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MSK ish I don't know Flashcards

(104 cards)

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1
Q

What is the purpose of glucocorticoids in the context of RA?

A

relieves pain while waiting for DMARD drugs to work

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2
Q

How long are glucorticoids useful for in RA?

A

Less than 6 months

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3
Q

Do glucocorticoids change disease progression in RA?

A

Nope

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4
Q

What is MAC? What does it measure?

A

minimal alveolar concentration. Concentration of inhalation anesthetic that prevents movement in response to surgical stimulation in 50% of subjects.

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5
Q

What does the blood:gas partition coefficient measure?

A

Relative affinity of an anesthetic for the blood compared with that of inspired gas. There is an inverse relationship between blood:gas partition coefficient and rate of anesthesia

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6
Q

In one word, what does blood:gas partition coefficient measure?

A

Solubility

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7
Q

blood:gas partition coefficient relationship

A

If you increase partition coefficient, you decrease rate of onset

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8
Q

What are side effects of lidocaine?

A

low dose - sleepiness, visual/auditory hallucinations

high dose - nystagmus, muscular twitching, convulsions.

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9
Q

What is the duration of action of lidocaine?

A

medium, used for epidurals

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10
Q

What is the duration of action of procaine?

A

short

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11
Q

What is the rude regarding amide anesthetics?

A

They have two I’s in the name!

Example: lidocaine, mepivacaine

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12
Q

What is the only topical anesthetic with vasoconstriction properties?

A

cocaine

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13
Q

Carisoprodol is a antispasmolytic with which uses?

A

anxiolytic and anticonvulsant

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14
Q

Carisoprodol is metabolized into?

A

Meprobamate

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15
Q

Is carisoprodol addictive?

A

Yes

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16
Q

What drug decreases rate of spontaneous breathing?

A

Vecuronium

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17
Q

What drug might you want to co-administer with propofol for burning?

A

lidocaine

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18
Q

What is the MAC of nitrous oxide?

A

> 100%

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19
Q

What is segmental demyelination?

A

involves demyelination of Schwann cells and loss of myelin. no dysfunction of the axon. does not affect all Schwann cells

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20
Q

What is axonal degeneration?

A

primarily involves neuron and its axon and myelin shealth

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21
Q

Traumatic neuroma is described as?

A

non-neoplastic haphazard whorled proliferation of axonal processes and associated Schwann cells that results in a painful nodule

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22
Q

What is a myelin ovoid?

A

Schwann cells catabolize myelin and later engulf axon fragments, producing small oval compartments

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23
Q

Type 2 (fast twitch) fibers are degenerated because of?

A

inactivity, disuse due to fracture, steroid myopathy

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24
Q

What is mono neuritis multiplex? Whats an example?

