PATHOGNOMONIC

SIGNS
Prepared By:
John Gil B. Ricafort, BSN, RN
Diseases and Pathognomonic Signs
A
Abdominal Aortic Aneurism
- pulsating abdominal mass
Abruptio Placenta
- painful bleeding, board-like abdomen
Acute Renal Failure
- azotemia, uremic frost on skin
Addison’s Disease
- bronze pigmentation of skin
Angina Pectoris
- pain upon exertion
Appendicitis
- Mc Burney’s sign
Atrial Septal Defect
- murmur heard high on chest
Autism
- rocking, spinning, routines
B
Bacterial Vaginosis
- grayish white discharges
Basilar Fracture
- raccoon’s eye
Breech Birth
- meconium staining
Bulimia Nervosa
- Binge eating
C
Carbon Monoxide Poisoning
- cherry pink flushed face, carbon in the
secretions, non-productive cough
Carpal Tunnel Syndrome
- Jack Hammer Syndrome (TINEL’s sign)
Cataract
- cloudy vision
Celiac Disease
- gluten sensitivity, foul smelling stool
Chicken Pox
- maculopopular rash
Cholera
- rice water stools
Colic
- pulling up of arms and legs, red-faced
crying
COPD
- barrel chest, clubbing of fingers
Cushing’s Syndrome
- moon face, buffalo hump
CVA
- homonymous hemianopsia
Cystocele & Rectocele
- feeling of fullness at vagina
D
Delirium
- recent and past memory defect
Dementia
- recall or learning memory impairment
Detached Retina
- flashes of light, shadow/ curtain across
the vision
DM
- polydipsia, polyuria, polyphagia
Diptheria
- pseudomembrane
Diverticular Disease
- cramping, colicky pain in left lower
abdominal quadrant
Down Syndrome (Trisomy 21)
- saddle nose, brushfield’s spots
E
Ectopic pregnancy
- Cullen sign
Endometriosis
- premenstrual pain decreasing as
menstrual flow decreases
F
Failure to Thrive (FTT)
- “Radar gaze”

G
GERD
- Barret esophagus
Glaucoma
- halos around the light, tunnel vision
Grave’s Disease
- exopthalmia

H
Hemophilia
- hemarthoses
Hepatic Disease
- asterixis, jaundice
Hirschprung’s Disease
- ribbon-like, foul smelling stool
H-mole
- grapelike growth, large abdomen
Hydrocephalus
- Setting sun eyes
Hypocalcemia
- Trousseau sign, Chvostek Sign,
Hyperreflexia
I
Increased ICP
- high pitch cry
Increased IOP
- Doll’s eye
Intestinal Obstruction
- no passage of meconium
IDA
- activity intolerance
K
Kawasaki
- strawberry tongue
Kleibsiella Pneumonia
- red gelatinous sputum

L
Left-sided Heart Failure
- pulmonary manifestations
Low birth weight
- less than 2.5kg or 5 1/2lbs
Lyme Disease
- red-tinged circular rash (erythema
chronicum migrans)

M
Malaria
- blackwater fever
Meniere’s Disease
- whirling vertigo, tinnitus
Meningitis
- Kernig’s sign, Brudzinski’s sign
Moniliasis
- white “cheesy” discharge
Multiple Sclerosis
- descending weakness, Charcot’s Sign
(intention tremor, nystagmus, scanning
speech)
Myasthenia Gravis
- nasal smile
Mycoplasmal Pneumonia
- nonproductive that progresses to
mucoid sputum
Myocardial Infarction
- Levine sign, viselike or crushing pain
radiating to shoulder, arms, jaw or back

O
Opthalmia Neonatorum
- purulent conjunctivitis
Oral Thrush
- white patches on tongue
Osteoporosis
- kyphosis
Otosclerosis
- ringing or buzzing, longer bone
conduction than air conduction

