MSK Flashcards Preview

First Aid Diseases > MSK > Flashcards

Flashcards in MSK Deck (60):
1

Osteogenesis imperfecta

AD, no type I collagen (bone matrix formation impaired)
- fx at birth, blue sclera, deafness, sm teeth

2

Achondroplasia
- sx

AD, constitutively act'd FGFR3 gene (mutations incr w/ dad's age) -> inhib's chondrocyte prolif, bad cartilage at growth plates
- short arms/legs but nl head/axial sk (bc are membranous ossification not endochondral)

3

Osteopetrosis
- mutation?
- sx

AR (severe) or AD (less severe), bad osteocl's -> incr'd bone formation (see persistence of 1* unmineralized spongiosa in medullary canals)
- CA II mutation so no acidic envt for osteoclasts to work
- fx, visual/hearing loss (CN compression)

4

Osteomyelitis usu at? usu due to?
- In Sickle cell due to?
- Draining sinuses at higher risk of?

Metaphysis (tibia, fibula) in kids and epiphysis (from open wound) in adults
S. aureus
Salmonella paratyphi
SCC

5

Osteoporosis
=
2* causes
Trtmt
Type I =
Type II =

loss of mineralized bone & organic bone matrix (osteoid)
- incr'd cortisol, heparin, hypogonadism, malnut'n, space travel
- bisphosphonates (inhib resorption)
I = postmenopausal (decr'd estrogen)
II = senile type

6

Osteochondrosis

aseptic necrosis of ossification center in kids

7

Legg-Calve-Perthes dz

osteochondrosis; aseptic necrosis of femoral head ossification center in boys 3-10yo

8

Osteochondritis dissecans
usu due to?
most common site
late comp?

Osteochondrosis limited to articular epiphysis
- trauma, or ischemia
- distal femur
- OA

9

Osgood-Schlatter dz

painful swelling of tibial tuberosity in boys (at insertion of patellar tendon) -> knobby-appearing knees

10

Paget's dz of bone
- See incr'd?

Osteoclastic phase -> osteoblastic phase, so have thick weak bone (mosaic, woven, bone)
- Alk phos

11

Fibrous dysplasia

defect in osteoblastic differentiation and maturation -> medullary bone replaced by fibrous tissue w/ cyst formation, usu in ribs or femur

12

McCune-Albright's synd

unilat polyosteotic bone involvement (fibrous dysplasia, cysts in bones bc no osteobl's), cafe au lait spots, precocious puberty

13

1* malignant tumors of bone in decr'ing order of freq?

MM > osteogenic sarcoma > chondrosarcoma > Ewing's sarcoma

14

Osteomalacia/Rickets
- low serum phos from?
- incr'd serum what?

VitD defic -> can't mineralize/calcify osteoid (see osteoid matrix accum around trabeculae and widened osteoid seams)
- low VitD -> low serum Ca -> high PTH -> low serum phos
- alk phos from high osteobl activity

15

Giant cell tumor (osteoclastoma)
- age, gender, location
- XR shows
- histo

- 20-40yo, F>M, in epiphyseal end of long bones (distal femur or prox tibia)
- double bubble or soap bubble
- spindle-shaped cells w/ multinuc'd giant cells

16

Osteochondroma =

benign lat projection from growth plate, cartilagenous cap (metaphysis of distal femur)

17

Osteosarcoma
- in who?
- location?
- XR shows

- M>F, 10-20yo
- metaphysis of long bone (distal femur, prox tibia)
- Codman's triangle (from elevation of periosteum) or sunburst pattern

18

Ewing's sarcoma
- who gets it?
- location
- derived from
- see what on histo?
- genetics?

- boys <15yo
- diaphysis of long bones, pelvis, scapula, ribs
- from neuroectoderm
- onion-skin appearance in bone (new bone growth around tumor), sm blue cell in tumor
- t(11;22)

19

Chondrosarcoma =
- who gets it
- mets to?

malig cartilaginous tumor in medullary cavity of diaphysis
- M 30-60yo
- lungs

20

Osteoma
- location
- assoc'd w/?

- facial bones
- Gardner's polyposis synd

21

Osteoid osteoma =
- location (on XR?)
- pain?

benign tumor of osteobl's surrounded by rim of rctive bone (osteoma)
- long bone cortex in diaphysis (on XR see bony mass w/ lucent core)
- resolves w/ ASA

22

Osteoblastoma =

like osteoid osteoma but in vertebra and no pain response to ASA

23

OA =
- Other findings
- Sx
- On fingers see?

noninflamm jt dz, from wear and tear, progressive degen of articular cartilage
- osteophytes at jt margins; clefts, subchondral cysts; no fusion of bone
- Jt stiffness after inactivity
- Heberden's (DIP) nodes and Bouchard's (PIP) nodes

24

Ochronosis (alkaptonuria) =
- causes?

AR, defic of homogentisic acid oxidase -> accum of homogentisic acid (urine turns blk when ox'd) -> deposits in intervertebral discs -> OA and other systemic findings

25

RA =
- Fusion of jts from?
- Hand sx
- Assoc'n w/ HLA?
- Abs to?

RF from B cells (IgM against Fc of IgG) combos w/ IgG -> imm complex -> C' -> chronic synovitis and pannus formation (granulation tissue)
- Pannus formation -> cytokines that destroy articular cartilage -> fusion of jt by scar tissue
- MCP and PIP jts, symmetric, ulnar dev and morning stiffness, swan neck deform and Boutonniere deform
- HLA-D4
- RF, but anti-cyclic citrullinated peptide Ab is more sp

26

Sjogren's synd
- sx
- incr'd risk of?
- dx by?

autoimm destruc of minor salivary gl's and lacrimal ducts
- RA, dry eyes, dry mouth, dental carries
- B cell lymphomas
- (+) ANA, RF, anti-SS-A/-B; confirm by lip bx

27

JRA
- RF?
- Still's dz for 20% = ?

