MSK Random Flashcards
(243 cards)
1
Q
ACL
A
starts laterally
2
Q
abnormal passive abduction
A
lateral force (valgus)-medial widening MCL injury
3
Q
abnormal passive adduction
A
medial force (varus)-lateral widening LCL injury
4
Q
popping external rotation
A
medial meniscus
5
Q
popping internal rotation
A
lateral meniscus
6
Q
Greenstick fracture
A
incomplete fracture partway through width of bone
bending stress-bone bent like twig
7
Q
Torus fracture
A
axial force to immature bone
simple buckle fracture
8
Q
unhappy triad
A
ACL, MCL, medial meniscus
from lateral force to planted leg
lateral meniscus injury more common
9
Q
prepatellar
A
front of kneecap
10
Q
Baker cyst
A
popliteal fluid collection in gastrocnemius-semimembranous bursa
communicates with synovial space (from chronic joint disease)
11
Q
empty can test
A
supraspinatus
suprascapular nerve innervation
12
Q
starts abduction
A
supraspinatus
13
Q
laterally rotates arm
A
infraspiantus
14
Q
adducts and laterally rotates
A
teres minor
innervated by axillary nerves
15
Q
medially rotates and adducts
A
subscapularis
16
Q
arm abduction
A
supraspinatus
deltoid
trapezius >90
serratus anterior >100
17
Q
repetitive flexion
A
medial epicondylitis
18
Q
repetitive extension
A
lateral epicondylitis
19
Q
most commonly fractured carpal bone
A
scaphoid
20
Q
cause of avascular necrosis and nonunion scaphoid
A
retrograde blood supply
21
Q
dislocation of lunate
A
acute carpal tunnel syndrome
22
Q
entrapment of median nerve
A
carpal tunnel
23
Q
sensation spared in carpal tunnel
A
palmar cutaneous branch external to carpal tunnel
24
Q
associations carpal tunnel
A
pregnancy, RA, hypothyroidism, diabets, acromegaly, dialysis related amyloidosis
25
Tinel sign
percussion of wrist causes tingling
26
flexion of wrist causes tingling
Phalen maneuver
27
Guyon canal syndrome
compression of ulnar nerve
| seen in cyclists
28
fractured surgical neck and anterior dislocation of humerus
axillary-flattened deltoid
| loss of shoulder abduction
29
upper trunk compression
musculocutaneous
| loss of forearm flexion and supination
30
midshaft fracture or compression of axilla
radial
wrist drop, decreased grip strength
loss of sensation over posterior (including thumb)
31
supracondylar fracture of humerus, carpal tunnel and wrist laceration
median
| loss of wrist flexion of lateral fingers
32
fracture medial epicondyle of humerus, fracture hook of hamate
ulnar
radial deviation of wrist upon flexion
loss of wrist flexion medial fingers
33
superficial laceration of palm
recurrent branch of median nerve
| loss of thenar group muscle but no loss of sensation
34
Erb palsy
upper
deltoid, supraspinatus, infraspinatus, biceps brachii
abduction, lateral roation, flexion and supination
35
Klumpke palsy
lower
intrinsic muscles of hand
leads to total claw hand
36
Thoracic outlet syndrome
compression of lower tunk and subclavian vessels due to cervical rib and Pancoast tumor
also causes Klumpke palsy
37
Winged scapula
long thoracic nerve lesion
defect to serratus anterior
cannot abduct above horizontal
inability to anchor scapular to thoracic cage
38
distal ulnar and median lesion
clawing
39
proximal lesions
deficits during voluntary flexion of digits
40
atrophy thenar
median nerve
41
atrophy hypothenar
ulnar nerve
42
thenar muscles
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
43
hypothenar muscles
opponens digiti minimi
abductor digiti minimi
flexor digiti minimi brevis
44
injury abdominal surgery
iliohypogastric
motor to transversus abdominis and internal oblique, sensory to suprapubic region
T12/L1
45
injury laproscopic surgery
cremaster motor and sensory to scrotum and medial thigh
| absent cremasteric reflex L1/L2
46
anterior and lateral thigh sensation
lateral femoral cutaneous
| L2/L3
47
pelvic surgery
obturator
sensory medial thigh
motor to obturator externus, adductor longus and brevis, gracilis, pectineus, adductor magnus
L2/L4
48
pelvic fracture
femoral
motor to quad, iliopsoas, pectineus, sartorius
sensory-anterior and medial thigh
L2/L4
49
herniated disc
sciatic
motor to semitendinous, semimembranous, biceps femoris, adductor magnus
sensory-posterior thigh
L4/S3
50
fibular neck fracture
```
common peroneal
motor to biceps femoris, tibialis anterior, extensor of foot
sensory dorsum
everts and dorsiflexes
