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SYMPTOMS-SIGNS-INVESTIGATIONS WHICH ARE MORE IMPORTANT IN MAKING A DIAGNOSIS?

O P Kapoor
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

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Symptoms

There are certain diseases which are best diagnosed only by symptoms and might have no physical signs at all. The examples are:-
1. Angina pectoris - stable and unstable

2. Irritable bowel syndrome

3.Patients having allergic bronchial asthma

Signs

There are certain diseases which are diagnosed only by signs even if there are no symptoms at all:
1.Mitral stenosis and any rheumatic or congenital heart disease

2.Lymphadenopathy - the aetiology may be kochs or lymphoma.

3.Cirrhosis of the liver with or without portal hypertension.

Investigations

There are certain diseases which are diagnosed only by investigations. Such diseases are usually picked up by so-called "Executive Health Check up". Again depending on the number of "special investigations" each health check up offers more and more of these illnesses can be diagnosed.

Following are the examples:-
1.Silent diabetes mellitus or high lipids by blood chemistry.

2. A silent IHD by a TMT (Stress Test).

3.Mild hypothyroidism by a routine TSH level.

4.Health check up doing routine abdominal sonography will pick up many patients having silent gall stones, kidney stones or uterine fibroids or rarely even a silent cancer.

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