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Goljan facts Flashcards

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1
Q

Pathological fractures at birth, deafness, and blue sclera. What is the treatment?

A

OI–> Bisphosphanates= increase bone mineralization

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2
Q

Impaired proliferation of cartilage at growth plate causing normal sized head with short limbs. What is the genetics?

A

AD mutation in FGFR 3 gene

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3
Q

“Marble bone” disease causing TOO much bone that is brittle caused by deficiency of osteoclasts?

A

Osteopetrosis

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4
Q

PT with pathological fractures, Anemia, visual and hearing loss due to nerve compression. Dx?

A

Osteopetrosis

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5
Q

Most common route and site of spread of osteomyelitis?

A

Hematogenous

METAPHYSIS

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6
Q

MCC of osteomelitis?

A

S. aureus

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7
Q

MCC of osteomyelitis in SCD patients?

A

Salmonella

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8
Q

Hematogenous spread of lung infection to vertebral column?

A

TB osteomyelitis= POTT’s disease

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9
Q

Osteomyelitis caused by puncture of foot through rubber footwear?

A

P. aeruginosa

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10
Q

What are sequestra and involucrum?

A

Sequestra–> Dead bone

Involucrum–> Reactive bone formation

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11
Q

What is a consequence of Draining sinus tracts associated with Osteomyelitis?

A

SCC

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12
Q

Pt with Fever, bone pain, and CT showing dead bone with a rim of bone formation. MCC?

A

Osteomyelitis= S. aureus

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13
Q

Loss of both organic bone matrix and minerals with associated Decreased thickness of Cortical and trabecular bone?

A

Osteoporosis

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14
Q

Diagnosis of osteoporosis is done by?

A

Dual photon absorptiometry

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15
Q

What are the MCC of avascular necrosis?

A

Corticosteroids
Alcohol
SCD

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16
Q

MC site of avascular necrosis?

A

Femoral head and condyle

*Scaphoid bone

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17
Q

Pt w. localized pain that is exacerbated with movement, MRI showing increased density known as “double line sign” of bone?

A

Avascular necrosis

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18
Q

Trauma–> ischemia–> separation of cartilage from bone –> articular epiphysis fails MC in Distal Femur?

A

Osteochondritis dissecans

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19
Q

Men >50 yo, targets pelvis + femur and ENLARGED skull, possibly caused by viruses?

A

Paget’s disease

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20
Q

Weak, thick, mosiac bone, with high vascularity, increased ALK, Bone pain. What are other complications of this disease?

A

Osteogenic Sarcoma
High OUTPUT Heart Failure
Hearing Loss

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21
Q

Increased Hat size?

A

Pagets disease== increased Skull size during osteoblastic phase

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22
Q

Defect in Osteoblastic differentiation and maturation?

A

Fibrous dysplasia

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23
Q

Medullary bone replacement by fibrous tissue and cyst formation most commonly in RIBS and femur?

A

Fibrous dysplasia

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24
Q

Fibrous dysplasia involving many bones (polyostotic) + Cafe au lair spots + precocious puberty?

