MSK Flashcards
(168 cards)
1
Q
cant extend wrist … triceps reflex diminshed …. touch sensation decresed on deltoid and later post arm
A
posterior cord
2
Q
pelvic fracture can damage which nerve
A
femoral
3
Q
common peroneal nerve function (L4 S2)
A
PED
Peroneal Everts and Dorsiflexes
damage —- dropped foot
4
Q
tibial nerve (L4 S3)
A
TIP
tibial Inverts and plantar flextion
5
Q
15 year old basketball player…. 6 months of knee pain … better with rest ,,,swelling erythema tenderness of anterior leg ….
A
osgood sclatter
pain at knee extension … condition devlps where the patellar tendon inserts at tibial tubercle of proximal tibia
6
Q
characterized by tenderness at the attachment site of the quadriceps tendon which is the inferior patellar pole.
A
patellar tendonitis
7
Q
39 yr old … facial rash on cheeks ,,,pustules papules seen on forehead that get worse with sun exposure
erythemia with telengectasia
tx>
A
Rosascea
topical metronidazole
8
Q
which zoonotic inf can be treated with amox clav
A
pastreulla by cat dog bites
9
Q
cat scratch disease agent and TXT
A
bartonella henslae….
azithromycin
10
Q
trip to Great lakes … verrucous skin lesions and bone lytic lesions
A
blastomycosis
broad base budding
11
Q
diminution of chondrocytes and thickening of synovium
A
RA
12
Q
Clusters of neutrophils with needle-shaped crystals
A
gouty arthritis
13
Q
islodged pieces of cartilage and subchondral bone
A
osteoperosis
14
Q
levels of calcium alkaline phosphate magnesiums and phosphorus is osteoperosis
A
ALL NORMAL
15
Q
elevated alkaline phosphatase (ALP) level in the setting of normal micronutrient levels
A
paget disease
increased activity of osteoclasts…
16
Q
Elevated calcium and alkaline phosphatase levels may indicate
A
bone metastasis
17
Q
primary hyper PTH
A
calcium is high
phosphorus is low
alp is high too
18
Q
erbs palsy which nerve roots damaged and which muscle is still OK
A
c5 c6
triceps ok
19
Q
infraspinatus function
A
lateral arm rotation
20
Q
polymyositis
A
no rash involved
endomysial infiltration of CD8 t cells
21
Q
dermatomyositis
A
PERIMYSIAL infiltraition CD4 tcells
thinl perimysium is closer to skin
22
Q
antiU1RNP antibodies
A
MCTD
23
Q
pt has a known allergy to seafood and he consumes it what type of reaction is this
A
, type 1 hypersensitivity reaction
e to mast cell degranulation of the superficial dermi
24
Q
impact of prevalence on PPV AND NPV
A
, as the prevalence of disease increases, the positive predictive value (PPV), the probability that a positive test result is truly positive, increases and the negative predictive value (NPV), the probability that a negative test is truly negative, decreases
25
femoral head fracture which artery affected
medial circumflex artery
26
Negatively birefringent crystals in joint fluid
GOUT
27
Weakly positively birefringent crystals in joint fluid
pseudogout
| normal 50+ pt
28
evelops into the central nervous system, encompassing the brain, spinal cord, and retina.
neuroectoderm
29
melanocytes, the peripheral nervous system (dorsal root ganglia, etc), and Schwann cells
neural crest cells
30
Endoderm
gut tube epithelium from the esophagus all the way to the anal canal above the pectinate line.
lungs liver gall bladder
31
outer portion of our bodies, including skin and sweat glands
ectoderm
32
seronegative spondyloarthropathies
```
PAIR
psoriasis
Ankylosing spondy
Inflmmtry bowel d
Reative arthritis
```
33
Damage to gap junctions occurs in
chagas
34
Pemphigus vulg
desmosin
| desmoglein
35
nerve block agent
upivacaine binds to the intracellular portion of voltage-gated sodium channels, blocking the sodium influx into nerve cells, which prevents depolarization of the nerve.
bupivacaine
36
NMDA receptor antagonist.
