NAILS

NAILS:

Q. What is the approximate growth rate of normal fingernails?
A. 0.1 mm/day
B. 0.2 mm/day
C. 0.3 mm/day
D. 0.4 mm/day

Ans: A

Exp:   Fingernails grow at 3 mm/month (0.1 mm/day) and take 5–6 months to regrow.

Toenails grow at 1 mm/month (0.03 mm/day) and take 12–18 months to regrow.

Q. A 60-year-old man develops transverse white bands in all of his nails that blanch with pressure. The most appropriate initial test would be?
A. Arsenic level
B. Albumin
C. Liver function
D. Chest x-ray
E. Fasting glucose

Ans: B (albumin). The description is that of Muehrcke’s nails. This is classically associated with low albumin. Arsenic level should be checked with Mees’ lines, which do not blanch with pressure.

Non-blanching transverse white bands that grow out with the nail = Mees lines, classically

associated with arsenic poisoning

Blanchable paired transverse white bands that do not grow out with the nail = Muehrcke’s nails, classically associated with hypoalbuminemia

 Opaque proximal nail with 1–2 mm distal pink band = Terry’s nails, associated with cirrhosis

Proximal pallor with brown/pink distal half of nail = Lindsay’s nails or half-and-half nails, associated with renal failure.

 

 Pic of 
Muehrcke’s nail

Q. Pterygium inversum unguis is associated with which of the following diseases?
A. Psoriasis
B. Lichen planus
C. Scleroderma
D. Alopecia areata
E. Congestive heart failure

Ans:  C (scleroderma). Pterygium inversum unguis is associated with scleroderma and lupus.

Dorsal pterygium is associated with lichen planus.

Q. Epidermal growth factor receptor inhibitors can cause which of the following side effects?
A. Onycholysis
B. Paronychia
C. Yellow nails
D. Clubbing
E. Splinter haemorrhages

Ans: B (paronychia).

Paronychia, periungual pyogenic granulomas, and xerosis are associated with epidermal growth factor receptor inhibitors