Guide to Clinical Examination/Quick Guide/Quick examination of everything

FINGERNAILS The condition of the nail beds has been associated with no fewer than 24 diseases. Here are some signs to observe: Curved down at the tip = associated with respiratory, heart or liver disease Curved up = nutritional deficiency esp Iron (koilonychia) Ridges --transverse (Beau’s lines) = hyperthyroid, also infectious diseases such scarlet fever or typhus --longitudinal = rheumatoid disease White lines (Mee’s lines) = heart disease, Hx of fever, arsenic poisoning Absence of lighter area at base = hypo-thyroidism or cardiac weakness Enlarged area at base = hyper-thyroidism Bluish area = Wilson’s disease Reddish area = Cardiac failure, hypo-thyroid Entirely white nail (Terry’s nails) = cirrhosis, hypo-albuminemia Half & half (Lindsay’s nails) = renal disease Hemorrhages in nail = subacute bacterial endocarditis, trichinosis Pitted and discolored = Psoriasis Crumbling = Onycholysis = fungal infection Thickened = Onichogryposis = Thyroid toxicosis