Ketamine
| systemic medication
37
Increasing GABA channel closing time and potentiating sodium channels
propafol
38
sjigern syndrome HLA and increase risk of>
HLA DR3
| risk of lymphoma
39
first line treatment burn patient
| pseudomonas
piperacilin taazobactam
40
graves disease asooc with HLA
DR3
41
RA assoc with HLA
DR4
42
Multiple sclerosis HLA
DR2
43
Infliximab
Crohn disease, ulcerative colitis, and severe cases of this patient’s condition
monoclonal antibody
44
njectable drug used for rheumatoid arthritis that works by blocking TNF-alpha binding.
etanercept
45
two rows of upper and lower teeth, facial features that are “leathery” in appearance, and several small abscesses on his upper and lower extremities without surrounding erythema
of Job syndrome is the FATED mnemonic: Facies that are coarse, Abscesses that are cold, retained primary Teeth, increased IgE, Dermatologic problems.
failure to make IL 17
46
failure to synthesize major histocompatibility complex II
SCID
47
Microtubule dysfunction
chediak higashi
| albinism, megakaryocytes, peripheral neuropahty
48
Progressive destruction of B and T cells
Wiskott-Aldrich syndrome due to a lack of cytoskeletal proteins
thrombocytopenia eczema recurrent pyogenic
49
denosumab
monoclonal AB against RANKL
50
alendronate side effect
esophagitis
| pt can have bleeding ulcer for ex
51
trendelenburg gait
superior gluteal nerve
pt LEANS TOWARDS the affected side
the tilt is contralateral to the affected side
52
femoral nerve injury
inability to straighten knee
53
cross-links major histocompatibility complex II (MHC II) molecules on antigen-presenting cells to T-cell receptors on T cells independent of antigen
Tsst 1
54
nonspecific T-cell activation by exotoxin A
strept pyogenes can mediate a toxic shock like sydnormw
55
winged scapula nerve injury
long thoracic C567
56
c7 c8 injury pt presents with
decrease hand grip
57
IV muscle relaxant is guven to pts ... muscles twitch
| wha twas the agent
succniylcholine
mimics ACh and acts as an agonist at the nicotinic acetylcholine (nACh) receptor, depolarizing the muscle at the motor endplate. For this reason, patients often initially develop fasciculations soon after administration
58
nondepolarizing neuromuscular blocking agent. It is an acetylcholine receptor antagonist
veroconium
59
prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle by binding the ryanodine receptor.
dantrolene
| Neuroleptic malignant syndrome
60
78 woman
blurring of vision initiallty at night now during day
wakes up with stiff neck and shoulders
giant temporal arteritis
| txt with steroids
61
embolus composed of fibrin surrounding clear clefts
cholestrol embolus
62
deep femoral artery supplies what part of the thigh
posterior part
63
mandibular pain after a dental procedure and draining pus that reveals sulfur (“yellowish”) granules
actinomyces
| penicillin
64
Muscle spindles are small sensory organs enclosed in a capsule ... what are they imp for
proprioception
65
supracondylar fracture of the humerus is a fracture that occurs just above the elbow of the distal humerus
median nrve
66
r malignancies with bone metastasis:
```
PB KTTL
prostate
Breast
kidney
thyroid
testes
lung
```
67
nucleotide excision repair, which impairs a cell's ability to repair damage induced by ultraviolet radiation.
xeroderma P
68
carpal tunnel syndrome which muscles are most commonly weaknd
oponens pollicis
flexor pollicis brevis
abductor pollicis brevis
supplied by median nerve ... thenar brach which is compressed
69
cachexia
TNF alpha … macrophages
70
bcl2 function
inhibit actions of pro apoptotic proteins
71
Duchene mutation mechanism
frameshift deletion
72
a point mutation in the fibroblast growth factor receptor (FGFR-3) gene
achondroplasia
| inhibition of chondrocyte prolif
73
which signs can show mandibular nerve is intact
he lack of jaw deviation and intact general sensation
74
drooping of the side of the mouth
cranial nerve 7
| exits stylomastoid foramen
75
treatment for tinea corporis
| mechanism and name
Griseofulvin
| interferes with microtubule formation … alpha beta tubulin dimers
76
Antimicrosomal antibodies are associated with
hashimoto
77
Anti-Jo-1 antibodies
are directed against histidyl–tRNA synthetase.
| dermatomyositis
78
ailure of the resorption and remodeling of bone
lack of meduillary canal
remnants of primary spongiosa
osteopetrosis cant resorb bone
79
hyper igE
jobs
| th17 stat3 mutation --- impaired recruitment of neutrophils
80
define the mnemonic FATED
```
Facies coarse
Abscess
Teeth 2 rows
E hyper igE
Dermatitis
```
81
which arachidonic acid product increases in aspirin txt
leukotrienes
LT CDE are bronchoconstrictors
LTb4 neutrophil chemotaxis
82
strept pyogene infcts a childs throat … appropriate antibiotic can save which complication
theumatid heart dsease
| affects the mitral valve
83
Tumor necrosis factor antagonists
| which test to do before giving these
infliximab adalimumab
PPD
can reactivate TB
84
which tongue muscle is innervated by cranial nerve 10
palatoglossus
| elevates posterior tongue
85
after squats or other weight-bearing exercise of the lower extremity, causing difficulty in adducting the thigh.
obturator nerve
86
quotidian fevers, arthritis, and a classic salmon pink rash
Juvenile idiopathic arthritis (JIA)
87
ntellectual disability, self-mutilation behaviors, gout, and disordered movement
lesch nyhan
HPGRT deficiency
Since guanine and hypoxanthine are being lost as uric acid, the de novo synthesis pathway for purines must compensate; this compensation pathway utilizes folate and vitamin B12.
