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44 Cards in this Set
- Front
- Back
What's the dx? et? associations?
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Dx: palmar erythema
Et: Deep telengiectasias Assoc: Chronic liver disease and pregnancy |
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What is the finger length in males? females?
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Males: typically the ring finger is longer than or the same length as index finger
Females: typically the index finger is longer than or the same length as ring finger. |
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What's the dx? et?
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Dx: pseudohypoparathyroidism
Et: Congenital end-organ unresponsiveness to PTH; causes 4th and 5th fingers to be shorter due to shortening of the metacarpals. |
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What's the dx? assoc?
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Dx: arachnodactyly
Assoc: commonly associated w/ Marfan's syndrome |
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How can you differentiate b/e the slender digits of a Marfan's patient and a patient who is just slender?
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A positive thumb sign (steinberg sign)
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When is a steinberg sign (thumb sign) positive?
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When the fingers are clenched over the thumb and the end of the thumb protrudes beyond the hypothenar eminence.
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What is a positive wrist sign?
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When the pt. encircles wrist w/ thumb and little finger just prox. to styloid process of ulna and the thumb/little finger overlap by 1-2cm.
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What is the paronchyia?
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The soft tissue surrounding the nail border.
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How quickly do fingernails grow?
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about .1 mm/day and take ~6 months to grow from base to tip
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What is the eponychium?
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The stratum corneum layer of skin covering the nerve root. aka the cuticle
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How can you tell the dominant hand from the thumbnail?
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The dominant hand thumbnail will have a wider base and the angles formed by the base and the lateral aspects of the nail are usually more obtuse
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What is lovibond's angle?
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The nail forms an angle w/ the skin proximal to the nail that is usually 150 degrees
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What is clubbing?
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A painless enlargement of the terminal phalanges that results when the nail bed overgrows and pushes the proximal nail upward.
Increases Lovibond's angle to > 180 degrees, and increases the interphalangeal depth ratio to > 1.0 |
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What is a positive shamroth sign? what does it dx?
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Positive shamroth sign abolishes the diamond-shaped window seen in normal fingers.
Dx: clubbing |
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What do spongy nails feel like?
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A spongy or floating quality
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What is the probable etiology of clubbing?
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When platelets aggregate and megakaryocytes become trapped in the distal digits and release a variety of platelet-derived growth factors that stimulate tissue proliferation.
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What happens when clubbing and periosteal new bone formation occur? what is this a manifestation of?
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Hypertrophic osteoarthropathy.
A manifestation of bronchogenic squamous cell carcinoma |
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What is the dx? Et?
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Dx: Mees nails
Et: Arsenic poisoning or serious illness such as sepsis, acute renal failure, MI or physical/emotional shock |
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What is the dx? et?
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Dx: Beau's lines
Et: Serious illnesses such as sepsis, acute renal failure, MI or physical/emotional shock Difference b/e Mee's and Beau's nails is Mees' nails only have one transverse ridge, Beau's nails have RIDGES |
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What's the dx? Et?
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Dx: nail pitting
Et: PSORIASIS or as a result of focal trauma to nail plate |
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What's the dx? et?
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Dx: lindsay nail ("half and half nail")
Et: occurs in pts w/ renal failure |
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What's the dx? et?
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Dx: Terry's nail
Et: chronic hepatic cirrhosis |
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What's the Dx? Et?
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Dx: Terry's nail type 2
Et: Congestive Heart Failure |
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What's the Dx? Et? interesting factors? Associations?
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Dx: Muehrcke's Lines
Et: Hypoalbuminemia IF: White bands are not in the nail plate and so they do not move distally w/ nail growth Associations: Look for edema! |
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What's the Dx? Et?
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Dx: Leukonychia Punctata
Et: minor injury/manipulation of nail plate *resolve spontaneously |
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What's the Dx? Et?
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Dx: Onychorrhexis
Et: Radiation |
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What's the Dx? Et?
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Dx: Onycholysis
Et: Hyperthyroidism and Fungal infection *separation of the nail plate from the nail bed at its distal and lateral attachments. |
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What's the dx? et? associations?
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Dx: koilonychia ("spoon nails")
Et: Iron deficiency anemia Assoc: Blood loss and iron deficiency. So look for blood in stool |
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What causes yellow nails? associations?
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Et: lung carcinoma and lymphatic obstruction
Associations: Exudative pleural effusion |
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What is onychomycosis?
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A nail infection that is caused by any fungus
Causes the nail to be thicker from the accumulation of debris |
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What's the dx? et?
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Dx: onychomychosis
Et: Fungal infection |
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How can you distinguish onychomycosis from psoriasis?
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Onychomycosis does NOT have pitting, psoriasis does
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What's the Dx? Et?
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Dx: splinter hemorrhage
Et: Infectious Endocarditis (a bacterial infection on a heart valve) trichinosis and manual labor |
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What is paronychia?
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Inflammation of the paronychium
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What's the dx? et?
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Dx: Paronychia
Et: Bacterial invasion b/e nail fold and nail plate |
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What is a ingrown nail?
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When the nail pierces the lateral nail fold and grows into the dermis
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What's the Dx? Et?
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Dx: Ingrown nail
Et: poor fitting shoes or excessive trimming of lateral nail plate. |
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What is a subungual hematoma?
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Trauma to the nail plate causing bleeding and severe pain
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What's the Dx? Et? Tx?
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Dx: Subungual hematoma
Et: Trauma Tx: Hematoma will remain until the nail grows out or is decompressed |
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What's the Dx?
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Dx: subungual melanoma
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What should a subungual hematoma be distinguished from?
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A subungual melanoma
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What effect on breast would hypothyroidism have? benzodiazipines?
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Could cause milk discharge
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If there is trauma to the nail that damages the nail root will the nail grow back?
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Probably not, maybe, but probably not
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What underlying diseases could cause this sign?
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Heart disease/disorders, Lung disease/disorders,
ulcerative colitis and hyperthyroidism |
