false incorrets of vdrl
h viral infections, rheumatic fever, lupus, or leprosy.
white lump curd ike discharge in vagina
vulvovaginitis
an old woman has high inhibin b what could the diagnosis be
granulosa cell tumor
contraindications of ocps
OCPs are contraindicated in women who have migraines with aura, smoke cigarettes above the age of 35 years, or have a history of stroke, thromboembolism, breast cancer, or liver disease.
histology of an oocyte
surrounded by flat granulosa cells, stroma surrounds granulosa
when does meiosis complete in an ococyte
Primary oocyte arrest occurs in prophase I of meiosis I (think PROphase = PRior to Ovulation).
Secondary oocyte arrest occurs in metaphase II of meiosis II (think METaphase = before egg MET sperm).
female embryonic deriative of gubarnaculum
Ovarian ligament
what is the purpose of giving ocps in pcos
increases SHBG binds to testosterone decreases androgens
how does progesterone act
it arrests endometrium at certain stage
raloxifene contraindications
previous throm
does endometriois increase risk of malignancy
yes
what is round ligament responsible for
anteverson antiflexion of uterus
what is artery of sampson
anatomosis in uterine and ovarian artery
what is a dermoid cyst
A mature cystic teratoma that can occur on the head, the neck, spine, cranium, and in the abdomen (most common ovarian tumor in females). Cysts typically become symptomatic as they grow in size. They are treated with complete surgical excision.
how tod istinguish uterine prolapse from cytocele
urinary symotoms same, but cystocele has vaginal protusion uterine prolapse has decent of utrus
gestial sac visualistion and dilated cervix is
Visualization of the gestational sac and dilatation of the cervix in a woman at only 31 weeks’ gestation would be concerning for preterm labor. A
causes of congenital torticollis
., secondary to clavicular fracture, cervical fracture, or dislocation of C1/C2 with spastic contracture of the sternocleidomastoid muscle
defective intraellular transport of meanosomes to keratinocyes
post inflammatory hypopigmenation
a pregnant with prexisitng heart disease
systolic benign diastolic path
vaterl association leads o
polyhydraminos
best drug for treating postpartum hemorrhage
oxytocin
small pelvis shallow intragleutal cleft maternal diabeties
caudal regression syndrme
which rrna trasncript is transcribed outside the nucleous
rrna transcrpit 5s rna poly 3
i give a person azothoprine and he has xanthine oxidase deficiency
no secretion of thiouric acid azothoprine completely blocks HGPRT, since it blocks HGPRT no salvage= increased toxicity
uti by klebseilla causes what colour change of agar
greent o purple
pyrdazimide tb drug
requires acidic ph to be activated so its only functional within lysosomes not exxtracellular
pyrdazimide tb drug
requires acidic ph to be activated so its only functional within lysosomes not exxtracellular
which is the only trna that does not bind to A site
Methonine
what is the function of N fromylmethonine
it codes for chemotaxis of neutrophils
where does n and o glycosylation occur
n occurs in rer o occurs in golgi in n aspargine is involved in o serine and theorine
which aminoacid is excised due to post transitaional modification
The first methionine is subsequently removed by an N-terminal peptidase as a part of the cotranslational or posttranslational modification, while all other sulfur-containing amino acids are not excised
which is inovled in methylatiuon
SAm
how does the process of N acetylation work
its simple aminoacid methionine is removed by aminoacid peptidase, then replaced by acetyl group by acetyl coa via acetyl transferase this always happens
aceylation also occurs in lysine residudes of histones
what is the moa of ampicillin gentamicin synergestic effect
it makes bacterial cell wall more permeable
difference between elastin and collagen synthesis
