clinicals

Question 1

what are the areas that need to be examined to elicit Pallor?

Answer 1

Anterior rim of Lower Papeberal Conjuctiva
Tongue/oral mucosa
Palms
nail bed

Question 2

If a patient is presented to you with Pallor for what associated features you will look for to get a primary idea about the type of anemia?

Answer 2

Kolonychia - Iron deficiency anemia
Knuckle hyperpigmentation-Vit B 12 defiency anemia
Bleeding tendancies - Bone marrow disorders

Question 4

what are the conditions in which the pallor is present without Anemia?

Answer 4

I. decreased blood flow-

blood flow obstruction
Shock
Left Heart failure
Peripheral vascular disorder

I I . decreased blood pressure

Addisons disease
hypopitutarism
hypothyroidism

Question 5

How would you estimate the Heamoglobin concentration of Patients Based on the General Physical examination? (Pallor examination)

Answer 5

If Pallor is visible on
Skin & mucous membranes only- Hb is less than 10gm%
Palm creases are less pigmented than the surrounding area-Hb is less than 8 gm%

Anemia of Hb Conc B/W 10 to 13 gm% wont show any signs of Pallor

Question 6

medium to Dark brown Lines on Nails indicate______________________

Answer 6

Deficiency of Vit-B 12 & VIT-D

Question 7

Short White Lines (OR) white Spots on Nails indicate________________________

Answer 7

zinc deficiency

Question 8

yellow Nails indicate____________________

Answer 8

Smoking (OR) fungal infection

Question 9

If the whole nail is truning into white it indicates______________________

Answer 9

Liver (Or ) kidney disease

Question 10

clubbed (OR) Bulged nails indicates_________________________

Answer 10

Not Enough oxygen in the blood
(OR)
lung, Liver, Cardiovascular disease

Question 11

pitted nails indicates___________________

Answer 11

Psoriasis, Eczema, other skin conditions

Question 12

Brittle Nails indicates____________________

Answer 12

Biotin (OR) Calicum deficiency

Question 13

Spoon like nails indicates______________

Answer 13

IRON deficiency

koilonachyia

Question 14

vertical ridges on nails indicates__________________

Answer 14

iron deficiency

Question 15

Blue (oR) Purple nails indicates___________________

Answer 15

not enough oxygen in Blood

Question 16

mention four causes of Terrys nails

Answer 16

liver disease (cirrhosis , hepatitis)
chronic Kidney disease
congestive Heart failure
Diabetes mellitus

Question 17

Lindsay’s (half white & half Penk/brown nails) nails indicates________________

Answer 17

Chronic kidney disease.

Question 18

Azure lunula indicates__________________

Answer 18

wilsons disease (Copper toxicity
Argyria (silver Poisoning)
Hepatic failure

Question 19

muehrCke’s Lines

Answer 19

Hypo Albuminemia (<2.2grm)

-Nephrotic syndrome
- chronic liver disease
- malnutrition
- chemotherapy

Question 20

mee’s Lines

Answer 20

Arsenic poisoning
Heavy metal poisioning (thallum, Lead)
Severe systemic illness (sepsis)
chemotherapy

Question 21

Beau’s Lines

Answer 21

severe infections
myocardial infraction
chemotherapy
malnutrition
Trauma

Question 22

Clubbing

Answer 22

pulmonary diseases (Lung cancer, Bronchiectasis, Tuberculosis, interstitial lung disease)

Cardiac diseases (Cynotic congenital Heart disease, infective Heart disease)

Gastrointestinal disease (cirrhosis, inflammatory bowel disease)

Question 23

yellow nail syndromme

Answer 23

Primary Lymphedema
chronic respiratory diseases (bronchiectasis, Chronic bronchitis, pleural effusion)

Question 24

Splinter Hemorrhages

Answer 24

infective endocarditis

vasculitis (SLE, antiphospholipid syndromme, Rheumatoid arthritis, Trauma)

Question 25

Nail fold capillary Telangiectasia

Answer 25

Connective tissue diseases Systemic sclerosis Dermatomyositis systemic Lupus Erythematosus mixed connective tissue disease

Question 26

Kolonychia

Answer 26

Iron deficiency anemia plummer-Vinson Syndromme Hypothyroidism Hemochromatosis malnutrition