P
Pancreatitis
- steatorrhea
PDA
- machinery-type murmur throughout
the heartbeat in the left 2nd or 3rd
interspace
Parkinson’s Disease
- pill rolling, bradykinesia, rigidity
Peritonitis
- board-like abdomen
Pernicious Anemia
- Beefy red tongue
Pertusis
- paroxysmal cough ending with a
whoop
PID
- fever, vaginal discharges, lower
abdominal cramping
Placenta Previa
- painless bright red bleeding
Pneumococcal Pneumonia
- purulent rusty sputum
Pneumothorax (Flail Chest)
- paradoxical respiration – loose chest
segment moves inward during
respiration and outward during
expiration
PIH
- edema, proteinuria, hypertension
Preterm infant
- 36 weeks or less
Prolapse Uterus
- pelvic heaviness
Pulmonary Embolism
- sudden dyspnea, sharp pleuritic pain
Pyloric Stenosis
- projectile vomiting, non bile stained
vomitus,
R
Rabies
- hydrophobia
Retinoblastoma
- diminished vision, strabismus, retinal
detachment, abnormal pupilary reflex
Right Ventricular Failure
- Systemic manifestation
Rocky-Mountain Spotted Fever
- rose colored macules
Rubella (German Measles)
- Foreschimer’s Spot (small red macules
on soft palate)
Rubeola (Measles)
- Koplik spots
S
Schizophrenia
- Association, affect, ambivalence,
autistic thinking
Sickle Cell Anemia
- “painful episodes” or “vaso-occlusive
crisis”
Staphyloccocal Pneumonia
- yellow-blood streaked sputum
SIDS
- frothy, blood-tinged fluid fills mouth
and nose
Syphilis
- chancre on genitalia, mouth, anus
SLE
- butterfly rash on face
T
Tetanus (lockjaw)
- spasms
TOF
- Pulmonary valve stenosis, RVH,
Overriding of the Aorta, VSD
Thrombophlebitis
- Homan’s sign
Tracheoesophageal Fistula
- coughing, choking, cyanosis
Trichomoniasis
- malodorous thin yellow discharges
Typhoid fever
- rose-colored papules on the abdomen
Tuberculosis
- low grade fever, night sweats,
hemoptysis
U
Ulcerative Colitis
- bloody, watery, purulent, mucoid
stools

