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A diagram of a human torso labelled with the most common symptoms of an acute HIV infection
Signos que incluyen (hígado y bazo agrandados) y síntomas (que incluyen dolor de cabeza y vómitos) de una infección aguda por VIH .

Los signos y síntomas son los signos observados o detectables y los síntomas experimentados de una enfermedad, lesión o afección. Un signo, por ejemplo, puede ser una temperatura más alta o más baja de lo normal, una presión arterial alta o baja o una anomalía que se muestra en una exploración médica . Un síntoma es algo fuera de lo común que experimenta un individuo, como tener fiebre, dolor de cabeza u otro dolor o dolores en el cuerpo. [1] [2]

Un signo médico es una indicación objetiva de una enfermedad, lesión o estado fisiológico anormal que puede detectarse durante un examen físico . [3] Estos signos son visibles o detectables, como una erupción o un hematoma . Los signos médicos ayudan a llegar a un diagnóstico preciso . Ejemplos de signos incluyen presión arterial elevada , uña en palillo de tambor de las uñas de las manos o de los pies, marcha tambaleante y arcus senilis y arcus juvenilis de los ojos. Un signo se distingue de una indicación.que es una razón específica para utilizar un tratamiento en particular . Un síntoma es algo que se siente o se experimenta, como dolor o mareos. Los signos y los síntomas no son mutuamente excluyentes, por ejemplo, una sensación subjetiva de fiebre puede notarse como un signo utilizando un termómetro que registre una lectura alta. [4]

Los signos y síntomas a menudo no son específicos, pero algunas combinaciones pueden sugerir ciertos diagnósticos , lo que ayuda a delimitar lo que puede estar mal. Un conjunto particular de signos y síntomas característicos que pueden estar asociados con un trastorno se conoce como síndrome . En los casos en los que se conoce la causa subyacente, el síndrome se denomina, por ejemplo, síndrome de Down y síndrome de Noonan . Otros síndromes, como el síndrome coronario agudo, pueden tener varias causas posibles.

En otros casos, cuando se conocen como signos y síntomas cardinales , son específicos hasta el punto de ser patognomónicos . Un signo cardinal o síntoma cardinal también puede referirse al signo o síntoma principal de una enfermedad. [5] Los reflejos anormales pueden indicar problemas con el sistema nervioso . Los signos y síntomas también se aplican a estados fisiológicos fuera del contexto de la enfermedad, como por ejemplo al referirse a los signos y síntomas del embarazo , o los síntomas de la deshidratación . A veces, una enfermedad puede estar presente sin mostrar ningún signo o síntoma cuando se la conoce como asintomática . [6]El trastorno se puede descubrir mediante pruebas que incluyen exploraciones. Una infección puede ser asintomática y aun así ser transmisible . [6]

Signos versus síntomas [ editar ]

Los signos son diferentes de los síntomas experimentados. Un signo de un trastorno es algo que puede ser observado por otra persona o detectado durante un examen o procedimiento médico. [3] Por ejemplo, la presión arterial alta se puede observar como un signo durante un examen para el cual no se han reportado síntomas. Un síntoma es algo experimentado y notificable por una persona, como dolor de cabeza o fatiga . Los signos y síntomas pueden superponerse, como hemorragia nasal, que el individuo experimenta como inusual (síntoma) y que otros observan (signo).

El CDC enumera varias enfermedades por sus signos y síntomas, como el sarampión, que incluye fiebre alta, conjuntivitis y tos , seguidos unos días después por la erupción del sarampión . [7]

Condiciones [ editar ]

Los signos y síntomas pueden ser leves o graves, breves o más duraderos cuando pueden reducirse ( remisión ) o luego reaparecer ( recaída o recrudescencia ), lo que se conoce como un brote . Un brote puede mostrar síntomas más graves. [8]

El término queja principal , también "problema de presentación", se usa para describir la preocupación inicial de un individuo cuando busca ayuda médica, y una vez que esto se nota claramente, se puede tomar un historial de la enfermedad actual . El síntoma que finalmente conduce a un diagnóstico se llama síntoma cardinal.

