Bob is an 64 year old who presents with clubbing of his fingers on a background of a 60 year smoking history, and extensive alcohol intake.

What are the likely causes of this presentation?

1. Cirrhosis of liver
2. Lung cancer

What are the causes of clubbing?

1. Lung cancer
2. Lung pulmonary fibrosis
3. Sepsis
4. Heart disease (congenital)
5. Infective endocarditis
6. Cirrhosis of liver
7. Crohns disease

Reading

1. Murtaghs General Practice Chapter 129 – http://murtagh.mhmedical.com/content.aspx?bookid=1522&sectionid=116046129
2. Murtaghs Practice Tips – Chapter 8 – Nail Problems – http://murtagh.mhmedical.com/content.aspx?bookid=1920&sectionid=143276631

Podcast

1. GP Core Content Podcast Episode 150 – Dermatology | Nails