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• Unexplained weight loss

Weight loss when it is unexplained should be a serious concern. Many conditions may be responsible, such as an overactive thyroid (hyperthyroidism) or a disorder in the absorption of food (malabsorption syndrome), diabetes mellitus, cancer, liver disease, depression, etc.

• Persistent or high fever

Fever is the most obvious symptom of an infection, most commonly caused by viruses or bacteria. Of course, autoimmune diseases or malignant neoplasms also cause fever. Particular attention should be paid if there is an embolic or hemorrhagic rash, an episode of convulsions, a severe cough with chest pain or chills and it does not respond to antipyretic drugs. Also, be careful if the fever lasts more than 3 days.

• Respiratory distress

It may be a symptom of an asthma attack, chronic obstructive pulmonary disease, pulmonary embolism, myocardial infarction, or pneumothorax. Of particular importance is the acute onset and the feeling of anxiety. A feeling of shortness of breath can be caused by a panic attack.

• Unexplained changes in bowel habits and stool pattern

Changes in stool pattern may indicate infection with parasites, viruses, or bacteria such as Campylobacter, Salmonella, and more rarely Shigella and Yersinia. Persistent diarrhea and persistent constipation require medical investigation. Bleeding from the intestine may be associated with intestinal polyps, colon cancer, or inflammatory bowel disease. Blood in the stool in the neonatal-infant period is reminiscent of a cow’s milk allergy. When associated with acute anxiety, it may be associated with intussusception or intestinal torsion.

• Feeling full after an extremely small meal.

Especially if associated with weight loss, a feeling of heartburn, fullness of the stomach, nausea and vomiting, it may indicate reflux disease, an ulcer or stomach cancer. In the best case scenario, they are due to functional digestive disorders.

• Flashes of light

Light spots or flashes of light may be characteristic manifestations of a migraine episode, the nature of which the sufferer recognizes from similar episodes in the past. Much more seriously, however, the flashes may signal retinal detachment.

• Headache that interrupts sleep or occurs with morning awakening accompanied by vomiting

Headache with the above characteristics may indicate a stroke, subarachnoid hemorrhage, hypertensive crisis, increased cerebrospinal fluid pressure due to a brain tumor or other process, or benign intracranial hypertension (pseudotumor cerebri). In these cases, a Magnetic Resonance Imaging (MRI) or CT scan is mandatory.

• Persistent nosebleeds or recurrent nosebleeds or unexplained skin bruises or purpuric rash

Usually nosebleeds subside within a few minutes after applying pressure with the thumb and index finger. Otherwise, nasal endoscopy is needed or thrombocytopenia or blood clotting disorders or hematological malignancies may be hidden.

• Persistent hoarseness

Usually external irritants or viral infections last a few days. Otherwise, recurrent disease, vocal cord damage from HPV viruses or malignant transformation may be hidden. However, immediate laryngoscopy is required.

• Bone pain with nocturnal exacerbation

Clearly localized bone pain that worsens at night or limits movement requires immediate investigation because it may conceal locally developing malignancy or metastatic disease.