Algunos síntomas pueden ser engañosos como resultado de un dolor referido , donde, por ejemplo, un dolor en el hombro derecho puede deberse a una vesícula biliar inflamada y no a una presunta distensión muscular.

Pródromo [ editar ]

Muchas enfermedades tienen una etapa prodrómica temprana en la que algunos signos y síntomas pueden sugerir la presencia de un trastorno antes de que surjan otros síntomas específicos. El sarampión, por ejemplo, tiene una presentación prodrómica que incluye tos seca, fiebre y manchas de Koplik en la boca. [9] Más de la mitad de los episodios de migraña tienen una fase prodrómica. [10] La esquizofrenia tiene una etapa prodrómica notable, [11] al igual que la demencia . [12]

Síntomas inespecíficos [ editar ]

Los síntomas inespecíficos son muy generales y pueden asociarse con una amplia gama de afecciones. También se conocen como síntomas constitucionales cuando afectan la sensación de bienestar. Los síntomas incluyen pérdida de peso, dolor de cabeza, dolor, fatiga, pérdida de apetito, sudores nocturnos y malestar. [13] Un síntoma constitucional puede ser primario o secundario.

Signos vitales [ editar ]

Los signos vitales son los cuatro signos que pueden dar una medida inmediata del funcionamiento general y el estado de salud del cuerpo. Son temperatura , ritmo cardíaco , ritmo respiratorio , y la presión arterial . Los rangos de estas medidas varían con la edad, el peso, el sexo y la salud en general.

Se ha desarrollado una aplicación digital para su uso en entornos clínicos que mide tres de los signos vitales (no la temperatura) utilizando solo un teléfono inteligente y ha sido aprobada por el NHS de Inglaterra . La aplicación está registrada como Lifelight First , y Lifelight Home está en desarrollo (2020) para el uso de monitoreo por parte de las personas en el hogar que usan solo la cámara de su teléfono inteligente o tableta. Esto medirá además la saturación de oxígeno y la fibrilación auricular . Entonces no se necesitan otros dispositivos. [14]

Síndromes [ editar ]

Más información: Lista de síndromes y Lista de tríadas, tétradas y pentadas médicas

Muchas afecciones están indicadas por un grupo de signos o signos y síntomas conocidos. Estos pueden ser un grupo de tres conocido como tríada; un grupo de cuatro conocido como tétrada y un grupo de cinco conocido como petrada. Un ejemplo de tríada es la tríada de Meltzer que presenta púrpura como una erupción, artralgia dolorosa en las articulaciones y mialgia dolorosa y músculos débiles. La tríada de Meltzer indica la condición de crioglobulinemia . La enfermedad de Huntington es una enfermedad neurodegenerativa que se caracteriza por una tríada de signos y síntomas motores, cognitivos y psiquiátricos. [15] Un gran número de estos grupos que pueden ser característicos de una enfermedad en particular se conocen comosyndrome. Noonan syndrome for example, has a diagnostic set of unique facial and musculoskeletal features.[16] Some syndromes such as nephrotic syndrome may have a number of underlying causes that are all related to diseases that affect the kidneys.[17]

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.[18]

Positive and negative[edit]

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.[19]Symptoms are also grouped in to negative and positive for some mental disorders such as schizophrenia.[20] Positive symptoms are those that are present in the disorder and are not normally experienced by most individuals and reflects an excess or distortion of normal functions.[21] Examples are hallucinations, delusions, and bizarre behavior. Negative symptoms are functions that are normally found but that are diminished or absent such as apathy and anhedonia.[21]

Neuropsychiatric[edit]

Neuropsychiatric symptoms are present in many degenerative disorders including dementia, and Parkinson's disease. Symptoms commonly include apathy, anxiety, and depression.[22] Neurological and psychiatric symptoms are also present in some genetic disorders such as Wilson's disease.[23] Executive dysfunction is an often found symptom in many disorders including schizophrenia, and ADHD.