foot drop
L4/S2
```
51
knee trauma, baker cyst and tarsal tunnel syndrome
```
tibial
motor to triceps surae, plantaris popliteus, flexor muscles of foot
sensory sole of foot
inverts and plantar flexes
L4/S3
```
52
injection to upper medial region
superior gluteal
motor to gluteus medius and minimus, tensor fascia latae
L4/S1
53
Trendelenburg
lesion is contralateral to side of hip that drops
54
posterior hip dislocation
motor to gluteus maximus
| inferior gluteal L5/S2
55
stretch injury during childbirth
external urethral and anal sphincters
| pudental S2/S4
56
nerve block
ischial spine as landmark
57
internal rotators of hip
gluteus medius, minimus, tensor fascia latae
58
external rotators of hip
iliopsoas, gluteus maximus, piriformis, obturator
59
cause of herniation
posterolateral due to thin posterior longitudinal ligament
60
L3-L4 herniation
decrease patellar reflex
61
L4-L5 herniation
difficulty in heel walking
62
L5-S1 herniation
decrease achilles reflex
63
with long thoracic
lateral thoracic
64
with axillary
posterior circumflex
65
with radial
deep brachial
66
with median
brachial
67
with tibial at popliteal
popliteal
68
with tibial at medial malleolus
posterior tibial
69
T tubules
extension of plasma membrane with terminal cisternae of sarcoplasmic reticulum
70
dyad
cardiac
| 1 T tubule and 1 terminal cisterna
71
triad
skeletal
| 1 T tubule and 2 terminal cisternae
72
binds to troponin C
Ca
| causes conformational change that moves tropomyosin
73
shortening in contraction
H and I bands
between Z lines
A remains same length
74
type 1 muscle
slow twitch; red fibers
| increase mitochondria and myoglobin
75
type 2 muscle
fast twitch; white fibers
| anaerobic glycolysis
76
smooth muscle
calmodulin to MLCK contraction
| NO cGMP to MLCP relaxation
77
endochondral ossification
```
axial skeleton
cartilage first (woven then lamellar)
defective in achondroplasia
```
78
membranous ossification
calvarium, facial bones, clavicle
| without cartilage first
79
origin osteoblast
mesenchymal stem cells in periosteum
80
markers osteoblastic activity
ALP, osteocalcin, type I procollagen
81
chronically increase PTH
osteitis fibrosa cystica
82
cause closure of epiphyseal plate
estrogen
83
failure of endochondral ossification
achondroplasia
| AD
84
genetics achondroplasia
FGFR3 (gain of function)
85
osteoporosis
trabecular and cortical bone loss and interconnections
86
drugs osteoporosis
steroids, alcohol, anticonvulsants, anticoagulants, thyroid replacement therapy
87
medical conditions osteoporosis
hyperparathyroidism
hyperthyroidism
MM
malabsorption syndromes
88
T score osteoporosis
89
screening recommendation osteoporosis
>65 years old
90
osteopetrosis
due to defective osteoclasts
91
mutation osteopetrosis
CA II
| impair ability of osteoclast to generate acidic environment
92
treatment osteopetrosis
bone marrow transplant
| osteoclasts derived from monocytes
93
x ray osteopenia
looser zones
94
rickeys x ray
epiphyseal widening
| metaphyseal cupping/fraying
95
labs osteomalacia
decrease Ca increase PTH decrease PO4
| increase ALP
96
Paget
osteoclastic
| followed by osteoblastic
97
labs paget
only increase ALP
98
fractures paget
chalk-stick fractures
99
results paget
AV shunts may cause high-output heart failure
| risk of osteosarcoma
100
femoral head avascular necrosis
due to insufficiency of medial circumflex femoral artery
101
causes avascular necrosis
corticosteroids, alcoholism, sickle, trauma, bends, legg-calve-perthes, gaucher, slipped capital femoral epiphysis
102
Brown tumors
subperiosteal thinning
| increase Ca, increase PTH and ALP
103
secondary hyper-PTH
compensation for CKD
| increase PO4
104
labs hypervitaminosis D
decrease PTH
increase Ca and PO4
seen in granulomatous disease
105
bony exostosis with cartilaginous cap
osteochondroma
106
multinucleated giant cells that express RANKL
giant cell-in epiphysis
| soap bubble
107
most common location giant cell
distal femur and proximal tibia
108
predisposing factors osteosarcoma
Paget, bone infarcts, radiation, familial retinoblastoma, Li-Fraumeni
109
Codman traingle or sunburst pattern on x-ray
osteosarcoma
110
treatment osteosarcoma
surgical en block resection
| chemotherapy
111
location Ewing
diaphysis of long bones, belvis, scapular, ribs
112
anaplastic small blue cell
Ewing sarcoma
