Hand Signs

Question 1

Koilonykia

Answer 1

Iron deficiency (anaemia)
Haemochromatosis
Infection eg fungal
Endocrine ge acromegaly, hypothyroid. 
Malnutrition. 
B12 or folate deficiency.

Question 2

Onycholysis- detach nail bed from nail

Answer 2

Hyperthyroid
Fungal infection
Psoriasis

Question 3

Beau’s lines- transverse furrows to to arrest of nail growth

Answer 3

CHEMO
Severe infection
MI
Trauma
Altitude or deep sea.

Question 4

Splinter haemorrhage

Answer 4

Infective endocarditis
Microemboli
Minor trauma

Question 5

Clubbing

Answer 5

CHEST-
Bronchial CA, empyema or abcess, bronchiectasis, CF, fibrosing alveolitis, mesothelioma, TB. 
GI-
IBD especially crohns, cirrhosis, lmyphoma, malabsoption eg coeliac. 
CVS-
Cyanotic congenital heart defect
Endocarditis
Atrial myxoma
Aneurysms
Infected grafts
RARE-
Familial, thyroid acropachy
UNILATERAL-
Hemiplegia, vascular lesions.

Question 6

Palmar erythema

Answer 6

Cirrhosis
High output states eg pregnancy, hyperthyroid, RA, polycythaemia.
Chemo

Question 7

Pale palmar creases

Answer 7

Anaemia

Question 8

Dupuytrens contracture- fibrosis and contracture of palmar fascia.

Answer 8

Liver disease
Trauma
Epilepsy
Ageing
Idiopathic
AI
Malignancy
DM

Question 9

Heberdens and Bouchards nodes- osteophytes

Answer 9

OA

Question 10

Oslers nodes (tender in finger pulps) and janeway lesions (red macules on palm)

Answer 10

Infective endocarditis

Question 11

Fine tremor

Answer 11

Beta agonist use

Question 12

Intrinsic muscle wasting

Answer 12

Pancaost tumour

Question 13

Asterixis flap

Answer 13

CO2 retention
Hepatic encephalopathy
Uraemia from renl disease

Question 14

Leukonykia

Answer 14

Hypoalbuminaemia eg nephrotic syndrome, liver failure.