactile fremitus 86, 94
Tactile localization 283
Tactile sensation 280
examination of 281f
Tall stature 54
causes of 54
Tamiflu 499
Tandem walking 294, 294f
Tardive cyanosis 37
Taste sensation 240
examination of 238f
Taylor hammer 268
Tazobactam 497
Tectal pupils 228
Tedisamil 479
Teeth, clenching 268
Telangiectasia 531
Telmisartan 488
Temporal elements 152
Temporal lobe 245
Temporomandibular joint 352, 352f
Tender hepatomegaly 168
Tenderness 86
Tendon reflex 311
deep 191, 268, 274, 322
Tenesmus 150
Tenofovir disoproxil fumarate 500
Tenosynovitis 338
Tense ascites 175
Tension pneumothorax 71
Terazosin 488
Terbutaline 486
Terfenadine 396
Testicular atrophy 158
Tetracycline 499
Tetralogy of Fallot 114, 446f
Thalamic pain 285
Thalidomide 331
Thallium
intoxication 330
poisoning 330
Theophylline 486
Therapeutic cases 380
Thermanalgesia 285
Thermhyperesthesia 285
Thermhypoesthesia 285
Thermometer 28, 29f
Thiacetazone 478
Thiamine 51
Thiazides 485
Thiazolidinediones 494
Thienopyridines 481
Thionamides 492
Thomas test 348, 348f
Thoracic cord lesion, feature of 323
Thought abnormalities 372
Thrills 120
Throat 76
Throckmorton's sign 275
Thrombocytopenia 482
Thromboembolic complications 484
Thrombolytic agents, use of 503b
Thrombotic thrombocytopenic purpura 482
Thumb
adduction 261f
extension 261
flexion 261f
sign 58f
Z-shaped deformity of 347f
Thyroid
disease 353
dysfunction 182
function tests 545, 545t
Thyroidectomy 247
Thyromegaly 470f
Thyroxine 492
Tibial artery, posterior 17
Tibial pulse, palpation of posterior 17f
Tibialis
anterior 257
anticus 264f
posterior 257
posticus 264f
Tic 305, 527
Ticlopidine 482
Tidal percussion 89, 89f
Timed up and go test 365f
Timed vibration test 283
Timolol 488
Tinea
corporis 468f
cruris 468f
manuum 468f
versicolor 467f
Tiotropium 462, 487
Tissue
biopsy 458
disorders, connective 161
Titubation 290, 297
Tobramycin 463, 498
Toe finger test 291, 291f
Toe-walking 301
Tolcapone 483
Tolosahunt 251
Tone 190, 322, 526
abnormalities of 255
decay 242
in arms, testing for 254
in legs, testing for 254
Tongue 250f
anterior two-thirds of 237
bald 35f
bluish discoloration of 38f
deviation 249, 250
numbness 236
palpation of 250f
paralysis 210
small 250
wasting 474f
Topognosis 283
Torsades de pointes 391
Torsemide 485
Toxic epidermal necrolysis 475f
Toxicity 498
Toxicology 507
Toxins 148
Trachea 79, 81, 95, 433, 433f
breath sounds 91
position, palpation for 82
shift, implication of 82
tug 121
tug sign 82
Trail sign 79, 79f
Trandolapril 488
Transient ischemic attack 311–313, 316, 481, 495, 529
types of 317
Transpyloric plane 165f
Transverse diameter, examination of 84f
Trapezius muscle 249f
testing 248
Traube's space
landmarks of 173f
obliteration of 172
percussion of 89, 89f, 172, 172f
upward shift of 172
Traveler's diarrhea 149
Tremor 289, 304, 332, 527
flapping 160, 160f
intention 290
relieving 482
Trendelenburg
gait 299, 301f
sign 348f
test 348
Trepopnea 70, 519
causes 70
Triamterene 488
Triceps reflex 270f, 271f
Tricuspid area, auscultation of 134
Tricuspid regurgitation 117, 119, 123, 125, 130–133
auscultation of 134f
Tricuspid stenosis 119, 125, 132, 133
Trigeminal nerve 189, 232
disorders 236
involvement, causes of 235
mandibular division of 233f
motor component of 233f
ophthalmic division of 233f
sensory component of 232f
three divisions of 232f
Trihexyphenidyl 482
Triplegia 194
Tripod sign 308, 308f
Trisection method 10
Troisier's sign 47
Tromner's neurological reflex hammer 268
Tromner's reflex 277, 277f
Trousseau sign 47
Trousseaus syndrome 47
Trsemide 488
Trucut biopsy gun 458
True syncope, causes of 109, 109t
Trumpet player's neuropathy 236
Trunk 191
muscles 257
Tuberculin syringe 457
Tuberculosis 41, 68, 150
bilateral upper lobe active 447f
chemoprophylaxis 477
choroid tubercles in 218f
external markers of 74
sequelae of 447f
X-ray signs of 447
Tuberculous
foci 477, 477t
meningitis 311
Tuberous sclerosis 201, 468f
complex 201t
Tumor 197, 531