V
Varicosities
- tortous veins
VSD
- low, harsh murmur heard throughout
systole
 Common Laboratory Values
Albumin
3.5-5.0 g/100 ml
Ammonia
12-55 umol/L
Amylase
4-25 units/ml
AST, SGOT
Male: 8-46U/L
Female: 7-34U/L
Bilirubin
Total: up to 1.0mg/100ml
Bleeding Time
3-7 min
BUN
8-25mg/ml
Calcium
8.5-10.5mg/100ml
Carbon Dioxide
24-30mEq/L
Chloride
100-106mEq/L
Cholesterol
<200mg/dl
Creatinine Kinase (CK)
Male: 17-148U/L
Female: 10-79U/L
CPK
<150U/L
CPK-MB
0-5ng/ml
Creatinine
0.6-1.5mg/100ml
ESR
Male: 1-13mm/Hr
Female: 1-20mm/Hr
Fibrinogen
160-450mg/dl
Glucose
70-110mg/100ml
HCO3
22-26mmol/L
HDL
30-75mg/dl
Hemoglobin
Male: 13-18g/ 100ml
Female: 12-16g/ 100ml
Hematocrit
Male: 45-52%
Female: 37-48%
Iron
50-150u/100 ml
WBC
-10,000-15,000/mm3
LDH
70-180
Lipase
2 units/ml or less
Magnesium
1.5-2 mEq/l
pH
7.35-7.45
PO2
75-100mmHg
PCO2
35-45mmHg
Phosphorus
3.0-4.5mg/ 100ml
Platelets
150,000-400,000/mm3
Potassium
3.5-5mEq/l
Protein
6.0-8.4g/ 100ml
PT
10-12 sec
PTT
30-45 sec
RBC
Male: 4.6-6.2 million/ mm3
Female: 4.2-5.9 million/mm3
Sodium
135-145mEg/L
T3
75-195 ng/ 100ml
T4, total
4-12 u/ml
Thrombin Time
11-15 sec
Triglycerides
40-150mg/ 100ml
TSH
0.5-5U/ml
Urea Nitrogen
8-25mg/ 100ml
Uric Acid
Male: 4-9 mg/dl
Female: 3-6.6 mg/dl
DIAGNOSTIC
TESTS &
PROCEDURES
Wag kalimutan…
Cardiovascular System
 Electrocardiography
- noninvasive test
- graphical representation of the heart’s
electrical activity
- interpret EKG for changes
 Holter Test Monitoring(Ambulatory EKG)
- noninvasive test
- records the heart’s electrical activity
and cardiac events for 24 hours
- advise the patient on activity limitations
while wearing monitor
 Cardiac Catheterization
- invasive, fluoroscopic procedure
- examines intracardiac structure,
pressure, oxygenation and cardiac
output.
- Note the patient’s allergies before
testing
- Report immediately if with chest pain
 Echocardiography
- noninvasive test
- uses echoes from sound waves to
visualize intracardiac structures and
blood flow
- Determine the patient’s ability to lie
still.
 Stress Testing
- noninvasive test
- study of the heart’s electrical activity
and ischemic events during levels of
exercise.
- Light breakfast before the test
- STOP the test if patient develops
cardiopulmonary symptoms
Respiratory System
 Bronchoscopy
- invasive test
- allows for visualization of the trachea
and bronchial tree
- Check cough and gag reflex AFTER
procedure
 Pulmonary Angiography
- invasive test involving injection of
radiopaque dye
- allows for radiographic examination of
pulmonary circulation
-NOTE allergies to iodine, seafoods, and
radiopaque dyes BEFORE test
 Thoracentesis
- invasive procedure using needle
aspiration
- allows removal of pleural fluid and
specimen examination
- PLACE the patient in proper position
 Pulmonary Function Tests (PFTs)
- noninvasive test
- measures lung capacity
- Document bronchodilators or narcotics
used before testing
 Arterial Blood Gas analysis (ABG)
- blood test
- arterial blood measurements of tissue
oxygenation, ventilation and acid-base
balance.
- APPLY pressure to the site 5 minutes
after procedure
 Lung Biopsy
- invasive test
- removal of a small amount of lung
tissue for histologic evaluation
- OBSERVE for signs of pneumothorax
and air embolism after procedure
Nervous System
 Electroencephalography (EEG)
- noninvasive test
- graphic representation of the brain’s
electrical activity
- WITHHOLD medications and caffeine 8
hours before the procedure
 Cerebral Angiogram
- invasive procedure using a radiopaque
dye
- allows examination for the cerebral
arteries
- NOTE patient’s allergies before the
procedure
 Lumbar Puncture
- invasive test
- collection of CSF for analysis
- CONTRAINDICATED in the presence of
increased ICP
Gastrointestinal System
 Upper GI Series (Barium Swallow)
- allows for examination of the
esophagus, stomach, duodenum and
other portions of the small bowel after
swallowing
- BEFORE procedure, administer fluids,
cathartics, and enema, as prescribed
 Lower GI Series (Barium Enema)
- Allows for examination of the large
intestine after administration of a barium
enema
- BEFORE procedure, withhold food
 Endoscopy
- procedure using an endoscope for
visualization
- WITHHOLD food and fluids 6 to 12
hours before the test
 Fecal Occult Blood Test
- laboratory test using a reagent
- analysis of stool for blood
- ADVISE the patient to AVOID red meat,
iron and high fiber for 1 to 3 days prior
to the procedure
 Fecal Fat Test
- laboratory test using a stain
- analysis of stool for fat
- ADVISE the patient to restrict alcohol
intake and maintain a high-fat diet for 72
hours before examination
 Cholangiography
- invasive procedure using an injection
of a radiopaque dye through a catheter
- allows for examination of the biliary
duct system
- BEFORE the procedure, note the
patient’s allergies
 Liver Scan
- invasive procedure using an IV
injection of a radioisotope
- provides an image of blood flow in the
liver
- Assess the patient for allergic reaction
after the procedure
 Gastric Analysis
- aspiration of the contents of the
stomach through an NG tube
- measures the acidity of gastric
secretions
- Instruct NOT TO SMOKE for 8 to 12
hours before the test
 Ultrasonography
- noninvasive procedure that uses
echoes from sound waves
- provides visualization of body organs
- WITHHOLD food and fluids for 8 to 12
hours before the procedure
 Liver Biopsy
- invasive procedure using needle for
the percutaneous removal of a small
amount of liver tissue
- Before the test, assess clotting studies
- During the test, hold the breath
- After the test, Right lateral position
Urinary System
 Urinalysis
- laboratory test for urine
- examines the color, appearance, pH,
specific gravity, protein, glucose,
ketones, RBCs, WBCs and casts
- OBTAIN first morning urine specimen
 Urine Culture and Sensitivity
- laboratory test for urine
- detects bacteria
- Collect midstream sample in sterile
container
 24-hour Urine Collection
- laboratory test for urine
- samples collected over 24 hours to
determine kidney function
- instruct the patient to void and note
time
- discard the first urine collected
 Blood Chemistry
- laboratory test of blood sample
- analysis for potassium, sodium,
calcium, phosphorus, glucose,
bicarbonate, BUN, creatinine, protein,
albumin, and osmolality
- check the site for bleeding
 Cystoscopy
- procedure using cystoscope to
visualize the bladder
- Check the patient’s urine for blood
clots after the procedure
 Renal Angiography
- procedure using injection of
radiopaque dye through a catheter
- examination of the renal arterial supply
- NOTE the patient’s allergies before the
procedure
Hematopoietic System
 Bone Marrow Examination
- percutaneous removal of bone marrow
- examines erythrocytes, leukocytes,
thrombocytes, and precursor cells
- GIVE analgesics or anxiolytics, as
ordered.
 Schilling Test
- administration of oral radioactive
cyanocobalamin and I.M.
cyanocobalamin
-microscopic examination of 24-hour
urine sample of cyanocobalamin
- WITHHOLD food and fluids post HS