Symptomatic When a disease is evidenced by symptoms it is known as
symptomatic. There are many conditions including
subclinical infections that display no symptoms, and these are termed
asymptomatic. Signs and symptoms may be mild or severe, brief or longer-lasting when they may become reduced (
remission), or then recur (
relapse or
recrudescence) known as a
flare-up. A flare-up may show more severe symptoms. The term
chief complaint, also "presenting problem", is used to describe the initial concern of an individual when seeking medical help, and once this is clearly noted a
history of the present illness may be taken. The symptom that ultimately leads to a
diagnosis is called a cardinal symptom. Some symptoms can be misleading as a result of
referred pain, where for example a pain in the right shoulder may be due to
an inflamed gallbladder and not to presumed muscle strain.
Prodrome Many diseases have an early
prodromal stage where a few signs and symptoms may suggest the presence of a disorder before further specific symptoms may emerge.
Measles for example has a prodromal presentation that includes a hacking cough, fever, and
Koplik's spots in the mouth. Over half of
migraine episodes have a prodromal phase.
Schizophrenia has a notable prodromal stage, as has
dementia.
Nonspecific symptoms Some symptoms are
specific, that is, they are associated with a single, specific medical condition.
Nonspecific symptoms, sometimes also called
equivocal symptoms, are not specific to a particular condition. They include unexplained weight loss, headache, pain, fatigue, loss of appetite, night sweats, and
malaise. A group of three particular nonspecific symptoms – fever, night sweats, and weight loss – over a period of six months are termed
B symptoms associated with
lymphoma and indicate a poor prognosis. Other sub-types of symptoms include: •
constitutional or
general symptoms, which affect general well-being or the whole body, such as a fever; •
concomitant symptoms, which are symptoms that occur at the same time as the primary symptom; •
prodromal symptoms, which are the first symptoms of a bigger set of problems; •
delayed symptoms, which happen some time after the trigger; and •
objective symptoms, which are symptoms whose existence can be observed and confirmed by a healthcare provider.
Vital signs Vital signs are the four signs that can give an immediate measurement of the body's overall functioning and health status. They are
temperature,
heart rate,
breathing rate, and
blood pressure. The
ranges of these measurements vary with age, weight, gender and with general health.
Syndromes Many conditions are indicated by a group of known signs, or signs and symptoms. These can be a group of three known as a triad; a group of four ("tetrad"); or a group of five ("pentad"). An example of a triad is
Meltzer's triad presenting
purpura (a rash),
arthralgia (painful joints), and
myalgia (painful and weak muscles). Meltzer's triad indicates the condition
cryoglobulinemia.
Huntington's disease is a
neurodegenerative disease that is characterized by a triad of motor, cognitive, and psychiatric signs and symptoms. A large number of these groups that can be characteristic of a particular disease are known as a
syndrome.
Noonan syndrome for example, has a diagnostic set of unique facial and musculoskeletal features. Some syndromes such as
nephrotic syndrome may have a number of underlying causes that are all related to diseases that affect the
kidneys. Sometimes a child or young adult may have symptoms suggestive of a
genetic disorder that cannot be
identified even after
genetic testing. In such cases the term
SWAN (syndrome without a name) may be used. Often a diagnosis may be made at some future point when other more specific symptoms emerge but many cases may remain undiagnosed. The inability to diagnose may be due to a unique combination of symptoms or an overlap of conditions, or to the symptoms being atypical of a known disorder, or to the disorder being extremely rare. It is possible that a person with a particular syndrome might not display every single one of the signs and/or symptoms that compose/define a syndrome.
Positive and negative Sensory symptoms can also be described as
positive symptoms, or as
negative symptoms depending on whether the symptom is abnormally present such as tingling or itchiness, or abnormally absent such as
loss of smell. The following terms are used for negative symptoms:
hypoesthesia is a partial loss of sensitivity to moderate stimuli, such as pressure, touch, warmth, cold;
Anesthesia is the complete loss of sensitivity to stronger stimuli, such as pinprick;
Hypoalgesia (analgesia) is loss of sensation to painful stimuli. Symptoms are also grouped into negative and positive for some
mental disorders such as
schizophrenia.
Positive symptoms are those that are present in the disorder and are not normally experienced by most individuals and reflect an excess or distortion of normal functions; examples are
hallucinations,
delusions, and bizarre behavior.
Negative symptoms are functions that are normally found but that are diminished or absent, such as in
apathy and
anhedonia. Those with the metabolic myopathy of
McArdle's disease (GSD-V) and some individuals with
phosphoglucomutase deficiency (CDG1T/GSD-XIV), initially experience exercise intolerance during mild to moderate aerobic exercise, but the symptoms alleviate after 6–10 minutes in what is known as "
second wind".
Neuropsychiatric Neuropsychiatric symptoms are present in many
degenerative disorders including
dementia, and
Parkinson's disease. Symptoms commonly include
apathy,
anxiety, and
depression.
Neurological and psychiatric symptoms are also present in some
genetic disorders such as
Wilson's disease. Symptoms of
executive dysfunction are often found in many disorders including
schizophrenia and
ADHD.
Radiologic Radiologic signs are abnormal
medical findings on
imaging scanning. These include the
Mickey Mouse sign and the
Golden S sign. When using imaging to find the cause of a complaint, another unrelated finding may be found known as an
incidental finding.
Cardinal Cardinal signs and symptoms are those that may be diagnostic, and
pathognomonic – of a certainty of diagnosis.
Inflammation for example has a recognised group of cardinal signs and symptoms, as does
exacerbations of chronic bronchitis, and
Parkinson's disease. In contrast to a pathognomonic cardinal sign, the absence of a sign or symptom can often rule out a condition. This is known by the Latin term
sine qua non. For example, the absence of known genetic mutations
specific for a
hereditary disease would rule out that disease. Another example is where the
vaginal pH is less than 4.5, a diagnosis of
bacterial vaginosis would be excluded.
Reflexes A
reflex is an automatic response in the body to a stimulus. Its absence, reduced (hypoactive), or exaggerated (hyperactive) response can be a sign of damage to the
central nervous system or
peripheral nervous system. In the
patellar reflex (knee-jerk) for example, its reduction or absence is known as
Westphal's sign and may indicate damage to
lower motor neurons. When the response is exaggerated damage to the
upper motor neurons may be indicated.
Facies A number of
medical conditions are associated with a distinctive facial expression or appearance known as a
facies. An example is
elfin facies which has facial features like those of the
elf, and this may be associated with
Williams syndrome or
Donohue syndrome. The most well-known facies is probably the
Hippocratic facies that is seen on a person as they near death.
Anamnestic signs Anamnestic signs (from
anamnēstikós, ἀναμνηστικός, "able to recall to mind") are signs that indicate a past condition, for example paralysis in an arm may indicate a past
stroke.
Asymptomatic Some diseases, including
cancers and infections, may be present but show no signs or symptoms and these are known as
asymptomatic. ==History==