Which of the following conditions is associated with nails?

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

The image shows splinter hemorrhages, which are thin, reddish-brown vertical lines under the nail plate.
These hemorrhages are caused by tiny blood clots (microemboli) that originate from infected heart valves in infective endocarditis.
The emboli travel through the bloodstream and lodge in the small capillaries of the nail bed, causing them to rupture and bleed.
The presence of multiple splinter hemorrhages is a classic peripheral sign of infective endocarditis.

Option A: Iron deficiency anemia is not associated with splinter hemorrhages.
Option B: Psoriasis does not typically cause splinter hemorrhages, although it can occur uncommonly.
Option D: Kidney disease is not the primary condition associated with splinter hemorrhages.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nail abnormalities as indicators of systemic disease as background academic context rather than a clinical decision trigger.
Nail examination is a non-invasive and valuable component of the physical assessment, providing clues to underlying systemic diseases.
Nurses should document any nail abnormalities and report them, as they can be early signs of serious conditions like endocarditis, malnutrition, or organ failure.
What if? If the patient had a single splinter hemorrhage and a clear history of recent trauma to that finger (e.g., hitting it with a hammer), the finding would most likely be benign and traumatic in origin, not indicative of a systemic disease like endocarditis.

How to Approach the Question

First, carefully examine the image to identify the specific nail abnormality. Note the thin, vertical, reddish-brown lines. This is characteristic of splinter hemorrhages.
Next, recall the systemic diseases associated with various nail changes.
Evaluate the given options by connecting each disease to its typical nail manifestation.
Connect 'Infective endocarditis' with splinter hemorrhages, which are caused by microemboli from infected heart valves.
Rule out 'Iron deficiency anemia,' which is associated with koilonychia (spoon nails).
Rule out 'Psoriasis,' which is linked to nail pitting and onycholysis.

Concept Tested & Keywords

QMfsJJ71mBxlb3HfcSjW1t

E6 Medicine Davidson Principles Practice 24e p. 1281-1283

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1953-1955

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