Red flag symptoms

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Symptoms, which if present, raise the possibility of serious or treatable disease.

For instance, bladder dysfunction in back pain with bilateral sciaticia should prompt urgent exclusion of cauda equina syndrome by examination for saddle analgesia and onwards urgent imaging. Similarly, some symptoms such as a change in bowel habit or abdominal bloating can non-specifically suggest cancer and may warrant further assessment, even with such low specificity, as they can precede other more specific symptoms by many months. Abdominal pain in the context of hyponatraemia and hypertension suggests screening for acute intermittent porphyria.

Headache

Some red flags are:

  • Sudden onset never before so severe
  • Occipital - consider posterior fossa lesion or if posterior neck tenderness cranial arteritis
  • Crescendo
  • Diurnal pattern
  • Scalp tenderness -cranial arteritis
  • Vomiting
  • Fever
  • Rash
  • Young obese female - check for signs of idiopathic intracranial hypertension
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