Clubbing

Question 1

How do you assess clubbing?

Answer 1

Fingers together with nails and distal phalanx touching - should see Schamroth’s window, if not = positive for clubbing

Question 2

What are some pulmonary causes of clubbing?

Answer 2

Any pulmonary disease featuring chronic hypoxia (CC BITS)
Cancer - mainly non-small cell; mesothelioma
COPD (chronic hypoxia)
Bronchiectasis or CF
IPF
TB
Sarcoidosis

Question 3

What are some cardiac causes of clubbing?

Answer 3

Any cardiac disease featuring chronic hypoxia
Congenital cyanotic heart disease ie tetralogy of fallot
Bacterial endocarditis

Question 4

What are some GI causes of clubbing?

Answer 4

IBD
Cirrhosis - PBC and liver
Coeliac
GI lymphoma

Question 5

What are some malignant causes of clubbing?

Answer 5

Thyroid cancer
Thymus cancer
Hodgkin’s

Question 6

What are some other causes of clubbing?

Answer 6

Acromegaly 
Thyroid acropahy - Grave's disease 
Pregnancy 
(primary) hypertrophic pulmonary osteoarthropathy 
Familial or (racial - pseudo) clubbing