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). Image 1: Photograph of the patient's hands.Image 2: Photograph of the patient's right hand. Question:Considering the clinical presentation, which of the following diagnoses is NOT associated with the semiological finding presented in the images? Pulmonary neoplasm Chronic obstructive pulmonary disease Advanced chronic liver disease Bronchiectasis 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.Question:Among the situations noted below, which one does NOT usually progress with digital clubbing? Pulmonary emphysema Lung cancer Cystic fibrosis Severe bronchiectasis Congenital lesions of the heart Time is Up! Time's up
