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  1. #1
    hunteradam07 is offline Permanently Banned 511 points
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    Does COPD cause clubbing?

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    I had this question on my questions bank which described Hx of smoking and emphysema patient with clubbing. The question wants to know what is the cause of pt's finger clubbing.
    A. hypoxicemia.
    B. Occult CA.
    C. Hyperinflation of lungs
    D. Airflow obstruction



















    The answer is B= Occult CA. I have no idea why. Does anyone have a clue?

  2. #2
    sreec is offline Super Moderator 536 points
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    From wikipedia


    • It is worth noting that clubbing is not associated with chronic obstructive pulmonary disease (COPD). Indeed, the presence of clubbing in a patient with COPD should prompt a search for an underlying (lung) cancer.


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    MDXRS22 is offline Ultimate Member 515 points
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    I just read the same thing in FA path cases.
    COPD no clubbing, unless there is something beneath
    I need to think about something...maybe you know what...

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    chenghbk is offline Newbie
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    COPD do cause clubbing

    COPD patients do retain CO2 in their lung, so in their blood, PCO2 is high and PO2 is low. When PCO2 is high and PO2 is low, not enough oxygen in their blood and causes hypoxia. Chronic hypoxia do cause clubbing. That's why in COPD patients, give them home oxygen therapy when teir PO2 is less than 55mmHg to prolong their lives.

  5. #5
    hunteradam07 is offline Permanently Banned 511 points
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    Quote Originally Posted by chenghbk View Post
    COPD patients do retain CO2 in their lung, so in their blood, PCO2 is high and PO2 is low. When PCO2 is high and PO2 is low, not enough oxygen in their blood and causes hypoxia. Chronic hypoxia do cause clubbing. That's why in COPD patients, give them home oxygen therapy when teir PO2 is less than 55mmHg to prolong their lives.
    That is what i thought too but the answer is no according to UW! COPD doesnt cause clubbing and if u see clubbing in COPD pts must rule out occult CA. I dont why bt that is what it said

  6. #6
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    winston is offline Junior Member 510 points
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    Bottom line is if Clubbing develops in the setting of COPD, its cancer!
    "Anything worth doing is worth overdoing."
    -Mick Jagger

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    bigkap87 is offline Member
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    clubbing?

    Haha this prob will not clear it up but it may shed some light on the topic. Clubbing is actually part of a condition called Hypertrophic Osteoarthropathy. According to emedicine COPD can cause clubbing but maybe the vignette was referring to an acute onset of clubbing, warmth, burning, sweating which is a sign of an underlying pulmonary neoplasm. Check it out and educate yourselves: eMedicine - Hypertrophic Osteoarthropathy : Article Excerpt by Ali Nawaz Khan
    "A journey of a thousand miles must begin with a single step." -Lao Tzu

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    hunteradam07 is offline Permanently Banned 511 points
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    Quote Originally Posted by bigkap87 View Post
    Haha this prob will not clear it up but it may shed some light on the topic. Clubbing is actually part of a condition called Hypertrophic Osteoarthropathy. According to emedicine COPD can cause clubbing but maybe the vignette was referring to an acute onset of clubbing, warmth, burning, sweating which is a sign of an underlying pulmonary neoplasm. Check it out and educate yourselves: eMedicine - Hypertrophic Osteoarthropathy : Article Excerpt by Ali Nawaz Khan
    NOPE I read the question again and it only describes typical COPD with clubbing on PE nothing about acute clubbing.

  9. #9
    StodeMD is offline Senior Member 510 points
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    Hypoxemia is the issue....

    "Hypoxicemia" is a mis-spelling of hypoxemia?

    Hypoxemia is the issue. Anything that causes chronic hypoxemia will cause clubbing. It is proliferation of connective tissue of the nail bed in response to distal hypoxemia.

    You'll probably need to check this for yourself, but this is not an issue. It is in Bates, Mosby's, Robbin's, Merck Manual, Harrison's practice, they all say the same thing... it is hypoxemia, and can either be acute (ie Cancer or infection), or chronic (restrictive or obstructive categories).

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    mahmood k is offline Newbie 510 points
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    Clubbing of the digits is not a sign of COPD, and its presence should alert the clinician to initiate an investigation for causes of clubbing. In this population, the development of lung cancer is the most likely explanation for newly developed clubbing. harrison's 17th edition

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