Finger clubbing is found in:

Chitranjjan National Cancer Institute Kolkata - 2021

Medical & Surgical Nursing (E5)

Medium

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

Pulmonary suppuration refers to chronic, pus-forming diseases of the lung, such as lung abscess, bronchiectasis, and empyema.
These conditions cause chronic hypoxia (low oxygen) and systemic inflammation.
This chronic state is believed to release growth factors that lead to proliferation of soft tissue and blood vessels in the fingertips, resulting in clubbing.
About 80% of acquired clubbing cases are associated with thoracic diseases, with chronic suppurative conditions being a major cause.

Option A: Liver abscess is an acute or subacute infection. Clubbing is a sign of chronic disease, typically developing over months or years, not from acute infections.
Option C: Typhoid fever is an acute systemic bacterial infection. Its classic signs include a step-ladder fever pattern, abdominal pain, and rose spots, but not finger clubbing.
Option D: A duodenal ulcer is a localized sore in the lining of the duodenum. It is not associated with the systemic chronic hypoxia or inflammation that leads to finger clubbing.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of finger clubbing as background academic context rather than a clinical decision trigger.
Finger clubbing is a crucial clinical sign that should prompt a nurse to suspect a serious underlying systemic disease, most commonly of the pulmonary, cardiovascular, or gastrointestinal systems.
A simple bedside test, the Schamroth's window sign, can be used for assessment. The nurse asks the patient to place the nails of corresponding fingers from opposite hands together. The absence of the normal diamond-shaped 'window' is a positive sign for clubbing.
The presence of clubbing necessitates a thorough history and physical examination to identify the underlying cause, which may require further investigations like chest X-ray, CT scan, or echocardiogram.

How to Approach the Question

First, understand the core concept: Finger clubbing is a physical sign associated with chronic diseases, not acute illnesses.
Analyze the options provided. Categorize each option as either an acute or chronic condition.
Liver abscess and Typhoid are acute infections. Duodenal ulcer is a localized, often manageable condition.
Pulmonary suppuration represents a group of chronic, inflammatory lung diseases (like bronchiectasis or lung abscess).
Recall or deduce the link between chronic lung disease, persistent hypoxia, and the development of clubbing.
Select the option that represents a chronic condition known to cause clubbing, which is Pulmonary suppuration.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 579-581

E6 Medicine Harrison 22e Part 1 p. 320-322