Which pathology would present with clubbing of the fingers or toes?

• A. Ventricular septal defect
• B. Atrial septal defect
• C. Cystic fibrosis
• D. Epiglottitis

Answer: (C)

Clubbing occurs when long-standing hypoxia or chronic lung inflammation causes changes in the nail bed and distal digits. Cystic fibrosis fits this pattern because its chronic lung disease—especially recurrent infections and bronchiectasis—consistently leads to persistent lower oxygen levels and ongoing inflammation, which can produce clubbing.

The other conditions aren’t typical causes. Ventricular septal and atrial septal defects usually don’t cause clubbing unless they progress to Eisenmenger physiology with chronic cyanosis, which is not the common scenario in most pediatric patients. Epiglottitis is an acute inflammatory illness of the upper airway and does not create the chronic hypoxia associated with clubbing.