Clinical signs

Question 1

Answer 1

Clubbing

Nails abnormally curved. Loss of hyponychial angle. Due to chronic hypoxia to the tissue.

Causes:
Lung disease - bronchiogenic carcinoma, pyogenic conditions, abscess, empyema

Heart disease - subacture bacterial endocarditis, cyanotic congential heart disease

Gastrointestinal disease - cirrhosis, ulcerative colitis, Crohn’s disease

Question 2

Answer 2

Koilynychia

Spooning of the nail.

Causes: iron-deficiency anaemia, lupus, haemochromatosis

Question 3

Answer 3

Pitting

Pitting on the surface of the nail

Causes: psoriasis, ezcema,

Question 4

Answer 4

Splinter haemorrages

Dark lines under the nail, indicating the vessels under the nail are bleeding

Cause: subacute bacterial endocarditis, lupus, psoriasis , rheumatoid arthritis

Question 5

Answer 5

Dupuytren’s contracture

Tightening of palmar fascia resulting in permanent flexion (usually ring finger)

Causes: Alchoholic liver disease

Question 6

Answer 6

Coated candida (oral thrush)

Infection with candida albicans fungi

Causes: uncontrolled diabetes, HIV, cancer, corticosteroids, antibiotics

Question 7

Answer 7

Palmar erythema

Redding of the palms at thenar and hypthenar eminences

Causes: Cirrhosis, chronic liver disease, pregnancy, portal hypertension, ezcema, psoriasis

Question 8

Answer 8

Angular stomatitis

Cracking at the corners of the lips

Causes: iron deficiency anaemia, vitamin B deficiency, poor dental hygeine, poor nutrition

Question 9

Answer 9

Mouth ulcer

Round oval sores that form inside the mouth on the cheek or lips

Causes: damage to the mouth, stress and anxiety, iron defiency anaemia, vitamin B12 deficiency, immunodefiency, Crohns disease

Question 10

Answer 10

Gingivitis

Gum disease, red swollen gums (inflamed), abscesses can also be present

Causes: Poor oral hygeine, (diabetes, HIV more at risk)

Question 11

Answer 11

Central cyanosis

Seen on the lips and tongue, caused by low oxygen saturation of arterial blood and poor perfusion of the tissue

Causes: Cardiac or respiratory disease, abnormal Hb

Question 12

Nausea and vomiting

Answer 12

gastroenteritis
peptic ulcer disease
gastric obstruction
hepatitis
cholecystitis
pancreatitis
brain tumour
disseminated malignancy
sepsis
Addisons disease

Question 13

Answer 13

Jaundice

discolouration of the sclera and skin due to deposition of excess bilirubin

Causes: biliary and liver disease

Question 14

Answer 14

perioral pigmentation of the lips

Caused by Peutz-Jeghers syndrome, increased risk of gastric cancers

Question 15

Answer 15

glossitis

Inflammation of the tongue

Causes: Bacterial/viral infections, poor hydration of the tongue, irritants (tobacco, alchohol, spicy food)

Question 16

Answer 16

Spider naevi

dilated blood vessels near the surface of the skin, central red spot that radiates outwards

Causes: liver disease, pregnancy

Question 17

Answer 17

Swollen parotid gland

Causes: mumps, infection

Question 18

Answer 18

Xanthoma

firm, raised waxy-appearing papules (bumps) which may occur on the trunk, arms, and legs. May be skin-colored, pink or even yellow. Associated with hyperlipidemia (in blood)