113
onion skin periosteal reaction
Ewing sarcoma
114
t(11;22)
fusion protein EWS-FLI1
115
tumor metaphysis
osteosarcoma
116
Heberden
Dip
117
Bouchard
PIP
118
treatment osteoarthritis
acetaminophen, NSAIDs, glucocorticoids
119
formation of pannus (proliferation of granulation tissue)
RA
120
predisposing RA
HLA-DR4, smoking, silica exposure
121
rheumatoid factor
IgM that targets IgG Fc region
122
mores specific Ab RA
anti-cyclic citrullinated peptide antibody
123
cervical subluxation
RA
124
not DIP
RA
125
DMARDs
methotrexate, sulfasalzine, hydroxychloroquine, leflunomide
126
fibrinoid necrosis with palisading histiocytes
rheumatoid nodules
127
Caplan
RA and pneumoconiosis
128
Felty syndrome
interstitial lung disease, pleuritis, pericarditis, anemia of chronic diease, neutropenia, splenomegaly, RA
129
other associations RA
AA amyloidosis, Sjogren syndrome, scleritis, carpal tunnel syndrome
130
underexcretion uric acid
renal failure
| thiazides
131
overproduction
Lesch-Nyhan, PRPP excess, increase turnover, von Gierke
132
sites tophus
external ear, olecranon bursa or achilles tendon
133
acute treatment gout
NSAIDs, glucocorticoids, colchicine
134
associations pseudogout
hemochromatosis, hyper PTH, joint trauma
135
site pseudogout
knee
136
xray pseudogout
chondrocalcinosis
137
crystals pseudogout
rhomboid and weakly + birefringent
138
histology Sjogren syndrome
destruction of exocrine glands by lymphocytic infiltrates
139
labs sjogren
rheumatoid factor, antiribonucleotide Ab (Ro and La)
140
complications Sjogren
dental caries, MALT lymphoma
141
septic arthritis causes
staph, strep, neisseria
142
purulent arthritis or polyarthralgia, tenosynovitis, dermatitis
gonococcal arthritis
143
pencil in cup of DIP
psoriatic arthritis
144
joints ankylosing spondylitis
spine and sacroiliac joints
145
lungs ankylosing
restrictive lung disease due to limited chest wall expansion
146
causes reactive arthritis
shigella, yersinia, chlamydia, campylobacter, shigella
147
causes death in SLE
cardiovascular
infections
renal disease
148
drug induced lupus
anti-histone Ab
149
specific Ab SLE
anti-smith, anti-dsDNA
150
treatment SLE
NSAIDs, steroids, immunosuppressants, hydroxychloroquine
151
antiphospholipid Ab
lab findings of lupus anticoagulant, anticardiolipin anti-B2 glycoprotein Ab
152
false labs in antiphospholipid syndrome
PTT and VDRL
153
mixed connective tissue disease
features of SLE, systemic sclerosis, and polymyositis
154
Ab mixed connective tissue disease
anti-U1 RNP antibodies
155
labs sarcoidosis
increase ACE and CD4/8 ratio
156
associations sarcoidosis
restrictive lung disease, eryhtema nodosum, Bell palsy, epithelioid granulmas, Schaumann and asteroid bodies, uveitis, hypercalcemia (due to increase 1alpha hydroxylase activation in macrophages)
157
polymyalgia rheumatica
pain and stiffness in shoulders and hips
158
association polymyalgia rheumatica
tempral arteritis
159
labs polymyalgia
increase ESR CRP
160
treatment fibromyalgia
exercise, antidepressants (TCA, SNRI), anticonvulsants
161
labs polymyositis/dermatomyositis
increase CK +ANA +anti-Jo1 + anti-SRP +anti-Mi2
162
endomysial inflammation with CD8 T cells, symmetric proximal weakness
polymyositis
163
increase risk occult malignancy
dermatomyositis
164
perimysial inflammation with atrophy of CD4
dermatomyositis
165
shawl and face rash, Gottron papules, heliotrope
dermatomyositis
166
worse with use
myasthenia
167
causes myasthenia
thymoma
| thymic hyperplasia
168
cause lambert eaton
small cell lung cancer
169
white blue red Raynaud
ishemia, hypoxia, reperfusion
170
treatment Raynaud
Ca channel blockers
171
diffuse scleroderma
early visclera
| anti-Scl70
172
cause of death scleroderma
pulmonary sclerosis
173
CREST
calcinosis, anti-centromere Ab
| Raynaud, esophageal dysmotility, sclerodactyly, telangiectasia
174
skin layers
```
corneum (keratin)
lucidum
granulosum
spinosum (desmosomes)
basale (stem cells)
```
175
claudins and occludins
tight junction
176
calcium dependent adhesion
cadherins in adherens junctions
177
intermediate filament interactions
desmosomes
178
hyperkeratosis
increase corneum
| in psoriasis and calluses
179
parakeratosis
retention of nuclei in corneum
| psoriasis
180
increase thickness granulosum
hypergranulosis
| in lichen planus
181
epidermal accumulation of edematous fluid