Radiologic[edit]

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.[24]

Cardinal[edit]

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,[25] as does exacerbations of chronic bronchitis,[26] 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.[27] Another example is where the vaginal pH is less than 4.5, a diagnosis of bacterial vaginosis would be excluded.[28]

Reflexes[edit]

A reflex is an automatic response in the body to a stimulus.[29] 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[edit]

A number of medical conditions are associated with a distinctive facial expression or appearance known as a facies[30] 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.[31]

Anamnestic signs[edit]

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.[32]:81

Asymptomatic[edit]

Some diseases including cancers, and infections may be present but show no signs or symptoms and these are known as asymptomatic.[6] A gallstone may be asymptomatic and only discovered as an incidental finding.[6] Easily spreadable viral infections such as COVID-19 may be asymptomatic but may still be transmissible.[33]

History[edit]

Symptomatology[edit]

A symptom (from Greek σύμπτωμα, "accident, misfortune, that which befalls",[34] from συμπίπτω, "I befall", from συν- "together, with" and πίπτω, "I fall") is a departure from normal function or feeling. Symptomatology (also called semiology) is a branch of medicine dealing with the signs and symptoms of a disease.[35][36][37] This study also includes the indications of a disease.[38] It was first described as semiotics by Henry Stubbe in 1670 a term now used for the study of sign communication.

Prior to the nineteenth century there was little difference in the powers of observation between physician and patient. Most medical practice was conducted as a co-operative interaction between the physician and patient; this was gradually replaced by a "monolithic consensus of opinion imposed from within the community of medical investigators".[39][40] Whilst each noticed much the same things, the physician had a more informed interpretation of those things: "the physicians knew what the findings meant and the layman did not".[32]:82

Development of medical testing[edit]

Further information: Medical test

A number of advances introduced mostly in the 19th century, allowed for more objective assessment by the physician in search of a diagnosis, and less need of input from the patient.[39][40][41] During the 20th century the introduction of a wide range of imaging techniques have made a huge impact on diagnostic capability. Other developments in the field of genetics, medical biochemistry, and molecular diagnostics have also played major roles.

  • In 1761 the percussion technique for diagnosing respiratory conditions was discovered by Leopold Auenbrugger.[42] This method of tapping body cavities to note any abnormal sounds had already been in practice for a long time in cardiology.[42] Percussion of the thorax became more widely known after 1808 with the translation of Auenbrugger's work from Latin into French by Jean-Nicolas Corvisart.
  • In 1819 the introduction of the stethoscope by René Laennec began to replace the centuries old technique of immediate auscultation – listening to the heart by placing the ear directly on the chest, with mediate auscultation using the stethoscope to listen to the sounds of the heart and respiratory tract. Laennec's publication was translated into English, 1821–1834, by John Forbes
  • The 1846 introduction by surgeon John Hutchinson (1811–1861) of the spirometer, an apparatus for assessing the mechanical properties of the lungs via measurements of forced exhalation and forced inhalation. (The recorded lung volumes and air flow rates are used to distinguish between restrictive disease (in which the lung volumes are decreased: e.g., cystic fibrosis) and obstructive diseases (in which the lung volume is normal but the air flow rate is impeded; e.g., emphysema).)
  • The 1851 invention by Hermann von Helmholtz (1821–1894) of the ophthalmoscope, which allowed physicians to examine the inside of the human eye.
  • The (c. 1870) immediate widespread clinical use of Sir Thomas Clifford Allbutt's (1836–1925) six-inch (rather than twelve-inch) pocket clinical thermometer, which he had devised in 1867.[43]
  • The 1882 introduction of bacterial cultures by Robert Koch, initially for tuberculosis, being the first laboratory test to confirm bacterial infections.
  • The 1895 clinical use of X-rays which began almost immediately after they had been discovered that year by Wilhelm Conrad Röntgen (1845–1923).
  • The 1896 introduction of the sphygmomanometer, designed by Scipione Riva-Rocci (1863–1937), to measure blood pressure.