elastin doesnt undergo glyscosylation no hydroxylastion and lysine is crosslinked due to lysl oxidase what is solar elastossis? what is transglutaminase and lysloxidase
errors in ubiquintation
parkinson monoubq vs polyubq mom is for trafficking poly is for degradation
glucose 6 p to glucose
in ser
how do glucorticoids cause osteoporosis
apoptosis of osteocytes, inhibits differenction of mesenchymal cells to osteoblasts
high glucorticoid support RANKL synthesis by preosteoblasts
inhibits androgens and estrogens
osgood schatler disease
Overuse (especially sports involving sprinting and jumping) during the ossification period (adolescence) → excessive strain and repeated avulsion of the patellar ligament on the tibial tuberosity → inflammation → traction apophysiti
chronic inflammation of patella
secondary ossification of the tibial tuberosity → detachment of the apophysis → subsequent callous formation during the healing process → pronounced tibial tubercle [1]
chronic inflammation of patella
secondary ossification of the tibial tuberosity → detachment of the apophysis → subsequent callous formation during the healing process → pronounced tibial tubercle [1]
myophosphrylase deficiency lab findings and explain the why
flat venous lactate curve with exaggerated elevations in blood ammonia during exer
because glucose not produced to overwhelm the krebs cycle to form pyruvate which causes lactate to form
histopath of ewings
A t(11;22) chromosomal translocation, resulting in expression of fusion protein EWS-FLI 1, several layers of new bine around lytic bone
conversion of prostglandin H2 to txa2
thrombonxane synthase inhibtied by anti thrombitc drugs
which drugs inhibti DHF
pyrmethimee, trimethoprim and methotrexate
what is codmans triangle
basically when osteosarcomas bcome malignant they grow into the periosteum leading to periosteal reactions (these periosteal reaction are know as bony spicules giving it a suburst appearnence)
where do chrondromsarcomas commonly occur
chondrosarcomas commonly present with osteolytic lesions involving the pelvis, spine, or shoulder girdle and mainly occur in patients over the age of 50 years.
giant cell osteomas
they arise promixal to the knee and is associated with age 20 however osteosarcoma age 15
what is ragged muscle fibres
compensatory proliferation of mitochondria in gomori stain
polymyositis vs dermatomysositis
poly is endomysial inflammation, whereas dermato is perimysial
poly is cd8 t whereas dermato is cd4
cutaneus manifestaion of dem
mechanis hand, externsor papules symmetrically distributed,, helitrope rash
pagets vs osteopetoris
“bowing of the legs” is a buzzword for Paget’s disease, and it also tends to be more localized (whereas Osteopetrosis is diffuse). The warmth over the shins is also a clue towards Paget’s because of the increased vascularity (remember how it’s associated with AV shunts/high output
high pth what is changed
subperiosteal changes with cysts
osteoporosis what is changed
trabeculae
when is woven bone formed
Formed during embryonic development, after fractures (secondary bone healing), and in Paget disease
trabecular bone vs cortical bone
it is the ends of the bone which resists tensile strength
what are the muscle fibre changes in hypothyroid myopathy and what is elevated
Hypothyroid myopathy is characterized by noninflammatory type II muscle fiber atrophy with relative type I muscle fiber hypertrophy. This condition may also manifest with proximal muscle weakness and elevated creatine kinase,
why osteomyletits is common in children and why only in the metaphysis
blood is slow in metaphysis creates a sharp lopp whichcauses stasis of blood
why we have involvurum what is it and what is sequestrem
Inflammation in the marrow causes increased intramedullary pressure, which forces the exudate into the cortex, where it can rupture through the periosteum. More than 80% of cases of hematogenous osteomyelitis occur in the long bones, the femur and tibia being the most common, and cases usually originate in the metaphyses.