eczematous dermatitis
| spongiosis
182
acanthosis
epidermal hyperplasia
| seen in acanthosis nigricans
183
albinism causes
decrease tyrosinase activity or defective tyrosine transport
| risk of cancer
184
melasma
hyperpigmenation
| associated with pregnancy and OCP
185
vitiligo
autoimmune destruction of melanocytes
186
associations atopic dermatitis
asthma, allergic rhinitis, food allergies
187
histology psoriasis
acanthosis, parakerototic scaling
| increase spinosum and decrease granulosum
188
association psoriasis
nail pitting and psoriatic arthritis
189
SK
squamous proliferation with keratin filled cyst, appears stuck on
190
epidermal hyperplasia, hyperkeratosis, koilocytosis
verrucae
| condyloma acuminatum on genitals (HPV associated)
191
superficial dermal edema and lymphatic channel dilation
urticaria
192
associations angiosarcoma
radiation and chronic postmastectomy lymphedema
193
hepatic angiosarcoma
vinyl chloride and arsenic
194
cherry hemangioma
in elderly
195
cystic hydroma
cavernous lymphangioma of neck
| associated with Turner syndrome
196
glomus tumor
modified smooth muscle of thermoregulation
| painful red-blue tumor
197
pyogenic granuloma
polypoid lobulated capillary hemangioma
| associated with trauma and pregnancy
198
bulloua impetigo
usually staph
| could be strep
199
abscess
staph
200
exotoxin destroys keratinocyte attachments in statum granulosum only
staph scalded skin
201
TEN
destroys dermal-epidermal junction
202
staph scalded skin
seen in children and adults with renal insufficiency
203
hairy leukoplakia
lateral
EBV
cannot be scraped off
204
hairy leukoplakia patients
HIV and transplants
205
involvement of mouth
pemphigus vulgaris
| type II HSR
206
contents blisters bullous pemphigoid
contain eosinophils
| Nikolsky negative
207
often site dermatitis herpetiformis
elbows
208
histology dermatitis herpetiformis
IgA at tips of dermal papillae
209
>30% skin involvement
toxic epidermal necrolysis
210
actinic keratosis
premalignant
| risk of SCC
211
erythema nodosum associations
sarcoidosis, coccidio, histoplasmosis, TB, strep, leprosy, IBD
212
pruritic, polygonal, purple, planar papules and plaques
lichen planus
213
mucosal involvement lichen planus
Wickeham stria (reticular white lines)
214
histology lichen planus
sawtooth infiltrate of lymphocytes at dermal-epidermal junction
215
association lichen planus
hep C
216
dominant in sunburn
UVB
217
prominent in tanning and photoaging
UVA
218
most comon skin cancer
basal cell
219
waxy pink pearly nodules with telangiectasias and rolled borders
BCC
220
palisading nuclei
BCC
221
associations SCC
sunlight, immunosuppression, chronically draining sinuses, arsenic
222
keratin pearls
SCC
223
AK
precursor to SCC
224
keroacanthoma
variant that grows rapidly and spontaneously regresses
225
S-100
melanoma
226
mutation melanoma
activation BRAF kinase
227
inhibits platelet aggregation and promotes vasodilation
PGI2
228
overdose acetaminophen
hepatic necrosis due to NAPQI depletion of glutathione
229
inactivation acetaminophen
peripherally inactivated
| not anti-inflammatory
230
dose aspirin
low-anti platelet
intermediate-analgesic
high-anti inflammatory
231
aspirin toxicity
respiratory alkalosis early
| then mixed metabolic acidosis and respiratory alkalosis
232
celecoxib
reversible and selective inhibitor of COX2
233
adverse effects celecoxib
risk of thrombosis
| sulfa allergy
234
adverse effects NSAID
interstitial nephritis, gastric ulcer, renal ischemia, aplastic anemia
235
cause of renal ischemia NSAID
loss of prostaglandins to vasodilate afferent arteriole
236
MOA leflunomide
inhibits dihydroorotate dehydrogenase
| prevents pyrimidine synthesis and suppresses T cell proliferation
237
adverse leflunomide
diarrhea, HTN, hepatotoxicity, teratogenicity
238
teriparatide
recombinant PTH
| increases osteoblastic activity
239
adverse effects teriparatide
osteosarcoma (avoid in paget)
transient hypercalemia
avoid in patients with prior cancers or radiation
240
pegloticase
recombinant uricase that catalyzes metabolism of uric acid to allantoin (more water soluble)
241
probenecid
inhibits reabsorption of uric acid
| can precipitate uric acid calculi
242
NSAID in gout
avoid salicylates
| may decrease uric acid excretion
243
side effects colchicine
GI side effects