Turner's syndrome 114, 115, 115f
Twin beating pulse 12
Two-thumb technique 344
Tympanic membrane 245f
Typhus 473f
U
U waves 394
Ulcer 334, 531
duodenal 506
Ulcerative colitis 154, 493, 504t
severity index for 541
Ulnar deviation 346, 471f
Ulnar paradox 13
Umbilical node 163
Umbilicus 163
Uniocular movements 222
Up beat nystagmus 231
Upper airway cough syndrome 65
Upper limb 252, 256
examination of 344
latent reflexes of 277
reflexes, reinforcement of 268f
Upper motor neuron 195t, 240, 241, 255, 311, 314, 320, 329
disease 311
signs of 311t
palsy
bilateral 241
facial 240
Upper respiratory tract 76
demarcation of 76
examination of 60, 76
Urea and electrolytes 545, 545t
Urge incontinence 365
Urinary bladder, distended 177
Urinary incontinence, types of 365
Urinary retention, acute 153
Urinary tract infection
complicated 524
uncomplicated 524
Urine 545
bilirubin 37
increased specific gravity in 465
residual 197
values, normal 545t
Urinometer 465
Urogenital system 3
Urticaria, chronic spontaneous 479
Uvula, deviation of 241f
V
Vagal lesion, unilateral 247
Vagal paralysis, bilateral complete 247
Valdecoxib 484
Valerate 504
Valproate 478
Valsalva maneuver 137, 138, 138f
modified 138
phases of 137, 138
Valsalva ratio 310
Valsalva-Müller's maneuver, reversed 138
Valsartan 488
Vancomycin 498
Variegate porphyria 330
Vascular disease 443
Vasculitis 176, 330
Vasodepressor syncope 109
Vasovagal syncope 109
Vaughan Williams classification 479t
Veins, flow of 181f
Vena cava
edge of superior 437f
obstruction 181
Venous hum 165
Venous paradox 13
Venous pulse 26f
Ventilatory drive 68
Ventricular septal defect 117, 119, 120, 123, 126, 130, 131, 133, 393
Venturi mask 462
Venules, swelling of 341f
Verapamil 479, 481, 488
Vernakalant 479
Vernet jugular foramen syndrome 251
Vertebral body 318
Vertebral bruit 188
Vertebral pain 320
Vertebral tenderness 320
Vertigo 197, 242
Vesicle 531
Vesicular breath sounds 91
Vessel wall, condition of 15
Vestibular component 242, 245
Vim Silverman liver biopsy needle 457
Vincent's angina 108
Vincristine 331
Viral gastroenteritis 154
Visceral neuropathy 331
Visceral pleural line 444f
Visible pulsations 81, 119
Visual acuity 215
Visual agnosia 211
Visual field
defect 216, 217f
testing 215
Vitals examination 8, 9, 74, 98
Vitamin 51
A 51
B1 51
B11 51
B12 51
deficiency of 159
B2 51
B3 51
B4 51
B5 51
B6 51
B7 51
B8 51
B9 51
C 51
D 51, 496
deficiency 496
E 51
K 51
Vitiligo 467f
Vocal fremitus 61, 85, 86, 86f, 95
Vocal resonance 61, 93, 95
variations of 93
Vocalization 207
Voice, hoarseness of 72
Vomiting 142, 148, 152, 313, 521
causes of 148t
postoperative 148
von Hippel-Lindau disease 202
W
Waddling gait 299, 299f
Waist circumference 56
Waist-hip ratio 56, 56f
Wallenberg syndrome 315
Warfarin 502
Wartenberg's reflex 277
Wartenberg's sign 277f
Watson's water hammer pulse 14
Weakness 186, 194, 195
distribution of 186, 194, 311
progression of 186
qualitative assessment of 256
Weber test 243
Weber's syndrome 315
Weber's test 190, 242, 244f, 245
Weber-Dimitri disease 236
Webino syndrome 231
Wegener's granulomatosis 76
Weight gain 494
Weight loss 57
unintentional 521
Wemino syndrome 231
Wernicke's area 209
Wernicke's encephalopathy 207
Wernicke's hemianopic pupil 226
Westergren tube 465
Wet test 302, 302f
Wheeze 3, 59
classification of 92
Whipple's disease 150
Whispering pectoriloquy 93
White blood cell 339
William's syndrome 114
William's tracheal resonance 90
Wilson's disease 161
Winterbottom sign 47
Wintrich's sign 90
Wolff-Parkinson-White syndrome 392
Woltman's sign 279
Wrist 191
clonus 273
joint, examination of 344, 345f
sign 58f
Writer's cramp 305
X
Xanthelasma 467f, 474f
Xanthochromia 459
Xiphisternum 166f
X-linked dominant transmission 513f
X-linked recessive
disorders 511t
transmission, mode of 513f
Y
Yamaguchi's criteria 357
Young stroke, causes for 313t
Young's syndrome 76
Z
Z deformity 346, 471f
Zidovudine 500
Zieve's syndrome 159
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