Case 399

Medical history

A 52-year-old female patient was admitted for paracentesis due to massive ascites. She reports previous history of generalized intense itching, jaundice, episodes of hematemesis and recurrent ascites, in the last 2 years. Physical examination showed: mild jaundice (+/4+), reduction of vesicular breath sounds in the lung bases and changes in hand ectoscopy (Images 1 and 2).

Considering the clinical presentation, which of the following diagnoses is NOT associated with the semiological finding presented in the images?

Test question

[UFPR Residency Exam, 2006] Digital clubbing is a clinical finding on physical examination that can assist in the differential clinical diagnosis during the evaluation of a patient with respiratory complaints.

Among the situations noted below, which one does NOT usually progress with digital clubbing?

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