osteogensis imperfecta pathophys
cola1 mutation this codes for alpha chains in collagen
what are wormian bones
excessiove bones around crainal suture=OI
spinal stensosi associated with what genetic disease
achondroplasia
intestinal rupture which disease complication
ED vasuclar type type 3 collagen fucked
hyperextension of finger can lead to which tendone to rupture
digitoirum to profundus
if a ball hits the distal finger what could happen
hyperextension also known as baseball injury
what is a trigger finger
An inflammation of the flexor tendon sheath leading to a stenosing tenosynovitis. Patients experience a locking or catching sensation during active flexion-extension activity and often have a palpable nodule along the axis of the flexor tendon. The cause is unknown
mechanism of boutinere deformity in RA
Finger deformity caused by hyperextension of the distal interphalangeal joint with flexion of the proximal interphalangeal joint due to slipping or disruption of the central band of the extensor digitorum (ED) tendon. Can be caused by sharp or blunt trauma (e.g., jamming a finger in a door) or by rheumatoid arthritis (inflammation of the joint space pushes the central band of the ED out of its normal anatomical position).
epidural abscess presents as
An inflammatory reaction in the epidural space might be caused by an epidural abscess or bone metastases. Both could present with acute back pain and signs of spinal cord compression. However, the patient has no evidence of cancer. Furthermore, an epidural abscess would demonstrate point tenderness and constitutional symptoms (fever, chills) and is usually associated with risk factors such as IV drug use, diabetes, or immunosuppression. Additionally, the acute onset of symptoms makes both diagnoses unlikely.
a person comes with macroglossia and osa what could be etiologies
gh,hypothyroidism,glycogen storage disease(pompe)
DMPk deficiency
insulin resistance/arrhtymias
premature hair loss in men should hint u towards
myotonic dystrophy
how to assess supraspinotous injury px
empty can test, and subacromial tnederness
how to asses subscapularis muscle injury
liftoff test lift posteriorly
explain pathophys of malignant hyperthermia
A mutation in the ryanodine receptor gene of striated muscle cells results in a ryanodine receptor that can be activated by certain substances, such as inhalation narcotics (e.g., isoflurane). This activation leads to an uncontrolled release of Ca2+ from the SR, which results in a continuous contraction that increases the energy and oxygen consumption of the muscle cell enormously. Affected individuals present with lactic acidosis due to increased anaerobic glycolysis and hyperthermia due to increased muscle metabolism. This life-threatening condition is called malignant hyperthermia.
how to diagnose fibromyalgia vs polymalgia rheumatica(symmetrical pain)
flu like symotoms with tender points associated with other diseases such ad ibs or incontinence
neck, back, shoulders, and medial aspect of the knees
denosumab moa
nfkb inhibtor mimics osteoprogets=rin
how is osteoclast activated
Receptor activator of nuclear factor kappa B ligand; ligand of the osteoclast receptors
what are the common causes of becker muscular dystrophy
inframe mutations=reading fram intact
or point mutation which causes deletion
splice site mutations are caused in
cancers, dementia, epilepsy, and some types of β-thalassemia.
what can damage ulnar nerve
guyon cnaal fucked hamate fucked and pisirofrm fucked
posterior interossous nerve
A motor branch of the radial nerve that arises near the lateral epicondyle and innervates all muscles of the posterior compartment of the forearm except for the long head of the extensor carpi radialis (which is directly innervated by the radial nerve).