Diagnosis[edit]

The recognition of signs, and noting of symptoms may lead to a diagnosis. Otherwise a physical examination may be carried out, and a medical history taken. Further diagnostic medical tests such as blood tests, scans, and biopsies, may be needed. An X-ray for example would soon be diagnostic or not of a bone fracture. A noted significance detected during an examiniation or from a medical test may be known as a medical finding.[44]

Examples of signs and symptoms[edit]

See also: List of eponymous medical signs
Further information: List of medical symptoms § Medical signs and symptoms

See also[edit]

  • Biomarker (medicine)
  • Focal neurologic signs

References[edit]

  1. ^ "Beyond Intuition: Quantifying and Understanding the Signs and Symptoms of Fever". clinicaltrials.gov. 5 October 2017. Retrieved 9 January 2021.
  2. ^ "Symptoms and self-help guides by body part | NHS inform". www.nhsinform.scot. Retrieved 9 January 2021.
  3. ^ a b "Definition of SIGN". www.merriam-webster.com.
  4. ^ Marie T. O'Toole, ed., Mosby's Medical Dictionary, 9th ed. (St. Louis, MO: Elsevier/Mosby, 2013), Kindle loc. 154641. ISBN 9780323085410
  5. ^ Basu, S; Sahi, PK (July 2017). "Malaria: An Update". Indian Journal of Pediatrics. 84 (7): 521–528. doi:10.1007/s12098-017-2332-2. PMID 28357581. S2CID 11461451.
  6. ^ a b c d "Definition of ASYMPTOMATIC". www.merriam-webster.com.
  7. ^ "Measles Signs and Symptoms". Centers for Disease Control and Prevention. 5 November 2020. Retrieved 31 December 2020.
  8. ^ Shiel, William C. Jr. (20 June 2019). "Definition of Flare". MedicineNet. Retrieved 21 December 2019.
  9. ^ "Measles - Pediatrics". MSD Manual Professional Edition. Retrieved 2 March 2021.
  10. ^ Lynn DJ, Newton HB, Rae-Grant A (2004). The 5-minute neurology consult. Philadelphia: Lippincott Williams & Wilkins. p. 26. ISBN 9780683307238. Archived from the original on 13 March 2017.
  11. ^ Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. 2013. pp. 99–105. ISBN 978-0-89042-555-8.
  12. ^ Sherman C, Liu CS, Herrmann N, Lanctôt KL (February 2018). "Prevalence, neurobiology, and treatments for apathy in prodromal dementia". Int Psychogeriatr. 30 (2): 177–184. doi:10.1017/S1041610217000527. PMID 28416030. S2CID 46788701.
  13. ^ "Constitutional symptom (Concept Id: C0009812) - MedGen - NCBI". www.ncbi.nlm.nih.gov. Retrieved 25 March 2021.
  14. ^ "Solution". Lifelight. Retrieved 2 February 2021.
  15. ^ Jensen RN, Bolwig T, Sørensen SA (March 2018). "[Psychiatric symptoms in patients with Huntington's disease]". Ugeskr Laeger (in Danish). 180 (13). PMID 29587954.
  16. ^ "Noonan syndrome: MedlinePlus Genetics". medlineplus.gov. Retrieved 2 February 2021.
  17. ^ "Nephrotic Syndrome in Adults | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 3 March 2021.
  18. ^ "What does SWAN or being undiagnosed mean? | SWAN UK". www.undiagnosed.org.uk. Retrieved 3 March 2021.
  19. ^ Harrison's Principles of Internal Medicine, 19th edition, Chapter 31: Numbness, Tingling, and Sensory Loss
  20. ^ "Mental Health: a Report from the Surgeon General". Surgeongeneral.gov. 1999. Archived from the original on 11 January 2012. Retrieved 17 December 2011.
  21. ^ a b Understanding Psychosis Archived 2012-12-25 at the Wayback Machine, Mental Health Illness of Australia.
  22. ^ Mueller, C; Rajkumar, AP; Wan, YM; Velayudhan, L; Ffytche, D; Chaudhuri, KR; Aarsland, D (July 2018). "Assessment and Management of Neuropsychiatric Symptoms in Parkinson's Disease". CNS Drugs. 32 (7): 621–635. doi:10.1007/s40263-018-0540-6. PMID 30027401. S2CID 51701905.
