Triads
| Triad Name | Condition / Context | Components of the Triad | Clinical Relevance |
|---|---|---|---|
| ASA / Samter’s triad | Aspirin-exacerbated respiratory disease | – Asthma – Chronic rhinosinusitis with nasal polyps – Sensitivity to aspirin/NSAIDs | Predicts severe airway disease; avoid COX-1 NSAIDs, consider leukotriene antagonists |
| Beck’s triad | Acute cardiac tamponade | – Hypotension – Jugular venous distension – Muffled heart sounds | Emergent pericardiocentesis |
| Carcinoid triad | Carcinoid syndrome | – Flushing – Wheezing/bronchospasm – Diarrhoea | Suggests serotonin-secreting tumour; confirm with 24-h urinary 5-HIAA |
| Charcot’s biliary triad | Acute ascending cholangitis | – Fever – Jaundice – Right-upper-quadrant pain | Requires urgent biliary drainage ± antibiotics |
| Charcot’s neurologic triad | Multiple sclerosis | – Nystagmus – Intention tremor – Scanning (staccato) speech | Historical; MRI now diagnostic but triad aids recognition |
| Cushing’s triad | Raised intracranial pressure / brain herniation | – Hypertension (↑ PP) – Bradycardia – Irregular respirations | Pre-terminal sign; demands rapid neurocritical care |
| Heinrich’s / Whipple’s triad | Hypoglycaemia (esp. insulinoma) | – Symptoms of hypoglycaemia – Documented low plasma glucose – Relief after glucose | Core requirement before labelling “true” hypoglycaemia |
| Horner’s triad | Cervical sympathetic chain lesion | – Ptosis – Miosis – Anhidrosis (± facial flushing) | Localises lesion anywhere from hypothalamus to apex of lung |
| Hutchinson’s triad | Late congenital syphilis | – Sensorineural deafness – Interstitial keratitis – Peg-shaped (Hutchinson) incisors | Screen mother/infant; lifelong ocular & auditory follow-up |
| Kernig–Brudzinski triad (classically taught) | Meningeal irritation | – Fever – Neck stiffness – Altered sensorium | Modern practice adds headache & photophobia; needs urgent CSF |
| Menière’s triad | Menière’s disease | – Episodic vertigo – Tinnitus – Fluctuating sensorineural hearing loss | Salt restriction, diuretics, vestibular rehab |
| Murphy’s triad (obsolete term) | Appendicitis | – Pain – Vomiting – Fever | Superseded by Alvarado score & imaging |
| Pentalogy of Fallot (actually triad + 2) | Cyanotic congenital heart disease | – VSD, RV outflow obstruction, overriding aorta plus ASD & RV hypertrophy | Surgical repair in infancy |
| Reiter’s “classic” triad | Reactive arthritis | – Arthritis – Non-gonococcal urethritis – Conjunctivitis | HLA-B27 linkage; treat chlamydial or GI trigger |
| Trotter’s triad | Nasopharyngeal carcinoma | – Conductive deafness – Ipsilateral immobility of soft palate – Trigeminal neuralgia (V3) | Prompt ENT referral for biopsy |
| Virchow’s triad | Venous thrombosis pathogenesis | – Endothelial injury – Blood stasis – Hypercoagulability | Framework for DVT risk stratification & prophylaxis |
| Wernicke’s triad | Wernicke encephalopathy (thiamine deficiency) | – Ophthalmoplegia/nystagmus – Ataxia – Confusion | Give IV thiamine before glucose in malnourished/alcohol-use patients |