extensor carpi radials muscle preserved causes unapposed wrist deviation
radiological finding of gout vs chondrocalcinosis
chondrocalcinois doesnt have punctate radiological findings
radiological finding of gout vs chondrocalcinosis
chondrocalcinois doesnt have punctate radiological findings
where does calcification occur in pseudogout
Fibrocartilage (meniscus, annulus fibrosus of intervertebral disk)
supracondylar fracture various displavcements
anterior=brachial artery
anteriolateral=radial nerve
medial =median nerve
if you have a flexion type of supracondylar fracture
then you have ulnar nerve injury
obtruator artery destroyed in which fracture
acetabulum fracture
what is the branch of femoral profundus artery
middle femoral circumflex artery
lateral femoral circumflex artery
intertrochanteric artery
which muscle inserts in lateral 3rd of clavicle
trapexius muscle displaces posteriorly
what inserts in the lateral clavicle
deltoid
a person comes with muscle injury if i give him succinyl choline what will happen
cardiac arrythmia
which muscle relaxant has organ independant elimination
atarocium
which gender does inclusion body myositis
50 male ,assymetic of distal muscle polymositis is generally female
myasthenia gravis
fluctuating muscle weakness with ocular involvement worsens end of the day
what is seen in polymyalgia rheumatica
Inflammation of synovial structures (e.g., of the subacromial or subdeltoid bursas, of the glenohumeral joint) on ultrasound may be seen in polymyalgia rheumatica (PMR)
which physical exam finding is common in OSA
facial plethora
a patient develops facial redness on exposure to sunlight what could it be
delayed hypersensitivity reactions
what is the pathophys of malasezia causing hypo and hyperpigmentation
Malassezia spp. infect the stratum corneum → lipid degradation → production of acids that inhibit tyrosinase and damage melanocytes → hypopigmentation
the inflammation causes hyperpigmentation,
it is a well demarcated lesion
a person takes demeclocycline to treat his malignancy he later develops rash why
photosensitivity
if a patient ahs idiopathic rash due to hiv typically greasy could be associated with
sebarrhoreic keratosis
sle drug induced vs classical rash
drug induced is erythematous and scaly vs cassical spares nasolabial fold
what sort symtom is seen in plegarra
burning
ehat is helitroprash
An erythematous to violaceous rash on the upper eyelids, sometimes accompanied by edema. Classically associated with dermatomyositis
specify rash in dermatomyositis
associated with nasolabial
radiological finding of gout vs chondrocalcinosis
chondrocalcinois doesnt have punctate radiological findings
where does calcification occur in pseudogout
Fibrocartilage (meniscus, annulus fibrosus of intervertebral disk)
supracondylar fracture various displavcements
anterior=brachial artery
anteriolateral=radial nerve
medial =median nerve
if you have a flexion type of supracondylar fracture
then you have ulnar nerve injury
obtruator artery destroyed in which fracture
acetabulum fracture
what is the branch of femoral profundus artery
middle femoral circumflex artery
what is the most coommon fetal cause of spontaneus abortions
chromosomal abnormalities
which muscle inserts in lateral 3rd of clavicle
trapexius muscle displaces posteriorly
what inserts in the lateral clavicle
deltoid
a person comes with muscle injury if i give him succinyl choline what will happen
cardiac arrythmia
which muscle relaxant has organ independant elimination
atarocium
which gender does inclusion body myositis
50 male ,assymetic of distal muscle polymositis is generally female
myasthenia gravis
fluctuating muscle weakness with ocular involvement worsens end of the day
what is seen in polymyalgia rheumatica
Inflammation of synovial structures (e.g., of the subacromial or subdeltoid bursas, of the glenohumeral joint) on ultrasound may be seen in polymyalgia rheumatica (PMR)
which physical exam finding is common in OSA
facial plethora
a patient develops facial redness on exposure to sunlight what could it be
delayed hypersensitivity reactions
what is the pathophys of malasezia causing hypo and hyperpigmentation
Malassezia spp. infect the stratum corneum → lipid degradation → production of acids that inhibit tyrosinase and damage melanocytes → hypopigmentation
the inflammation causes hyperpigmentation,
it is a well demarcated lesion
a person takes demeclocycline to treat his malignancy he later develops rash why
photosensitivity
if a patient ahs idiopathic rash due to hiv typically greasy could be associated with
sebarrhoreic keratosis
sle drug induced vs classical rash
drug induced is erythematous and scaly vs cassical spares nasolabial fold
what sort symtom is seen in plegarra
burning
ehat is helitroprash
An erythematous to violaceous rash on the upper eyelids, sometimes accompanied by edema. Classically associated with dermatomyositis
specify rash in dermatomyositis
associated with nasolabial
how do antiphospholipid antibodies work
These antibodies inactivate anticoagulant proteins (e.g., protein C and protein S, antithrombin III) and activate platelets and vascular endothelium,
necrotising autoimmune myopathy
necrotic muscle fibers infiltrated by noninflammatory macrophages beside normal muscle fibers without immune cell infiltration. Occurs in association with other rheumatic diseases (e.g., scleroderma or mixed connective tissue disease) or statin use, but does not improve with discontinuation of statins.