  23. ^ "Symptoms & Causes | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 10 March 2021.
  24. ^ O'Sullivan, JW; Muntinga, T; Grigg, S; Ioannidis, JPA (18 June 2018). "Prevalence and outcomes of incidental imaging findings: umbrella review". BMJ. 361: k2387. doi:10.1136/bmj.k2387. PMC 6283350. PMID 29914908.
  25. ^ Freire, MO; Van Dyke, TE (October 2013). "Natural resolution of inflammation". Periodontology 2000. 63 (1): 149–64. doi:10.1111/prd.12034. PMC 4022040. PMID 23931059.
  26. ^ Archived 2006-04-06 at the Wayback Machine
  27. ^ Lynch HT, Lynch JF, Lynch PM, Attard T (2008). "Hereditary colorectal cancer syndromes: molecular genetics, genetic counseling, diagnosis and management". Fam Cancer. 7 (1): 27–39. doi:10.1007/s10689-007-9165-5. PMID 17999161. S2CID 20103607.
  28. ^ Mańka W, Adrianowicz L, Wesołek Z, Adrianowicz K (2002). "[The value of determining vaginal secretion reaction (pH) as a screening test of bacterial vaginosis]". Wiad Lek (in Polish). 55 (1–2): 51–5. PMID 12043316.
  29. ^ "Definition of REFLEX". www.merriam-webster.com.
  30. ^ "Definition of FACIES". www.merriam-webster.com. Retrieved 4 February 2021.
  31. ^ Chadwick, J. & Mann, W.N.(trans.) (1978). Hippocratic writings. Harmondsworth, UK: Penguin. pp. 170–71. ISBN 0-14-044451-3.CS1 maint: multiple names: authors list (link)
  32. ^ a b King, Lester S. (1982). Medical Thinking: A Historical Preface. Princeton, NJ: Princeton University Press. ISBN 0-691-08297-9.
  33. ^ Sayampanathan, Andrew A.; Heng, Cheryl S.; Pin; et al. (9 January 2021). "Infectivity of asymptomatic versus symptomatic COVID-19". The Lancet. 397 (10269): 93–94. doi:10.1016/S0140-6736(20)32651-9. PMC 7836843. PMID 33347812.
  34. ^ "Sumptoma, Henry George Liddell, Robert Scott, A Greek-English Lexicon, at Pursues". Perseus.tufts.edu. Retrieved 17 December 2011.
  35. ^ The British Medical Association (BMA) (2002). Illustrated Medical Dictionary. A Dorling Kindersley Book. p. 406. ISBN 978-0-75-133383-1.
  36. ^ "Definition of SYMPTOMATOLOGY". www.merriam-webster.com. Retrieved 9 January 2021.
  37. ^ "Definition of SEMIOLOGY". www.merriam-webster.com. Retrieved 9 January 2021.
  38. ^ David A. Bedworth, Albert E. Bedworth (2010). The Dictionary of Health Education. Oxford University Press. p. 484. ISBN 978-0-19-534259-8. Archived from the original on 9 May 2018.
  39. ^ a b Jewson, N.D., "Medical Knowledge and the Patronage System in 18th Century England Archived 7 March 2009 at the Wayback Machine", Sociology, Vol. 8, No. 3 (1974), pp. 369–85.
  40. ^ a b Jewson, N.D., "The Disappearance of the Sick Man from Medical Cosmology, 1770–1870 Archived 16 March 2009 at the Wayback Machine", Sociology, Vol. 10, No. 2, (1976), pp. 225–44.
  41. ^ Tsouyopoulos N (1988). "The mind-body problem in medicine (the crisis of medical anthropology and its historical preconditions)". Hist Philos Life Sci. 10 Suppl: 55–74. PMID 3413276.
  42. ^ a b Bedford DE (November 1971). "Auenbrugger's contribution to cardiology. History of percussion of the heart". Br Heart J. 33 (6): 817–21. doi:10.1136/hrt.33.6.817. PMC 458433. PMID 4256273.
  43. ^ Allbutt, T.C., "Medical Thermometry", British and Foreign Medico-Chirurgical Review, Vol. 45, No. 90, (April 1870), pp. 429–41; Vol. 46, No. 91, (July 1870), pp. 144–56.
  44. ^ "finding". The Free Dictionary. Retrieved 1 March 2021.

External links[edit]