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Flashcards in MSK Path High Yield Deck (92):
1

"failure of longitudinal bone growth (endochondrial ossification) leading to short limbs"

Achondroplasia

2

What is the mutation in achondroplasia?

a constitutive activation of fibroblast growth that inhibits chondrocyte proliferation

3

"trabecular (spongy) bone loses mass and interconnections despote normal bone mineralization"

Primary osteoporosis

4

Which 4 drugs classes cause osteoporosis?

1- antconvulsants
2- steroids
3- anticoagulants
4- Thyroid replacement therapy

5

Which type of osteoporosis is associated with increased osteoclast activity?

Type I post menopausal

6

Which type of osteoporosis is associated with decreased osteoblast activity?

Type II (senile)

7

"failure of normal bone resportion due to defective osteoclasts--> thickened dense bone"

osteopetrosis

8

What are associated findings with osteopetrosis?

Visual and

Pancytopenia and estramedullary hematopoiesis

9

What is the mutation in osteopetrosis?

Carbonic anhydrase II

10

"defective bone mineralization/ calficification of osteoid--> soft bones that bow out"

Osteomalacia/ rickets

11

What is the PTH level in osteomalacia/ rickets? The ALP level?

Increased!!!

ALP is increased because of the osteoblasts

12

"increase in both osteoblastic and osteoclastic activity leading to a mosaic bone pattern of woven and lamellar bone"

Paget disease of bone

13

What are the 4 stages of paget disease?

1- Lytic (osteoclasts)
2- Mixed (both)
3- Sclerotc (osteoblasts)
4- Quiescent (minimal activity)

14

What cancer is there an increased risk of with pagent disease of bone?

osteogenic sarcoma

15

What is a common cause of death in paget disease?

High Output cardiac failure

16

What is the most common site of osteonecrosis? What is the causative artery?

Femoral head

Medial circumflex femoral artery

17

What is Leff- Calve Perthes disease?

Idiopathic osteonecrosis

18

What are the abnormal lab values in osteoporosis?

None

19

What is the abnormal lab value in paget disease?

Increased ALP

20

What are the abnormal lab values in osteomalacia?

Decreased Ca
Decreased PO4
Increased ALP
Increased PTH

21

What are the abnormal lab values in Primary hyperparathyroidism?

Increased Ca
Decreased PO4
Increased PTH
Increased ALP

22

What are the abnormal lab values in secondary hyperparathyroidism?

Decreased Ca
Increased PO4
Increased ALP
Increased PTH

23

"brown tumor due to fibrous replacement of bone and subperiosteal thinning"

Osteitis fibrosa cystica

24

What are the 3 actions of vit D?

Intestine: Increased absortion of Ca and PO4

Kidney: increased reab of Ca and PO4

Bone: increased reab of calcium and phosphate

25

Location of osteoma?

facial bones

26

What is condition is osteoma associated with?

Gardner syndrome

27

"benign tumor of osteoblasts surrounded by a rim of reactive bone"

Osteoid osteoma

28

Bone tumor associated with nighttime pain that improves with aspirin

Osteoid osteoma

29

Where are osteoid osteomas typically located?

Diaphysis

30

Where is osteoblastoma usually located?

Vertebrae

31

What is the major difference between osteoblastoma and osteoid osteoma?

Pain does not resolve with aspirin in osteoblastoma

32

Where are osteochondromas usually found?

metaphysis (lateral projection)

33

"Tumor of bone with overlying cartilage cap"

Osteochondroma

34

"malignant proliferation of osteoblasts"

Osteosarcoma

35

Where are Osteosarcomas usually located?

Metaphysis

36

What is the X ray appearance of osteosarcoma on Xray?

Codman triange or sunburst pattern

37

"bone tumor composed of multinucleated giant cells and stromal cells"

giant cell tumor

38

Where are giant cell tumors usually located?

Epiphysis of long bones

39

What is the appearance of giant cell tumors on xray?

soap bubble appearance

40

"malignant proliferation of poorly differentiated cells derived from neuroectoderm"

Ewing sarcoma

41

Where are ewing sarcomas usually located?

diaphysis

42

Joint pain that improved with use?

Rheumatoid arthritis

43

Joint pain that worsens with use?

Osteoarthrtis

44

What type of hypersensitivity is RA?

Type III and Type IV

45

Which joints are spared in osteoarthritis?

MCP

46

What joints are spared in RA?

DIP

47

"inflammatory granulation tissue formation in joints seen in RA"

Pannus

48

What type of necrosis do rheumatoid nodules exhibit?

