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Board Review - C - MSK/Dermatology > MSK/Derm III > Flashcards

MSK/Derm III Flashcards

1
Q

muscle components

A 
Z disc - actin attachment
M line - myosin attach
A band - all myosin
H band - myosin only
I band - myosin only

sarcomere - Z disc to Z disc

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2
Q

smooth m contraction

A

nitric oxide - guanylate cyclase - increased cGMP

  • de-P myosin
  • relaxation

action potential - L-type Ca channel - increased Ca
-increased Ca/calmodulin complex > P of myosin

myosin-P bind actin and contraction occurs

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3
Q

endochondral ossification

A

cartilage bone - replaced by osteoclasts/blasts - into woven bone

remodeled to lamellar bone

woven bone - after fx and with pagets

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4
Q

membranous ossification

A

bones of calvarium and face

woven - without cartilage

later remodel to lamellar

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5
Q

osteoblast

A

from mesenchymal stem cell in periosteum

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6
Q

osteoclast

A

from monocyte/macrophage

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7
Q

PTH action

A

low - anabolic - build bone

chronic high - catabolic - osteitis fibrosa cystica

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8
Q

estrogen

A

inhibit apoptosis of osteoblasts
induce apoptosis osteoclasts

deficient - excess remodeling - osteoporosis

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9
Q

achondroplasia

A

fail long bone growth

  • affect endochondral ossification
  • membranous ossification unchanged

activation of FGFR3 - inhibit chondrocyte proliferation

auto dom - full penetrance
MCC dwarfism

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10
Q

primary osteoporosis

A

loss trabecular spongy bone and interconnections

with long term steroid use, anticonvulsant, antigcoag, thyroid replacement therapy

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11
Q

DEXA scan

A

T score

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12
Q

colles fx

A

distal radius

common with osteoporosis pt

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13
Q

type I osteoporosis

A

more resorption bc of low estrogen

post-menopause

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14
Q

type II osteoporosis

A

men and women >70yo

prophylaxis - Ca and vit D

tx - bisphosphonate, PTH analog, SERM

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15
Q

denosumab

A

mAb - RANKL

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16
Q

osteopetrosis

A

marble bone disease

failure resorption
-thick dense bones that fx

bone fills marrow space - pancytopenia

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17
Q

mutation of osteopetrosis

A

carbonic anhydrase II
-impair osteoclast ability generate acidic environment for bone resportion

bone in bone appearnce

get nerve impingement

18
Q

tx osteopetrosis

A

bone marrow transplant
-curative

bc osteoclasts from monocytes

19
Q

osteomalacia and rickets

A

Vit D deficient

defective calcification of osteoid - soft bones

low vit D, low serum Ca, igh PTH, low serum P

hyperactive osteoblast - elevated ALP

20
Q

osteitis deformans

A

paget disease of bone

21
Q

paget disease of bone

A

increased osteoblast and osteoclast activity

serum Ca, PTH, P - normal
elevated ALP

mosaic pattern of woven and lamellar bone

22
Q

pagets stages

A

1 - lytic - osteoclast
2 - mixed - osteoclast/osteoblast
3 - sclerotic - osteoblast
4 - quiescent - minimal clast/blast activity

23
Q

osteonecrosis

A

avascular

often femoral head - insufficient medial circumflex femoral a

with alcoholism, sickle cell, storage problem, pancreatitis, trauma, idiopathic, caisson

24
Q

lab values osteoporosis

A

normal except low bone mass

25
Q

osteopetrosis labs

A

possible low Ca
all else normal

dense brittle bone

low Ca if severe

26
Q

paget disease of bone labs

A

high ALP

abnormal mosaic bone pattern

27
Q

osteomalacia/rickets labs

A

low Ca
low P
high ALP
high PTH

soft bones

28
Q

primary hyperPTH labs

A

high Ca
low P
high ALP
high PTH

29
Q

secondary hyperPTH labs

A

low Ca
high P
high ALP
high PTH

compensation end stage renal disease - low P excretion and production of activated vit D

30
Q

giant cell tumor

A

B9

in epiphysis
aka osteoclastoma

often around knee
soap bubble o X-ray
multinucleated giant cell

31
Q

osteochondroma

A

B9 tumor
-often in kids

mature bone with cartilage cap

32
Q

ostesarcoma

A

aka osteogenic sarcoma
-2nd MC primary malignant bone tumor - after MM

bimodal

33
Q

risk fx osteosarcoma

A 
paget
bone infarct
radiation
Rb
li fraumeni
34
Q

location of osteosarcoma

A

metaphysis

see onion skin periosteal rxn of bone

35
Q

codman triangle

A

elevation of periosteum - with osteosarcoma

also see sunbursy apttern

spread - hematogenous

36
Q

ewing sarcoma

A

malignant tumor - boys

37
Q

prognosis of ewing sarcoma

A

often in young kid
aggressive with early mets
-responsive to chemo

38
Q

tumor of epiphysis

A

giant cell

39
Q

tumor of metaphysis

A

osteosarcoma

osteochondroma

40
Q

tumor of diaphysis

A

ewing
myeloma

osteoid osteoma - night pain with central nidus
fibrous dysplasia

41
Q

t (11;22)

A

translpation fusion ESW-FLI 1

ewing sarcoma
-11 + 22 = 33 partic ewing jersey #

42
Q

CD99 +

A

ewing sarcoma

Board Review - C - MSK/Dermatology (6 decks)

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