Which of the following is the characteristic feature of iron deficiency anaemia?

DSSSB 12 August 2024

Medical & Surgical Nursing

Easy

Appeared in: DSSSB 12 August 2024

Explanation

Koilonychia, also known as 'spoon nails', is a classic sign of severe, long-standing iron deficiency anemia.
The nails become thin, brittle, and develop a concave depression, losing their normal convex shape.
This change is thought to result from impaired keratinization of the nail bed due to a deficiency in iron-dependent enzymes.

Option A: Paronychia is an inflammation or infection of the tissue adjacent to the nail, typically caused by bacteria or fungi, and is not a systemic sign of anemia.
Option B: Onycholysis is the separation of the nail plate from the nail bed. While it can be caused by systemic issues, its primary causes are trauma, fungal infections, and skin conditions like psoriasis, not iron deficiency.
Option D: Clubbing is the enlargement of the ends of the fingers and a change in the angle of the nail. It is a hallmark sign of chronic hypoxia from cardiopulmonary diseases, not iron deficiency.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of iron deficiency anemia as background academic context rather than a clinical decision trigger.
Identifying koilonychia during a physical examination is a strong clinical indicator of chronic iron deficiency and should prompt further investigation into the patient's iron status (e.g., serum ferritin, TIBC) and potential underlying causes like chronic blood loss or malabsorption.
Nurses should assess patients' nails as part of a routine physical assessment, as changes can be early indicators of underlying systemic disease.
What if the patient had nail clubbing instead? The nurse's priority would shift from investigating anemia to assessing for chronic respiratory or cardiovascular issues, such as obtaining a detailed smoking history, checking oxygen saturation, and auscultating lung and heart sounds.

How to Approach the Question

This is a factual recall question that tests your knowledge of the clinical signs associated with specific nutritional deficiencies.
First, identify the core concept: iron deficiency anemia.
Next, recall the specific physical manifestations, particularly epithelial changes, associated with this condition.
Evaluate each option. 'Koilonychia' is the specific medical term for spoon-shaped nails.
Link 'koilonychia' to its most well-known cause, which is chronic iron deficiency anemia.
Differentiate this from other nail abnormalities: Paronychia (infection), Onycholysis (separation), and Clubbing (hypoxia), to confirm your answer.

Concept Tested & Keywords

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