Misc. MSK info

Question 1

What happens in the first 6 hours of a joint being immobilized

Answer 1

Muscle fiber protein synthesis decreases

Question 2

What happens in the first 24 hours of joint immobilization

Answer 2

Shortening of the muscle fibers

Question 3

What happens within the first 48 hours of immobilization of a joint

Answer 3

Tissue surrounding the muscle fibers have increased collagen deposition

Question 4

When is a goniometer used

Answer 4

Getting accurate joint measurements

Question 5

What is the most common physical symptom associated with stress and anxiety

Answer 5

Stress induced muscle tension

Question 6

What are tension heads caused by

Answer 6

muscle spasms in the neck

Question 7

What is fibromyalgia

Answer 7

Diffuse pain without the structural changes that cause the discomfort

Question 8

How does fibromyalgia present

Answer 8

Pain along fibromyalgia tender points
Decreased ability to inhibit pain
Increased perceived pain
Increased sensation of other stimuli

Question 9

What are some causes of fibromyalgia

Answer 9

Genetic predisposition
Increased substance P in CSF
Serotonin / catecholamine signaling pathways
Decreased overall gray matter
Reduced pain improvement with positive emotion

Question 10

What are the causes of viral myositis

Answer 10

A&B influenza
enterovirus

Question 11

What does viral myositis lead to

Answer 11

muscle necrosis

in extremes can lead to rhabdo or compartment syndrome

Question 12

What are the causes of bacterial myositis

Answer 12

Typically hematogenous spread of a pathogen

pyomyositis (abscess)

S. aureus

Question 13

What area of the body is most commonly effects with bacterial myositis

Answer 13

Legs (pain cramping, discomfort)

Question 14

What are the causes of parasitic myositis

Answer 14

Trichinosis
cysticercosis
Toxoplasmosis
* generally from travel

Question 15

What is polymyositis and dermatomyositis

Answer 15

Immune mediated myopathy

Question 16

What muscle groups are typically effected by polymyositis

Answer 16

Proximal with symmetrical muscle weakness

Question 17

What are the skin presentations that occur with dermatomyositis

Answer 17

Gottron papules
heliotrope eruption
facial erythema
holster sign

Question 18

What is inclusion body myositis

Answer 18

idiopathic inflammatory myopathy

Question 19

Where is inclusion body myositis typically seen

Answer 19

Distal finger flexor with asymmetric weakness

Question 20

What does rhabdomyolysis eventually lead to

Answer 20

myoglobinuria from the circulating intracellular contents

Question 21

What does the shift of the intracellular products during rhabdomyolysis cause

Answer 21

Disruption of the NA+K+ATPase pumps and increased intracellular calcium

Question 22

What are complications that can occur with rhabdo

Answer 22

Acute kidney injury
Compartment syndrome
DIC

Question 23

How will rhabdo present

Answer 23

Myalgia
red/brown urine
Malaise
fever
tachycardia

Question 24

What is the cause of osteomalacia

Answer 24

Vitamin D deficiency
malabsorption
hypophosphatemia
ETOH abuse
tumors
drugs

Question 25

How does osteomalacia present

Answer 25

Bone and muscle pain Increased fracture frequency fatigue

Question 26

What disease causes an insufficient mineralization of the growth plate

Answer 26

Rickets

Question 27

What is the cause of rickets

Answer 27

Inadequate calcium and/or phosphate

Question 28

In rickets, what will happen in abutting bones

Answer 28

osteoid accumulates

Question 29

What is an osteoid

Answer 29

Unmineralized bone

Question 30

What is calcipenic rickets associated with

Answer 30

Low vitamin D or inability to metabolize vitamin D into their active form

Question 31

What is the most common cause of phosphopenic rickets

Answer 31

Renal phosphate wasting

Question 32

In what disease does the osteoclastic activity outweigh the osteoblastic activity during remodeling

Answer 32

Osteoporosis / osteopenia

Question 33

What is another name for osteitis deformans

Answer 33

Pagets disease

Question 34

What is pagets disease

Answer 34

Idiopathic dysregulation of bone remodeling resulting in enlarged, deformed bones

Question 35

What happens cellularly with pagets disease

Answer 35

Hyperactive osteoclastic activity followed by abnormal osteoblastic activity

Question 36

What is the most common presentation of pagets disease

Answer 36

Hip pain

Question 37

What can happen with vitamin D deficiency

Answer 37

Hypocalcemia hypophosphatemia Rickets osteomalacia

Question 38

What occurs with hypocalcemia

Answer 38

Decreased circulating calcium causes an increase in parathyroid function = more bone breakdown

Question 39

If a patient has a femoral neck fracture that leads to AVN, what vessel was damaged

Answer 39

Circumflex (will experience groin pain from AVN)

Question 40

What can cause a meniscal tear

Answer 40

Twisting with planted foot squatting

Question 41

What is the psoas sign and how do you test it

Answer 41

Stretch to test it Can test for appendicitis

Question 42

What can cause an anterior hip dislocation

Answer 42

Ski tip gets stuck and lead to external rotation and abduction of the leg

Question 43

What ligament tears with a patellar dislocation

Answer 43

Retinaculum

Question 44

What ligament do you tear with an ankle sprain

Answer 44

ATFL

Question 45

what is a Liz franc fracture

Answer 45

Separating of metatarsal bones * need wt bearing and non wt bearing films

Question 46

What is the diabetic foot collapse known as

Answer 46

Charcots foot

Question 47

Why is staph aureus so hard to treat

Answer 47

It has coagulase and created a biofilm Also inhibits osteoblast activity

Question 48

Why are uncontrolled diabetics considered immunocompromised

Answer 48

Glucose messes with PMNs

Question 49

What can excessive alcohol cause

Answer 49

Leaky gut

Question 50

What does CREST stand for

Answer 50

Calcinosis Raynauds esophageal sclerodactyly telangiectasia

Question 51

Where is the neuromuscular bundle in the ribs found

Answer 51

In the costal groove