- usu neg
- F, rash, polyarthritis

28

Infec arthritis
- sx?
- caused by?

STD: Synovitis (knee), Tenosynovitis (hand), Dematitis (pustules)
- S. aureus, Strep, Neisseria gonorrhoeae

29

Reactive arthritis (Reiter's synd) =
- dx'ic sign?

post-GI or chlamydia infec's
- can't see (conjunctivitis), can't pee (urethritis), can't climb a tree (arthritis)
- Achilles tendon periostitis

30

If you have AS, you can also have?

Aortitis, uveitits w/ potential for blindness

31

SLE sx

I'M DAMN SHARP:
- Igg's (anti-dsDNA, anti-Sm, antiphospholipid)
- Malar rash
- Discoid rash
- ANA
- Mucositis (oropharyngeal ulcers)
- Neuro d/o's
- Serositis (pleuritis, pericarditis) (interstitial fibrosis of lung)
- Heme d/o's (Abs to cells)
- Arthritis
- Renal d/o's
- Photosensitivity

32

Drug induced lupus
- drugs?
- Ab?

- Procainamide, hydralazine, isoniazid
- antihistone Abs

33

Septic arthritis: 4 causes?

S. aureus, NG, Lyme dz, Pasteurella multocida

34

DMD
Becker's type?
at birth have incr'd?

XR, no dystrophin
- have dystrophin but is deficient
- CK, decr's as m's degenerate

35

Myotonic dystrophy
- sx

CTG trint repeat d/o, AD, atrophy of type I fibers
- sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement

36

Myasthenia gravis
- sx
- trtmt

autoAbs to ACh Rs
- m. wkns worse w/ exercise and better w/ rest; ptosis, diplopia
- Tensilon/Edrophonium (ACHE inhib) to test, pyridostigmine to trt

37

Fibromatosis
- sx
- assoc'd w/?

non-neoplastic, prolif ct d/o
- Dupuytren's contracture (of palmar fascia)
- Gardner's polyposis synd

38

Lambert-Eaton myasthenic synd
- sx

autoAbs to presyn Ca ch -> decr'd ACh release
- prox m. wkns that improves w/ m. use

39

Myositis ossificans

metaplasia of SkM to bone post-trauma, see mass in bone on XR

40

Molluscum contagiosum
- trtmt?

poxvirus; bowl-shaped lesions w/ central depression filled w/ keratin and viral particles
- spont remission in 6-9mo if imm competent

41

Polymyositis
- sx

endomysial inflamm w/ CD8 T cells
- symm prox m. wkns

42

Dermatomyositis
- sx
- incr'd risk of?
- Labs?

perimysial (edge of m.) inflamm and atrophy w/ CD4 T cells (Ab damage)
- bilat prox m. wkns w/ malar rash, Gottron's papules and heliotrope rash
- occult malig
- Incr'd CK, ANA(+), (+)anti-Jo-1 Abs

43

CREST synd =

Calcinosis and centromere Ab
Raynaud's
Eso dysmotility
Sclerodactyly
Telangiectasia

44

Hyperkeratosis =
seen in

incr'd thickness of stratum corneum
- Psoriasis

45

Parakeratosis =
seen in

hyperkeratosis w/ retention of nuc in stratum corneum
- Psoriasis

46

Acantholysis =
seen in

separation of epi cells
Pemphigus vulgaris

47

Acanthosis =
seen in

epi hyperplasia (incr'd spinosum layer)
Acanthosis nigricans

48

Dermatitis =
seen in

inflamm of skin
atopic dermatitis

49

Melasma (chloasma) =

hyperpigmentation assoc'd w/ preg or OCP use

50

Seborrheic keratosis =

flat, greasy, pigmented sq epi prolif w/ keratin-filled cysts (horn cysts), looks "stuck on"; most common benign tumor in older ppl

51

Leser-Trelat sign =

sudden appearance of multiple seborrheic keratoses -> underlying malig (GI like stomach adenoca, lymphoid)

52

Dermatitis herpetiformia =
- assoc'd w/? thus, trtmt is?

pruritic papules, vesicles and bullae; deposits of IgA at tips of dermal papillae; assoc'd w/ Celiac dz so resolves w/ gluten-free diet

53

Actinic (solar) keratosis =

premalig lesions caused by sun exposure; sm rough erythematous or brownish papules/plaques; risk of SCC (pearly grey-white)

54

Lichen Planus =
- assoc'd w/?
- histo shows?

6Ps: pruritic, purple, polygonal planar papules and plaques
- HepC
- sawtooth infiltrate of lymph's at dermal/epidermal jxn

55

Keratoacanthoma

variant of SCC that grows quick and regresses quickly too (benign crateriform tumor w/ central keratin plug)

56

Solar lentigo have incr'd # of?

melanocytes (liver spots in elderly)

57

Superficial spreading melanoma is?
Lentigo maligna melanoma is?
Nodular melanoma has?

- most common type of malig melanoma
- in elderly, least likely to have vertical phase
- no radial phase, only vertical phase (BAD)

58

Psoriasis - 2 other signs besides erythematous plaques w/ silver scales?

Munro microabscesses in stratum corneum and Auspitz sign

59

Innervation of rotator cuff m's

C5-6

60

Melanoma often driven by mutation in?
- sp trtmt?

BRAF kinase
- Vemurafenib = BRAF kinase inhib