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  1. #1
    FreeSpirit is offline Junior Member 510 points
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    crumbling, friable nails with hyperkeratotic debris

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    A 60-year-old woman complains to a physician because
    several of her toenails are discolored. Physical
    examination demonstrates crumbling, friable nails with
    distal-lateral separation from the nail bed.
    Hyperkeratotic debris is present under the affected
    part of the nail. Which of the following is the most
    likely pathogen?

    A. Aspergillus
    B. Candida
    C. Mucor
    D. Mycobacterium
    E. Trichophyton

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    Asclepius1 is offline Ultimate Member 536 points
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    Re: crumbling, friable nails with hyperkeratotic debris

    Quote Originally Posted by medstudent
    A 60-year-old woman complains to a physician because
    several of her toenails are discolored. Physical
    examination demonstrates crumbling, friable nails with
    distal-lateral separation from the nail bed.
    Hyperkeratotic debris is present under the affected
    part of the nail. Which of the following is the most
    likely pathogen?

    A. Aspergillus
    B. Candida
    C. Mucor
    D. Mycobacterium
    E. Trichophyton
    I don't know the answer but my guess is E. Trichophyton because aspergillus is usually in the lung. Candia is a fungus and it is usually thrush or uti. Mucor is usually in diabetes. Mycobacterium is serious stuffs and the question would elaborate on this.

  3. #3
    FreeSpirit is offline Junior Member 510 points
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    Re: crumbling, friable nails with hyperkeratotic debris

    Quote Originally Posted by medstudent
    A 60-year-old woman complains to a physician because
    several of her toenails are discolored. Physical
    examination demonstrates crumbling, friable nails with
    distal-lateral separation from the nail bed.
    Hyperkeratotic debris is present under the affected
    part of the nail. Which of the following is the most
    likely pathogen?

    A. Aspergillus
    B. Candida
    C. Mucor
    D. Mycobacterium
    E. Trichophyton
    The correct answer is E. The patient has a fungal nail infection. These infections are seen most commonly in the elderly, and are usually caused by dermatophyte infection, typically Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum. Some of the more superficial lesions can be removed by simply scraping the fungus off the nail. Systemic fungal therapy (notably terbinafine) of months duration (because nails are grown so slowly) may be required for deeper nail lesions.
    Aspergillus(choice A) may be a lung saprophyte or cause invasive disease.

    Candida(choice B) is a rare cause of fungal nail infection.

    Associate Mucor(choice C) with sinonasal infection.

    Mycobacterium(choice D) cause tuberculosis and leprosy.

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