88
sensation over the medial 1½ digits and hypothenar eminence and has a deep motor branch that supplies most of the intrinsic muscles of the hand
ulnar
89
acute gout drugs
NSAIDS
glucocorticoids
colchicine
90
e most commonly affected ligament in ankle sprains and will always be the first ligament to become injured
anterior talofibular ligament
91
X-linked disorder is characterized by nephritis with hematuria, sensorineural deafness, and ocular disorders
alport
92
UNHAPPY TRIAD
ACL MCL and Medial lemniscus
93
g staphylococcal toxic shock syndrome (TSS)
excessive t cell activation
| IL1 IL2 IL6 TNF IFNgmma
94
mechanism of sarcoidosis
t is a cell-mediated immune response to an antigen
Th1 CD4+ cells that are activated by foreign antigens will secrete IFN gamma, which activates macrophages. These macrophages secrete TNF-alpha which furthers macrophage maturation and induces granuloma formation.
95
Overgrowth of granulation tissue due to excess collagen p
keloid
96
failure of the maxillary, medial nasal to fuse
cleft lip[
97
atient with arthritis, conjunctivitis, and urethritis after treatment for chlamydial infection (obligate intracellular organism) is presenting with
what copuld be another assoc with this diagnosis
reactive arthritis
| sacroillitis
98
seronegative spondylopathies what is a common smptom
sacroiliitis HLA B27
99
endochondral bone formation due to a mutation in the fibroblast growth factor receptor-3 (FGF-3 gene)
endochondral ossification
achondroplasia
100
MEMBRANOUS ossification problem
will have an effect on bone formation not just the extremities like in achondroplasia
101
why does rigor mortis occus
dead cells cant generate ATP which is neede to realease actin from myosin
102
features calcium pyrophosphate deposition,
pseudogout
103
HLA DR2
multiple sclerosis, hay fever, systemic lupus erythematosus, and Goodpasture syndrome
104
HLA DR4
Addison DM 1 RA
105
HLA DQ8
celiac disease
106
is a folic acid analog that inhibits dihydrofolate reductase and acts as antimetabolite
MTX
107
deltoid, supraspinatus, infraspinatus, and biceps brachii are affected in whch type of injuery
erbs palsy
| C5 C6
108
defect in N-acetylglucosaminyl-1-phosphotransferase,
I cell disease
| in Golgi
109
lipid synthesis and detoxification
smooth ER
110
bullous impetigo is always caused by
staph aureus
111
stiffness, fatigue, poor sleep, cognitive disturbance, and symptoms of depression or anxiety
signs of fibromyalgia
| mostly in young females
112
cremasteric muscle is made from
internal obliquw
113
anemia of chrnoc disease
normochromic normocyic
114
osteonecrosis of the jaw presents with exposure of the mandibular or maxillary bones in the mouth, along with pain and inflammation surrounding the exposed bone.
bisphosphonates
115
drug for crohns disease and gout if taken together can cause hemolytic anemia
azathioprine and allopurinol
| blocking xanthine oxidase increases levels of 6MP …. toxic for pt
116
10-year-old boy presents with progressive neurologic and dermatologic symptoms
he has thick, dry, and scaly skin
difficulty with sense of smell and sensori neural hearing loss
low action potential propagation
Peroxisomes contain enzymes involved in very-long-chain fatty acid metabolism.
Refsum disease
117
an accumulation of uric acid and is associated with self-mutilation behaviors, intellectual disability, gout, and movement disorders.
HGPRT def
118
homeless man presenting with hemoptysis, worsening back pain, fever, and night sweats..... tender back
POTTS disease
119
high specificity for RA.
anti-CCP—an autoantibody against citrullinated protein—has high specificity for RA.
120
highly specific for limited scleroderma (CREST syndrome)
Antibodies against centromeres or small nuclear ribonucleotide proteins (snRNPs)
121
HIV-positive patient’s severe upper back pain and low CD4 count, together with a finding of caseating granulomas (necrotic inflammatory infiltrate and giant cells) on a bone biopsy specimen, suggest that
potts
| txt with antimycobacterial therapy, often consisting of isoniazid, rifampin, and pyrazinamide.
122
fever followed by an erythematous rash that begins on the face and spreads to the trunk and extremities
rash described as pink, coalescing macules that spread down to the trunk
rubelaa
123
roseola infantum characterized
HHV6
| rash starts at trunk then spreads to face
124
relapsing spiking fevers
transient macular, salmon-pink rash hemophagocytic syndrome, in which macrophages begin digesting RBCs (which is the cause of this patient's low hematocrit)
polyarticular joint pain, swelling
juvenile idiopathic arthritis (JIA).
