fingernail quiz res1modified top copy

7/30/2019 Fingernail Quiz Res1modified Top Copy

1/79

Fingernail Quiz Res1

pl 2010


2/79

Here is a little quiz which I hope you will enjoy and should

be educational too!

Medicine is a lot of fun as well as being a hard slog

Go thro the slides and write down what you see and

medical conditions the nail changes are associated with

The second part of the PP presentation gives the slides

again with the answers

You may find you will be able to catch out some of your

tutors. Probably the physcians not the surgeons!!

Modified from Medscapethanks to them


3/79


4/79


5/79

Fingernail abnormalities are commonly

caused by skin diseases + infections

but

May also indicate more general medical

causes

Here are some examples: describe thechanges seen and the possible cause [s]


6/79

No 1


7/79

No 2


8/79

No 3


9/79

No 4


10/79

No 5


11/79

No6


12/79

No 7


13/79

No 8


14/79

No 9


15/79

No 10


16/79

No 11


17/79

No 12


18/79

No 13


19/79

No 14


20/79

No 15


21/79

No 16


22/79

No 17


23/79

No 18


24/79

No19


25/79

No 20


26/79

No 21


27/79

No 22


28/79

And dont forget the toe nails


29/79

No 1


30/79

Clubbed fingernails

Softening of nail bed

Loss of angle between nailbed and fold

Increase in nail fold convexity

Thickening of end of finger [drumstick]


31/79

Loss of diamond shaped window


32/79

Causes of Clubbing

Pulmonary and Cardiovascular cause [80%]

eg lung cancer,lung abcess, interstitial fibrosis, sarcoid,SBE

aortic aneurism,pulm AV fistula

GI causes [5%]

eg IBD, sprue,neoplasms [oesophagus,liver,bowel]

Hyperthyroidism [1%]


33/79

No 2


34/79

Koilonychia [Spoon nail]

Concave nailnormal in children

Water drop test

Iron deficiency anaemia

[but also: diabetes,protein deficiency, SLE, Raynaulds disease]


35/79

No 3


36/79

Beaus Growth Arrest Lines

Transverse lines in substance of nail

Indicate previous acute illness

Causes include severe infection,MI,

hypotension/shock, hypocalcaemia and

surgery


37/79

No 4


38/79

Longitudinal striations

Called onychorrhexis

Sign of advanced age or Rh A,PVD,

Lichen planus ,Dariers Disease

Central ridges occur in Fe defic,folic acid

deficiency,protein deficiency


39/79

No 5


40/79

Central Nail canal [median nail

dystrophy] Associated with arterial disease

Malnutrition

Trauma


41/79

No6


42/79

Longitudinal brown lines

caused by increased melanin production by

melanocytes of nail matrix

found in Addisons Disease

breast cancer

melanoma


43/79

No 7


44/79

Central nail canal with Fir tree

PVD


45/79

No 8


46/79

Nail Pitting

Small punctate depressionscaused by nail

matrix inflammation

Psoriasis,alopecia.eczema,lichen planus


47/79

No 9


48/79

Nail Beading

Beads drip down like wax

Diabetes,thyroid disorders,Addisons diasese

vit B defic


49/79

No 10


50/79

Onycholysis

Distal separation of nail plate from nail bed

Thyrotoxicosis,psoriasis,trauma,tetracycline

eczema


51/79

No 11


52/79

Splinter haemhorrages

Caused by haemhorrage in the distal

capillary loop

Occur in:SBE,SLE,trichoniasis,pityriasis,psoriasis

renal failure


53/79

No 12


54/79

Terrys half and half nail

proximal part is white and distal part dark

indicates renal or liver disease


55/79

No 12


56/79

LeuconychiaWhite nails

Occur in

Anaemia,renal failure,cirrhosis,diabeteschemotherapy


57/79

No13


58/79

Mees Transverse White Lines

Any acute illness can cause these

Seen in heavy metal poisoning [arsenic]

chemotherapy


59/79

No 15


60/79

Black nails

occur with

fungal infections

haematomabeware the sub ungual melanoma


61/79

No 16


62/79

Blackgreen nails

Occur in:

trauma- haematoma

use of topical preparations containingchlorophyl,methyl green and silver

nitrate

chronic pseudomonas infection [on R]


63/79

No 17


64/79

Yellow nails

may suggest:

diabetis mellitus,amyloidosisjaundice

cigarette smoking

median /ulnar nerve injury


65/79

No 18


66/79

Thickened nails

slow nail growth leads to thickened nails

associated with:fungal infections,eczema, pvd

psoriasis, yellow nail syndrome


67/79

No 19


68/79

Abnormalities of lunula

absent suggests anaemia ,malnutrition

pale blue suggests diabetes

pyramidal suggests trauma [xs manicure]

red suggests CV disease,collogen vasc

disease or haematological malignancy


69/79

No 20


70/79

Peri ungal telangectasia

caused by dilated capillary loops with

atrophy of the cuticle

associated with collogen vascular disease

SLE /scleroderma/ dermatomyositis


71/79

No 21


72/79

paronychia

associated with separation of the seal

between the nail fold and nail plate

this acts a portal of entry for bacteriawith acute or chronic sepsis


73/79

No 22


74/79

Painted nails

Vanity, Vanity, Thy name is woman

Shakespeare


75/79


76/79


77/79


78/79

No 21


79/79

No 21

fingernail quiz res1modified top copy

Documents