A

several nerves damaged in haphazard way. polyarteritis nodosa

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25
What is chronic inflammatory demyelinating polyneuropathy?
- most common - symmetrical - lasts > 2 months - responds to steroids (makes it different than guillan barre)
26
What is the difference between chronic inflammatory demyelinating polyneuropathy and guillan barre?
Guillan barre does not respond to steroids
27
What is the most common cause of peripheral neuropathy?
Diabetes
28
Is diabetic neuropathy symmetric?
Yes
29
Diabetes has what weird association?
Autonomic dysfunction. IE postural hypotension, decreased bladder emptying, increased infection, sexual dysfunction
30
What is emery dreifuss muscular dystrophy? (EMD)
Triad: 1. ) progressive humeroperoneal weakness 2. ) cardiomyopathy 3. ) early contractors of achilles tendon
31
What is the mode of inheritance of EMD?
There are two. X-linked and AD
32
What does SMA affect?
destroys the anterior motor horn of babies
33
Gene in SMA? Mode of inheritance?
SMN1. AR
34
What is a type of SMA I know?
Werdig Hoffman
35
Motor neuron determines...?
Fiber type. all muscle fibers of a single unit are the same type?
36
What 3 main diseases are associated with neurogenic bladder?
1. ) MS 2. ) Parkinsons 3. ) diabetes
37
Guillan barre is what kind of neuropathy?
Polyneuropathy
38
Do reflexes disappear in GBM?
Yes
39
Describe the CSF in GBM
Increased CSF with little/no cells
40
What is the tx for GBM>
IVIG or plasmapheresis
41
What is the stain with leprosy?
AFB
42
What are the antibodies for dermatomyositis?
Anti-Jo and anti-mi2
43
What is the histology of dermatomyositis?
perifascicular atrophy
44
Where does pagets disease affect?
axial skeleton and femur
45
What is the pathognomonic histo finding of pagets?
mosaic pattern of lamellar bone aka jigsaw!
46
Ecoli, psuedomonaks, klebsiella are all associated with?
UTI and osteomyelitis
47
Salmonella is associated with?
Sickle cell osteomyelitis
48
Neiserria is associated with?
Osteomyeltitis in MAC deficiency
49
Whats the starred thing about osteochondroma?
It is continuous with the medullary cavity
50
What can osteochondroma turn into?
Chondrosarcoma
51
What is Ollier?
multiple enchondroma
52
What is maffuci? Increased risk for what?
Multiple enchondroma + angiomas with increased risk of chondrosarcoma
53
Whats the weird thing with Ewing sarcoma?
The amount of chemotherapy induced necrosis is an important prognostic finding. The more necrosis the better for some reason.
54
What is fibrous dysplasia?
Benign proliferation of fibrous tissue and bone that do not mature
55
When does fibrous dysplasia occur?
early adolescence
56
What is the buzz word for fibrous dysplasia?
ground glass
57
Prostate cancer spreads where? What kind of lesion is it?
It goes to the spinal cord. It is an osteoblastic lesion
58
What translation is liposarcoma?
t(12, 16)
59
What translation is synovial sarcoma?
t(x, 18)(11, 11)
60
What translation is a rhabdomyosarcoma?
t(2, 13)(35, 14) | t(1, 13)(36, 14)
61
Is calcitonin useful for treatment or prevention of osteoporosis?
Treatment, not prevention
62
Side effects of bisphosphanates?
1. ) osteonecrosis of the jaw 2. ) atypical femur fracture 3. ) esophagitis
63
Side effects of raloxifene?
DVT, PE, Stroke
64
What is a sequestrum and involucrum associated with?
osteomyelitis
65
Does No2 have a high or low blood gas partition coefficient?
Low. It has high solubility, high MAC (>100), rapid onset and recovery
66
Halothane:
- High blood gas partition coefficient - low MAC - medium rate of onset and recovery
67
The higher the MAC, the .... of potency?
Lower potency. No2 has low potency
68
Allergic reactions are more common with ester or amide?
Ester.
69
Does Ester have one or two I's?
One
70
Does amide have on or two I's?
Two
71
Is benzocaine topical?
Yes, only topical
72
bupivicaine length of action?
Long acting
73
What is procaine used for?
infiltration anesthesia
74
Axonal degeneration
→ muscle fibers in motor unit lose neural input & undergo denervation atrophy
75
What are angulated fibers?
atrophic fibers that are small and triangular shaped
76
What is acid maltase deficiency?
Mild adult form of pompe, respiratory and trunk muscles
77
What does inclusion body myositis look like?
Affected myofibers have vacuoles or cracks, which contain basophilic granules. These are best seen in cryostat sections stained with modified Gomori trichrome.
78
What is inclusion body myositis?
* Dz of late adulthood, >50 yo * most common inflammatory myopathy in pts > 65 yo * Slowly progressive muscle weakness, most severe in quadriceps & distal upper extremities * Starts with involvement of DISTAL muscles; esp extensors of knee (quadriceps) & flexors of wrist & fingers; asymmetric * Dysphagia from esophageal & pharyngeal m involvement * Rimmed vacuoles (inclusions with reddish granular rimming), highlighted by basophilic granules around the periphery, endomysial fibrosis
79
Describe diabetes:
symmetric neuropathy involving distal sensory & motor nerves • Numbness, loss of pain sensation, difficulty with balance
80
Does GBM have anti-myelin antibodies?
Yes
81
What is acute eczematous dermatitis
T-cell mediated inflammatory rxn (type IV | hypersensitivity)
82
What is mcardle disease?
Painful cramps associated with strenuous exercise; myoglobinuria occurs in 50% of cases; onset in adulthood (>20 years); muscular exercise fails to raise lactate level in venous blood; serum creatine kinase always elevated; compatible with normal longevity
83
erosive OA has what appearance in finger joints?
Seagull
84
What are examples of secondary OA?
trauma, joint infection, surgical reapir, congenital joints, hemochromatosis, psuedogout
85
What is DISH?
diffuse idiopathic skeletal hyperostosis - calcification and ossification of spinal ligaments and tendons. - men, back pain, t spine - 4 contiguous segments (4 letters in DISH)
86
Anti-ccp plus positive RF =?
99.5% specificity
87
What is ultrasonography good for?
joint effusion, synovitis, tendonitis, bursitis
88
6 months:
sits momentarily
89
9 months:
pulls up, cruises, sits well without support
90
1 year:
Stands momentarily
91
2 years:
walks up stairs two feet on each stair, kicks ball forward
92
3 years:
tricycle
93
4 years:
balance on one foot, hop on one foot
94
6 years:
skips
95
Most myopathies present with what?
Weakness in the proximal muscles
96
How are DTRs in a myopathy?
Normal but may decrease as weakness progresses
97
DMD is what kind of mutation?
Frameshift
98
When is DMD first noted?
1.5 to 2 years old.
99
What is the mutation in myotonia congenital? What does it code for?
CLCN 1 gene mutation which is a chloride channel.
100
What is the clinical presentation of juvenile dermatomyositis?
Generalized muscle weakness. red or purple heliotrope rash. raised erythematous papules (gottron)
101
What can GGT help with?
If the liver is involved. If elevated think liver. If normal think muscle.
102
what is musk myasthenia
No antibodies
103
ICU myopathy
aka myosin deficit myopathy critical illness with corticosteroid tx; profound weakness affects clinical
104
The lower the Mac, the more...?
Potent! inversely proportional

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