MSK/Derm V

Question 1

polymyositis

Answer 1

progressive symmetric prox muscle weakness

endomysial inflammation with CD8 T cells

tx - immunosuppression

Question 2

elevated CK, positive ANA, anti-Jo1, anti-SRP, anti-Mi-2 Abs

Answer 2

polymyositis

dermatomyositis

Question 3

dermatomyositis

Answer 3

gottron papules
heliotrope rash, shawl and face rash, mechanics hands

perimysial inflammation and atrophy with CD4 cells

Question 4

myasathenia gravis

Answer 4

autoAb - ACh receptor

worsen with use

associated - thymoma and thymic hyperplasia

Question 5

lambert eaton syndrome

Answer 5

autoAb presynaptic Ca channel

decreased ACh release

prox muscle weakness
autonomic sx
improve with muscle use

association - small cell lung cancer

Question 6

tx of myasthenia gravis

Answer 6

AChE inhibitor reverse sx

Question 7

myositic ossificans

Answer 7

metaplasia - skeletal m into bone
-after muscular trauma

suspicious mass or incidental finding on Xray

Question 8

scleroderma

Answer 8

systemic sclerosis

autoimmune
non-inflammatory vasculopathy
collagen deposition

2 types

• diffuse
• limited

Question 9

diffuse scleroderma

Answer 9

Scl-70 Ab - anti DNA topoisomerase I

widespread skin involved
rapid progression
early visceral involvement

Question 10

limited scleroderma

Answer 10

limited skin involvement - finger and face

CREST
calcinosis
raynaud
esophageal dysmotility
sclerodactyly
tenalgiectasia

anti-centromere Ab

Question 11

skin layers

Answer 11

epidermis
dermis
subQ

surface to base:
stratum corneum - keratin
stratum lucidum
stratum granulosum
stratum spinosum - desmosomes
stratum basale - stem cells

Question 12

zona occludens

Answer 12

tight junctions

claudins and occludins

Question 13

zonula adherens

Answer 13

adherens junction

below tight

form belt - connect actin of adjacent cells

Ca dependent

cadherin - lost in mets

Question 14

desmosome

Answer 14

macula adherens

keratin structural support

Abs - pemphigus vulgaris

Question 15

gap jxn

Answer 15

connexon - with central channel

permit communication cell to cell

Question 16

hemidesmosome

Answer 16

connect keratin in basal cell to BM
-basolateral surface

autoAb - bullous pemphigoid

Question 17

integrins

Answer 17

maintain basolateral membrane - binding collagen and laminin

Question 18

macule

Answer 18

flast lesion

Question 19

patch

Answer 19

macule >1cm

Question 20

papule

Answer 20

elevated solid

Question 21

plaque

Answer 21

papule >1cm

psoriasis

Question 22

vesicle

Answer 22

fluid containing blister

Question 23

bulla

Answer 23

blister >1cm

Question 24

scale

Answer 24

flaking stratum corneum

Question 25

crust

Answer 25

dry exudate

impetigo

Question 26

eczema

Answer 26

atopic dermatitis

itchy eruption

Question 27

intradermal nevi

Answer 27

papular

Question 28

junctional nevi

Answer 28

flat macule

Question 29

auspitz sign

Answer 29

pinpoint bleed from exposure of dermal papilla when scales ripped off

with psoriasis

Question 30

psoriasis

Answer 30

acanthosis and parakeratotic scaling

more stratum spinosum
less stratum granulosum

Question 31

rosacea

Answer 31

erythematous papules and pustules

no comedones

chronic change - rhinophyma - bulbous deformation of nose

Question 32

seborrheaic keratosis

Answer 32

flat greast pigmented squamous epithelium

keratin filled cysts - horn cysts

looks stuck on

Question 33

leser trelat sign

Answer 33

sudden appearance multiple seborrheaic keratosis

indicated underlying malignancy

Question 34

verrucae

Answer 34

warts - from HPV

epidermal hyperplasia
hyperkeratosis
koilocytosis

condyloma actuminatum - on genitals