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Gold standard case presentation
Yellow Nail Syndrome
In this case it is possible to attempt a diagnosis of Yellow Nail Syndrome based on the report of a recently tapped pleural effusion (described in the candidate brief) and the observation of yellowing of the toenails with onycholysis. The finding of bronchiectasis is certainly consistent with this diagnosis.
The final element of yellow nail syndrome that is not depicted here is lymphoedema, usually of the legs. This is typically present in around 80% of patients with YNS.
YNS is of unknown aetiology. It is also very rare, but has been described in PACES exams, partly owing to a small number of enthusiastic patients keen to share their story with training doctors.
It is characterised by the triad of:
- Yellow nails
- Pleural effusions (or even frank chylothorax);
Not all three features are required for a diagnosis, which is made clinically.
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Question 1 of 6
1. Question1 point(s)
What is the diagnosis?CorrectIncorrect
Question 2 of 6
2. Question1 point(s)
What is the aetiology of yellow nail syndrome?CorrectIncorrect
Question 3 of 6
3. Question1 point(s)
What clinical signs can be heard in the patient’s chest on auscultation?CorrectIncorrect
Question 4 of 6
4. Question1 point(s)
As well as yellow nails and respiratory problems, what other symptoms do patients with Yellow Nail Syndrome commonly experience?CorrectIncorrect
Question 5 of 6
5. Question1 point(s)
Aside from bronchiectasis, what other respiratory complication is seen in patients with yellow nail syndrome (not shown in our video)?CorrectIncorrect
Question 6 of 6
6. Question1 point(s)
The syndrome of Yellow Nail Syndrome is generally considered a triad of what three clinical features?