125
herniated bowel (which has passed through the internal inguinal ring and external inguinal ring to reach the scrotum) is covered by all three layers of spermatic fascia.
Indirect
| lateral to inferior epigastric and superior to inguinal ligamnt
126
triggered by a recent genitourinary or gastrointestinal infection with Shigella, Yersinia, Chlamydia, Campylobacter, or Salmonella
ShY ChiCS
| reative arthritis
127
best test for measuring the anti-CCP antibodies in this patient.
ELISA immunologic test used to detect a specific antibody or antigen in a patient's blood sample.
128
four muscles of mastication
```
Lateral Lowers jaw (lateral pterygoid)
Medial munch (masseter,l medial pterygoid and temporalis)
```
129
arthus reaction
An Arthus reaction is a type III hypersensitivity reaction in which immune complexes are deposited into the walls of blood vessels, causing painful swelling and erythema
130
s difficulty rising from a seated position and requires assistance when ascending stairs. It is also noted that he has difficulty abducting his thigh.
gluteal maximus
| inferior gluteal nerve L5 S2
131
HLA assovc with RA
HLA DR4
132
HLA B8
graves
133
HLA BW22
kawasaki
134
areas of increased unmineralized osteoid adjacent to normal trabeculae.
osteomalacia
135
Lack of a medullary canal and decreased numbers of osteoclasts
osteopetrosis
| lack of calcium and phosphorus causes osteocytes to produce less mineralized bone surrounding the cells
136
Pronation of the forearm
median nerve
137
ronic mucocutaneous candidiasis are thought to have a rare
t cell def
138
non bulous impetigo by staph wat would diff staph aur from strept
coagulase positive
| coagulase break fibrinogen to fibrin
139
characterized by a well-demarcated skin lesion with a black base, along with systemic symptoms
francisella tularenisis
140
coxsackie virus
SS +ve Rna
141
paramyxovirus
SS-ve RNA enveloped
142
Rubella
SS +ve enveloped RNA
143
general sensory info of e cornea, sclera, upper eyelid & conjunctiva.
V1
144
gents are commonly used against intracellular organisms.
Tetracyclines act by binding to 30s and prevent attachment of aminoacyl-tRNA.
145
Blockade of translocation at 50s
clindamycin
146
cover gram-negative organisms exclusively.
aminoglycoside
147
Irreversible binding of the 30S subunit
aminoglycoside
148
what is the problem in achondroplasisa
endochondrial ossification
| problem with hyaline cartilage model on which the osteoblasts work by laying out bone
149
what makes the diagnosis of Carpal tunnel more likely
tapping the nerve elicits a tingling response like pins n needles
150
trophied hypothenar eminence is assoc with which nerve pathology
ulnar nerve
151
treatment for M gravis
pyridostigmine which is acetylcholinesterase inhibitor
152
edrochonium is used for
ONLY DIAGNOSIS of MG
153
gram-negative bacteria that cause a positive Weil-Felix reaction
rickettsia species`
154
prosthetic joint and infection main pathogenB
staph aur
155
main muscles to laterally rotate arm are ....
| and which one more common in injury
infraspinatus and tere minor
| infraspinatus f=injury more common
156
enetic mutations of the Rb gene are associated withwhich bone tumor
osteosarcoma
| distal femur
157
abnormal cellular trafficking, which results in failure of phagolysosome formation
albinism, pyogenic infections, peripheral neuropathy, and bleeding tendencies.
chediak higashi
| microtubule dysf LYST
158
pt with history of typ2 diab and iv drug induced endocarditis comes with back pain
thoracic vertebrae --- tender warm erythema
what do us suspect
osteomyelitis
| DO MRI
159
fall on outsretched hand ... which fracture most common
scaphoid
| takes abt 2 weeks to be detevcted as a hyperdense xray
160
radial artery injury but hand still warm what contributes to the blood supply
superficial arch (ulnar continuation) and deep arch(radial)
161
atopic dermatitis has a defected .... protein
filaggrin protein..... disrupts tight juntion so allergen can enter dermis
162
what happens in pagets disease
increase in osteoclastic and osteoblastic activity
| ONLY ALP is high
163
multiple fractures from a minor accident, in the setting of high serum calcium and low phosphate,
osteitis fibrosa cystica
164
osteomalacia define
due to low vit D
| low calcium
165
untreated paget disease can lead to?
osteosarcoma
166
lyme disease pt under 8 years txt
amoxicillin
167
osteomyelitis in a homeless person ... blood culture shows gram negative oxidase +ve rod
pseudomonas
| IV drug
168
treatment for ETEC includes
fluoro and macrolides
