Synonyms: Faget sign, Sphygmo-thermic dissociation, Sphygmo-thermal dissociation Definition of Relative Bradycardia Physiologically, for each 1 °F rise in body temperature, there is a commensurate increase in the heart rate of 10 beats/min . When temperature elevations are not accompanied by a physiologic increase in the pulse, the patient is said…
Category: Clinical Skills and Approaches
History taking and examination skills and Flowchart approaches to commonly encountered medical conditions and diseases.
Clinical Skills and Approaches 
Diabetic Ketosis without Acidosis
Ketosis and Ketonuria Ketosis and Ketonuria may occur whenever increased amounts of fat are metabolized, carbohydrate intake is restricted, or the diet rich in fats (either “hidden” or obvious). This state can occur in the following situations: a. Metabolic conditions: Diabetes mellitus Renal glycosuria Glycogen storage disease (von Gierke’s disease)…
Clinical Skills and Approaches 
Tests for Knee Ligaments
Anterior Cruciate Ligament (ACL) Lacchman’s test It is performed with the patient supine and the knee flexed 20–30°. The examiner grasps the distal femur (from lateral side) with one hand and the proximal tibia with the other hand (from medial side). The lower leg is given a brisk forward tug…
Clinical Skills and Approaches 
Hot Potato Voice
Synonyms: Hot potato speech, Potato in mouth It is a term for a defect of resonance in which the speech has muffled quality, fancifully likened to a person speaking with a (very) hot potato in their mouth. Mechanism of Hot Potato Voice: Hot potato voice is the result of an…
Clinical Skills and Approaches 
Folstein Mini-Mental State Examination (MMSE): Mnemonic
ORARL, 5-3-5-3-9 1. Orientation: Time (5 points – 1 for each correct): What is the: (year) (season) (date) (day) (month)? Place (5 points – 1 for each correct): Where are we: (state) (county) (town) (hospital) (floor)? 2. Registration: Name three objects, ask patient to repeat (3 points – 1 for each on first…
Clinical Skills and Approaches 
Medical Significance of Bedbugs
Two species of bedbugs bite people: the common bedbug (Cimex lenticularis) and the tropical bedbug (Cimex hemipterous). These bugs are called udus (उडुस) in Nepali and khatmal (खटमल) in Hindi language. The adult bedbug is the approximate size, shape, and color of an apple seed. They are more commonly associated…
Clinical Skills and Approaches 
Percussion of Spleen
Traube’s semilunar space Borders: Superiorly: Left 6th rib superiorly Laterally: Left midaxillary line or Left anterior axillary line Inferiorly: Left costal margin Method: Patient’s position: supine with left arm slightly abducted. Percuss: from medial to lateral Interpretation: Resonance (Normal) and Dullness (Splenomegaly) Also: Pleural effusion or mass in stomach may…
Clinical Skills and Approaches 
Milkmaid’s grip in Chorea
Milkmaid’s Grip Milk maids grip is appreciated as an alternating squeezing and releasing of the finger like a milking motion, when asked to maintain a constant, firm grip of examiner’s fingers. This may reflect a combination of Chorea and Motor impersistence. As a result of poor grip, patients often involuntarily…