atrophic muscle fibres interspaced with hypertrophy
Atrophic muscle fibers interspersed among hypertrophic muscle fibers would be found in spinal muscular atrophy. While spinal muscular atrophy can manifest with progressive muscle weakne
which two diseases has gowers sign
SMA/becker, differentiation is spinal muscular atrophy has fasiculations, whereas and bulbar symotoms
which virus causes gullian barre syndrome, intial symtoms
zika virus back and limb pain
what is the most coommon fetal cause of spontaneus abortions
chromosomal abnormalities
decreased grip strenth with fall on outstretched hand
Decreased grip strength with pain in the anatomical snuffbox suggests a scaphoid fracture, which is typically caused by falling onto an outstretched hand.
colles fx vs scaphoid
colles dorsiflexed wrist abnormal wrist and radial angulation
pathophys of dupteryn contracture
Dupuytren contracture (palmar fibromatosis) is a fibroproliferative disorder of the palmar fascia [9] Injury (trauma/ischemia) to the palmar fascia triggers myofibroblasts → fibroblast proliferation and collagen (type III) deposition → thickening of the palmar fascia → formation of nodules in the palmar fascia The nodules are adherent to the overlying dermis → characteristic puckering of palmar skin [4] Nodules progress to form cords in the palmar fascia → flexion contractures of the palmar fas
osteochondritis disseca s presents with
diffusie joint pain withactivity
focal, aseptic necrosis of subchondral bone (most often the knee, elbow, or ankle) caused by mechanical stress and/or repetitive trauma. Results in the detachment of bone-cartilage fragments that become displaced within in the joint space and causes pain and progressive joint stiffness.§
radiograph xray of gout
Punched-out lytic bone lesions with spiky periosteal appositions can be detected in individuals with gout
trichenaliis
ransmitted via ingestion of encysted larvae in undercooked meat (especially pork). Infection can be subclinical or manifest with abdominal pain, nausea, vomiting, and diarrhea. In severe infections, larvae disseminate into the skeletal muscle and cause fever, pain, weakness, periorbital edema, and eosinoph
do skelektal myocytes have gap junctions
no bectherefore each cell must be stimulated via its endmotor plate
what is spigelian hernia
A rare type of hernia that arises in the ventral abdominal wall along the semilunar line, typically below the level of the umbilicus. Has a high risk of complications (e.g., incarceration, strangulation).
spinal accesory nerve
The spinal accessory nerve exits the skull through the jugular foramen and sends a branch to the sternocleidomastoid muscle 3 cm below the mastoid process before entering the posterior triangle of the neck to innervate the trapezius muscle. Spinal accessory nerve injury resulting in trapezius (and sternocleidomastoid) paralysis would be expected if there were an injury to the upper aspect of the posterior triangle of the neck.
where does azygous vein drain
svc at t4
what vessl extends to left supraclavicular space
thoracic duct
chondrocalcinosis affects which compartment and Oa affects which compartment
patellofemoral joint and the lateral knee compartment,
oa is medial kneww compartment
marginal erosion perarticular tissue opacificaiton=
gout
describe soap bubble appearence
loculated epiphyseal cyst
celidocranial dysplasia
n autosomal dominant condition characterized by delayed closure of the cranial sutures, craniofacial dysmorphism (e.g., frontal bossing, prominent chin, maxillary hypoplasia), dental abnormalities, and hypoplastic clavicles.