MNT Nail Anatomy & Disorders 3 — Questions and Answers
Question 1: Which layer of the nail plate is produced primarily by the proximal portion of the matrix?
- Ventral (lower) layer
- Middle layer
- Dorsal (upper) layer (Correct answer)
- All layers equally
Correct answer: Dorsal (upper) layer
The proximal matrix generates the harder dorsal layer of the nail plate, while the distal matrix produces the softer ventral layer.
Question 2: Terry's nails, characterized by white opacification of most of the nail with a distal pink or brown band, are associated with:
- Fungal infection
- Psoriasis
- Hepatic cirrhosis and systemic disease (Correct answer)
- Iron-deficiency anemia
Correct answer: Hepatic cirrhosis and systemic disease
Terry's nails are classically associated with hepatic cirrhosis, heart failure, and diabetes.
Question 3: Koilonychia, or spoon nails, is most commonly associated with:
- Hyperthyroidism
- Iron-deficiency anemia (Correct answer)
- Onychomycosis
- Psoriasis
Correct answer: Iron-deficiency anemia
Koilonychia produces concave, spoon-shaped nails and is strongly associated with iron-deficiency anemia.
Question 4: The nail plate is composed mainly of:
- Collagen fibers
- Hard keratin (Correct answer)
- Elastin
- Calcium hydroxyapatite
Correct answer: Hard keratin
The nail plate consists primarily of hard (alpha) keratin, making it firm and protective.
Question 5: Paronychia is defined as inflammation of the:
- Nail bed
- Nail matrix
- Periungual soft tissue (nail fold) (Correct answer)
- Hyponychium
Correct answer: Periungual soft tissue (nail fold)
Paronychia is infection or inflammation of the skin surrounding the nail, most often caused by bacteria or Candida.
Question 6: Which nail disorder is characterized by increased nail plate curvature causing the fingertip to appear rounded and bulbous?
- Koilonychia
- Clubbing (digital clubbing) (Correct answer)
- Onychogryphosis
- Pterygium
Correct answer: Clubbing (digital clubbing)
Clubbing involves loss of the normal angle between the nail plate and proximal fold, with bulbous fingertip enlargement, linked to cardiopulmonary disease.
Question 7: Leukonychia punctata refers to:
- Complete white discoloration of the nail plate
- Small white spots within the nail plate (Correct answer)
- Yellowish discoloration at the nail tip
- Brown longitudinal streaks
Correct answer: Small white spots within the nail plate
Leukonychia punctata presents as discrete white spots in the nail plate, typically caused by minor matrix trauma.
MNT Nail Anatomy & Disorders 3
Which layer of the nail plate is produced primarily by the proximal portion of the matrix?