Fibrinoid necrosis

49

What HLA type is associated with RA?

HLA DR4

50

What are the 2 autoantibodies associated withRA?

Anti- IgG antibody

Anti- cyclic citrullinated peptide antibody

51

"reactive bony formation seen in osteoarthritis"

Osteophyte

52

"reactive bony formation seen in osteoarthritis"

Osteophyte

53

Autoantibodies seen in sjogrens?

Anti SS-A and SS-B (ANA antibodies)

54

What are 2 possible complications of Sjogrens?

Dental carries

MALT (parotid enlargement)

55

Which genetic conditions cause an over production of uric acid?

Lesch- Nyhan syndrome
von Gierke disease
PRPP excess

56

What color are urate crystals under parallel light? Perpendicular light?

Parallel--> yellow

Perpendicular--> blue

57

"white chalky aggregates of uric acid crystals with fibrosis and giant cells seen in gout"

tophus

58

:"pain and effusion in a joint caused by deposition of calcium pyrophosphate crystals within the joint space"

Pseudogout

59

Shape of pseudogout crystals?

rhomboid crystals

60

What are 3 possible causes of pseudogout?

1- hemochromatosis
2- hyperparathyroidism
3- osteoarthitis

61

What color are pseudogout crystals in parallel light?

Blue

62

Most common cause of infectious arthritis in older children and adults?

S. aureus

63

What is the most common cause of infectious arthritis in young adults?

Neisseria gonorrhea

Migratory infections arthritis

64

What HLA type are Psoriatic arthritis, ankylosing spondyliti, IBD and Reactive arthritis associated wth?

HLA- B27

65

"chronic inflammatory disease of spine and sacroiliac joints"

Ankylosing spondylitis

66

What are 2 common findings of ankylosing spondylitis?

bamboo spine (vertebral fusion)

aortic regurgitation

67

"conjunctivitis + urethritis + arthritis"

Reactive arthritis

68

What are 4 organisms associated with reactive arthritis?

Shigella

Salmonella
Yersinia
Campylobacter
Chlamydia

69

What 2 renal presentations are seen in lupus?

Membranous glomerulonephritis---> nephrotic

DPGN--> Nephritic

70

What autoantibody is MOST SPECIFIC for lupus?

anti- dsDNA/ anti- smith

71

What are anti-smith antibodies against?

snRNPs

72

What is antihistone antibodies associated with?

drug induced lupus

73

What is needed for a diagnosis of antiphospholipid syndrome?

Hx of thrombosis

Lupus anticoagulant/ anticoardiolipin/ ant beta2 glycoprotein sntibodies

74

Anticardiolipin antibodies can cause a false positive in what test?

VDLR

75

:immune mediated, widespread noncaseating granulomas with elevated ACE levels"

Sarcoidosis

76

What is the ratio of CD4/ CD8 in sarcoidosis?

Increased!

77

Is sarcoidosis a restrictive or obstructive lung disease/

restrictive

78

What causes hypercalcemia in sarcoidosis?

Increased 1alpha hydroxylase mediated vit D activation in macrophagges

79

"pain andstiffness in soulders and hips with fever, malaise and weightloss"

Polymyalgia rheumatica

80

What disease is polymyalgia rheumatica associated with?

temporal (giant cell) arteritis

81

"chronic widespread musculoskeletal pain associated with stiffness, paresthesias, poor sleep and fatigue"

fibromyalgia

82

What are the antibodies associated with polymyosiitis and dermatomyositis?

ANti-Jo-1
Anti SRP
Anti Mi-2

83

"progressive PROXIMAL muscle weakness, characterized by endomysial inflammation with CD8+ cells"

Polymyositis

84

"progressive PROXIMAL muscle weakness with associated malar rash, grotton papules on elbows and knees, "shawl and face" rash"

Dermatomyositis

85

What is the cell type associated with polymyositis?

CD8+

86

What cel type is associated with dermatomyositis?

CD4+

87

Autoantibodies to presynaptic Ca channel leading to decreaed ACh release?

Lambert- Easton Syndrome

88

What condition is myasthenia gravis associated with?

Thymoma

89

"metaplasia of skeletal muscle into bone following muscular trauma"

Myositis ossificans

90

"autoimmunity, noninflammatory vasculopathy, collagen deposition with fibrosis"

Scleroderma

Tightening of the skin without wrinkles

91

What autoantibody is associated with diffuse scleroderma?

anti- Scl-70 (anti- DNA topoisomerase I antibody)

92

What is seen in limited scleroderma?

CREST

Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telandiectasia

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