A

Albright syndrome

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25
Most common benign tumor of bone?
Osteochondroma
26
Bone tumor in Epiphysis of Distal femur or proximal Tibia?
Giant Cell tumor of bone
27
Negatively birefringent--> Yellow= Parallel = ?
Monosodium urate crystals
28
Positively birefringent--> Blue= parallel = ?
Calcium pyrophosphate crystals
29
10-30 yo Male pt w/ an outgrowth of his Distal femur?
Osteochondroma
30
Medullary tumor in Small tubular bones of Hand/ Feet Dx?
Enchondroma
31
Male pt with mass in the Facial bones and hx of multiple GI polyps?
Osteoma --> associated with Gardner's polyposis syndrome
32
Male, 10-20 yo w. "Radiolucent focus surrounded by sclerotic bone" in cortex of his Proximal femur. Tx of his Nocturnal bone pain is?
Osteoid osteoma--> Aspirin
33
Radiolucent focus surrounded by sclerotic bone?
Osteoid--> sclerotic area | Osteoma--> FOCUS
34
Osteoid Osteoma occurring in Vertebrae and not relieved by Aspirin?
Osteoblastoma
35
Female 30-60 yo pt with Neoplastic mononuclear cells in the epiphysis around Knee. Describe Histology?
Giant cell tumor= Multinucleated giant cells
36
Male with growing mass in Pelvic bones that has metastasized to his lungs?
Chondrosarcoma
37
Male 10-25yo with growing mass in the Metaphysis around his KNEE, FHx of Blind sister, fibrous dysplasia. What are the MC radiologic findings?
Codmans triangle | "Sunburst"--> speculation of calcified tumor
38
What are the risk factor for Osteogenic sarcoma?
Pagets disease Retinoblastoma Radiation Fibrous dysplasia
39
Male 10-20 yo with small round blue cell tumor in the Diaphysis of his Femur or Pelvic girdle. MC radiological finding is?
Ewing sarcoma--> "Onionskin" appearance
40
"Onionskin" appearance of bone on radiography?
Ewing sarcoma
41
What forms of arthritis show "morning stiffness?"
RA SLE Polymyalgia rheumatica
42
Homogentisic acid deposits in intervertebral disks showing Black color and leading to Osteoporosis. Dx?
Alkaptonuria
43
Articular cartilage is made up of?
Type II collagen | Proteoglycans
44
Osteophytes/ enlargement of DIP joints are called?
Heberdens nodes
45
Osteophytes/ enlargement in PIP joints are called?
Bouchards nodes
46
What are the common joint features in Osteoporosis?
``` Subchondral sclerosis Bony spur Osteophytes Joint mice-> cartilage fragments NO ANKYLOSIS ```
47
Noninflammatory joint disease 2nd to neurological disease causing loss of Proprioception?
Neuropathic arthropathy
48
Causes of Neuropathic arthropathy?
Diabetes Mellitus Syringomyelia Tabes dorsalis
49
Disease of Women associated with HLA-DR4?
RA
50
B cells producing antibodies against Fc portion of IgG causes?
Rheumatoid factor--> RA
51
Granulation tissue that releases cytokines and destroys articular cartilage?
PANNUS--> repair causes Ankylosis
52
Ulnar deviation, Swan neck finger, Boutonniere deformity seen in?
RA
53
Describe joint space in RA?
Inflammation PANNUS eroding cartilage Fibrous + BONE ankylosis
54
What are some of the complications of RA?
``` Chronic pleuritis Interstitial Fibrosis (NSIP pattern) Anemia of chronic disease Carpal Tunnel Bakers cysts (popliteal) Rheumatoid nodules (Caplan syndrome in LUNGS) Sjogrens syndrome ```
55
Initial therapy for RA is?
NSAIDS
56
Sjogrens syndrome is associated with developing?
Lymphomas
57
Male dominance arthritis caused by Alcohol, high meat diets, treating leukemias?
Gout
58
What are some inborn errors of metabolism associated with GOUT?
HGPRT deficiency-> Lesch Nyhan syndrome
59
Complications of Gout include?
Urate nephropathy Uric acid stones HTN
60
Chronic gout leads to the formation of?
Tophi--> MSU deposits in soft tissue around joints
61
RF negative, arthritis of Skeleton/spine, Male dominance, Sacroiliitis, HLA-B27?
Seronegative Spondyloarthropathy Ex: Ankylosing spondylitis + Reiters syndrom + Psoriasis + Enterhepatic
62
HLA-B27?
Spondyloathritis
63
Male with Sacroiliitis morning stiffness?
Ankylosing Spondylitis
64
Longterm consequences of Ankylosing Spondylitis?
Bamboo spine--> ankylosis of vertebrae Aortitis w. Regurgitation Uveitis --> Blindness
65
Urethritis due to Chlamydia trochomatis, Achilles Tendon periostitis, conjunctivitis, Arthritis?
Reiters syndrome
66
Conjunctivitis + Urethritis + Arthritis ?
Reiters syndrome | can't SEE, cant PEE, cant climb TREE
67
Sausage shaped DIP joints, "pencil-in cup" deformity" + nail pitting?
Psoriatic arthritis
68
20yo female w. deficient in C5-C9, Knee arthritis, dermatitis?
Septic arthritis== Gonococcal
69
FIbers rich in mitochondria, oxidative enzymes, poor ATPase enzymes?
Type I = Slow twitch
70
Specailized for fine, skilled movements, poor mitochondria, rich in ATPase and glycolytic enzymes?
Type II== Fast twitch
71
Weakness and wasting of pelvic muscles, Gower's maneuver, Waddling gait. What is the genetics?
DMD--> X- recessive--> absent Dystrophin
72
What lab finding is seen in DMD?
Increased CK @ birth
73
Male adult pt, unable to relax grip, sagging face/ cant close mouth, testicular atrophy, cataracts. Genetics?
AD Tri-nulceatide repeats (CTG)--> Myotonic dystrophy
74
Antibodies against ACh receptors, thymic hyperplasia, endrophium test positive. What are the clinical signs of this disease?
``` Ptosis--> Upward gaze Diplopia Proximal muscle weakness-> WORSE w. exercise Dysphagia for solids + liquids NO sensory or reflex loss ```
75
5ps; pain, paresthesia, pallor, paralysis, pulselessness?
Compromised blood supply--> COMPARTMENT syndrome
76
Risk factors of Gonococcal arthritis?
C5-C9 deficiency Recent menstruation Pregnancy or postpartum SLE
77
Symmetric proximal muscle weakness + heliotrope rash + Elevated muscle enzymes + myopathic changes on EM + biopsy abnormality?
Polymyositis or Dermatomyositis
78
Heliotrope rash is high specific for?
Dermatomyositis
79
Anti-Jo antibodies?
Dermatomyositis or Polymyositis
80
Specific mutation significant for Pg of Osteopetrosis?
Carbonic Anhydrase II --> Acidic environment is required for Bone resorption
81
Fractures + leukopenia + hearing impairment + Renal tubule acidosis. Tx?
Osteopetrosis--> TRANSPLANT
82
Pigeon breast deformity + Frontal bossing + Beads in the Ribs?
RICKETS | Beads= rachitic rosary
83
Decreased Ca++ & phosphorus, increased PTH & ALK?
Osteomalacia
84
Activation of Osteoblasts causes and increase in what serum test?
ALK --> Alkaline environment is required to LAY down bone
85
Where does Osteomyelitis usually occur in children?
Metaphysis--> Growing bone need more Blood at the Metaphysis which brings in the Infection
86
Adults with osteomyelitis will the infection located where?
Epiphysis--> blood supply goes through growth plate and takes infection more distal
87
Main causes of avascular necrosis?
Trauma/ fracture SCD Steroids Caissons

Rheumatology (4 decks)

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