Q.1 Which of the following is the most common cause of longitudinal ridging of nails in elderly patients?
Psoriasis
Aging
Onychomycosis
Lichen planus
Explanation - Longitudinal ridging is often seen as a normal part of aging and is usually not associated with systemic disease.
Correct answer is: Aging
Q.2 A patient presents with yellow-green discoloration of the nails. Which organism is most likely responsible?
Staphylococcus aureus
Pseudomonas aeruginosa
Candida albicans
Trichophyton rubrum
Explanation - Pseudomonas aeruginosa infection can cause yellow-green discoloration of nails, commonly referred to as 'green nail syndrome'.
Correct answer is: Pseudomonas aeruginosa
Q.3 Terry's nails are most commonly associated with which condition?
Cirrhosis
Iron deficiency anemia
Diabetes mellitus
Hypothyroidism
Explanation - Terry's nails are characterized by white nails with a distal pink or brown band and are commonly associated with liver cirrhosis.
Correct answer is: Cirrhosis
Q.4 Which nail disorder is characterized by distal thinning and splitting of the nails often associated with thyroid disease?
Onycholysis
Plummer's nails
Beau's lines
Koilonychia
Explanation - Plummer's nails show onycholysis (distal separation) often associated with hyperthyroidism.
Correct answer is: Plummer's nails
Q.5 Leukonychia totalis is most commonly caused by:
Trauma
Liver disease
Congenital abnormality
Renal failure
Explanation - Leukonychia totalis refers to complete whitening of all nails, often due to hereditary or congenital factors.
Correct answer is: Congenital abnormality
Q.6 A patient presents with horizontal depressions across the nails following a severe illness. This condition is called:
Beau's lines
Mee's lines
Muehrcke's lines
Onychomadesis
Explanation - Beau's lines are transverse depressions that occur after temporary cessation of nail growth due to systemic illness or trauma.
Correct answer is: Beau's lines
Q.7 Onychomycosis most commonly affects which part of the nail?
Proximal nail fold
Lunula
Distal nail plate
Cuticle
Explanation - Distal subungual onychomycosis is the most common type, where fungal infection starts at the distal nail edge.
Correct answer is: Distal nail plate
Q.8 Which of the following nail changes is characteristic of psoriasis?
Pitting
Yellowing
Thickening
Blue nails
Explanation - Nail pitting occurs due to defective keratinization of the proximal nail matrix and is characteristic of psoriasis.
Correct answer is: Pitting
Q.9 Muehrcke's lines are associated with which laboratory abnormality?
Low albumin
High bilirubin
Hyperthyroidism
Iron deficiency
Explanation - Muehrcke's lines are paired white lines in the nail bed associated with hypoalbuminemia.
Correct answer is: Low albumin
Q.10 Which nail disorder presents with transverse white lines after arsenic poisoning?
Beau's lines
Mee's lines
Muehrcke's lines
Onychoschizia
Explanation - Mee's lines are transverse white lines across the nails, classically seen after arsenic poisoning or systemic illness.
Correct answer is: Mee's lines
Q.11 Koilonychia is most commonly associated with:
Iron deficiency anemia
Diabetes mellitus
Psoriasis
Renal failure
Explanation - Koilonychia refers to spoon-shaped nails and is classically associated with chronic iron deficiency.
Correct answer is: Iron deficiency anemia
Q.12 Blue nails (cyanotic nails) indicate:
Iron deficiency
Cyanosis
Psoriasis
Fungal infection
Explanation - Blue nails suggest cyanosis, indicating decreased oxygenation of peripheral blood.
Correct answer is: Cyanosis
Q.13 Onycholysis is defined as:
Nail pitting
Separation of nail from nail bed
Thickening of nails
Transverse white lines
Explanation - Onycholysis is the painless detachment of the nail plate from the nail bed, often starting distally.
Correct answer is: Separation of nail from nail bed
Q.14 Paronychia is an infection involving:
Nail matrix
Nail bed
Cuticle and nail fold
Lunula
Explanation - Paronychia is an acute or chronic infection of the lateral or proximal nail fold, usually bacterial or fungal in origin.
Correct answer is: Cuticle and nail fold
Q.15 Which nail disorder is associated with systemic lupus erythematosus?
Lupus erythematosus nail changes
Beau's lines
Plummer's nails
Koilonychia
Explanation - Patients with SLE may show nail fold telangiectasia, periungual erythema, and longitudinal ridging.
Correct answer is: Lupus erythematosus nail changes
Q.16 Pachyonychia congenita primarily affects:
Skin only
Nails and skin
Hair and nails
Mucosa only
Explanation - Pachyonychia congenita is a rare genetic disorder affecting nails (thickened, dystrophic) and skin (keratoderma).
Correct answer is: Nails and skin
Q.17 Clubbing of nails is commonly associated with:
Chronic hypoxia
Iron deficiency
Diabetes
Psoriasis
Explanation - Clubbing is bulbous enlargement of distal fingers and nails, often seen in chronic hypoxia or lung disease.
Correct answer is: Chronic hypoxia
Q.18 Which type of nail discoloration is typically seen in renal failure?
Half-and-half nails
Terry's nails
Mee's lines
Blue nails
Explanation - Half-and-half nails (Lindsay nails) show proximal white and distal brown coloration, commonly associated with chronic renal failure.
Correct answer is: Half-and-half nails
Q.19 Onychomadesis refers to:
Separation of nail plate
Shedding of nails from proximal end
Thickened nails
White spots on nails
Explanation - Onychomadesis is the proximal detachment and shedding of nails, often following severe illness or trauma.
Correct answer is: Shedding of nails from proximal end
Q.20 Terry's nails differ from Muehrcke's lines in that:
Terry's nails are due to hypoalbuminemia, Muehrcke's are not
Terry's nails involve nail plate, Muehrcke's involve nail bed
Terry's nails are transverse, Muehrcke's longitudinal
Both are the same
Explanation - Terry's nails are nail plate changes, whereas Muehrcke's lines are apparent changes in the vascular nail bed without actual nail plate alteration.
Correct answer is: Terry's nails involve nail plate, Muehrcke's involve nail bed
Q.21 Which of the following is a characteristic feature of lichen planus affecting nails?
Longitudinal ridging and thinning
Thick yellow nails
Transverse white lines
Clubbing
Explanation - Nail lichen planus often causes longitudinal ridging, thinning, and sometimes pterygium formation.
Correct answer is: Longitudinal ridging and thinning
Q.22 Chronic paronychia is most commonly caused by:
Bacterial infection
Fungal infection
Trauma
Psoriasis
Explanation - Chronic paronychia is often caused by Candida species and presents with swelling, erythema, and nail changes.
Correct answer is: Fungal infection
Q.23 Which systemic disease is associated with Terry's nails besides cirrhosis?
Congestive heart failure
Diabetes mellitus
Hyperthyroidism
Psoriasis
Explanation - Terry's nails can also be seen in congestive heart failure, diabetes, and other systemic illnesses.
Correct answer is: Congestive heart failure
Q.24 A patient presents with thickened, yellow nails with distal onycholysis. This is most consistent with:
Onychomycosis
Psoriasis
Terry's nails
Koilonychia
Explanation - Distal subungual onychomycosis often presents as thickened, yellow nails with distal separation from the nail bed.
Correct answer is: Onychomycosis