Clubbing of fingers can be assessed by which of the following tests?

Appeared in: DSSSB 12 August 2024

Explanation

The Schamroth window test is the standard clinical sign used to assess for finger clubbing.
The test involves placing the dorsal surfaces of the distal phalanges of corresponding fingers together.
In a healthy individual, a small, diamond-shaped 'window' is visible between the nail beds.
The absence or obliteration of this window is a positive sign for clubbing, indicating a loss of the normal nail bed angle.

Option A: Virchow's triad is not a physical test but a theory that describes the three main factors that contribute to the formation of a thrombus (blood clot): venous stasis, endothelial injury, and a hypercoagulable state.
Option C: The Allen test is performed to evaluate the patency of the radial and ulnar arteries, ensuring adequate collateral blood flow to the hand.
Option D: The dorsiflexion test, also known as Homan's sign, involves checking for pain in the calf upon forced dorsiflexion of the foot. It is not related to the fingers.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment for finger clubbing as background academic context rather than a clinical decision trigger.
Finger clubbing is a crucial physical sign as it is often associated with serious underlying systemic diseases, particularly those causing chronic hypoxia.
Conditions linked to clubbing include lung cancer, interstitial lung disease, cystic fibrosis, cyanotic congenital heart disease, and inflammatory bowel disease.
A nurse's ability to correctly identify clubbing using the Schamroth window test can lead to early referral and diagnosis of these potentially life-threatening conditions.

How to Approach the Question

This is a factual recall question that asks for a specific clinical assessment technique.
First, identify the key concept in the question stem: 'assessment of clubbing of fingers'.
Second, systematically review the options provided.
Third, recall or deduce the purpose of each test. The Schamroth window test is specifically designed to check for the physical changes associated with clubbing.
Fourth, eliminate the other options by confirming their correct indications: Virchow's triad (thrombosis theory), Allen test (hand circulation), and Dorsiflexion test (DVT sign).

Concept Tested & Keywords

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E6 Medicine Macleod Clinical Examination 15e p. 36-38

E6 Anatomy Grays 43e Vol 2 Part 2 p. 73-75

Practise the full DSSSB 12 August 2024

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