Musc/Skin

Question 1

Prevent paracellular movement of solutes btwn epithelial cells?

Answer 1

Tight junctions= Composed of Claudins & occludins

Question 2

Forms a belt connecting Actin cytoskeleton of adjacent cells? Loss of this promotes Metastasis?

Answer 2

Adheren junctions. Cadherins (Ca dependent ahderins)

**Loss of E-cadherin= Mets

Question 3

Structural support via Keratin interactions?

Answer 3

Desmosome= Macula adherine

Question 4

Membrane proteins that maintain integrity of Basement membrane by binding to Lamina in BM?

Answer 4

Integrins= maintain INTEGRITY to BM

Question 5

Unhappy triad?

Answer 5

ACL
MCL
medial meniscus

Question 6

Slow twitch, high Mitochondria/ Myoglobin, Increased Ox-phos?

Answer 6

Type 1

Question 7

Osteoclast defect causing bone in bone appearing defects leading to pancytopenia, deafness, visual issues. What is the mutation?

Answer 7

Osteopetrosis== Carbonic anhydrase II 
**Rx= BM transplant since Osteoclasts are derived from Monocytes

Question 8

Pigeon breast, frontal bossing, ribs with bumps?

Answer 8

Rickets = Vit D def

Question 9

Man complains of increased hat size, hearing loss. Bone biopsy shows mosaic formation. What is he at risk for?

Answer 9

Pagets dz== Lytic phase–> Blastic phase
High output cardiac failure
Osteogenic sarcoma

Question 10

Labs values for:
Osteoporosis?
Osteopetrosis?
Osteitis fibrosa cystica?
Pagets dz?

Answer 10

porosis=> ALL normal
petrosis=> dec Ca, inc ALP
osteitis=> inc Ca/ALP/PTH, low Phosphate
Pagets=> High ALP

Question 11

Pt with early puberty, multiple bone lesions, and skin spots?

Answer 11

McCune-Albright syndrome

1. Polyostotic fibrous dysplasia
2. Precocious puberty
3. Cafe-au-lait

Question 12

20 yo with bone pain. X-ray shows growth off metaphysis with cartilaginous cap?

Answer 12

Osteochondroma

Question 13

What are the Risk factors for developing osteosarcoma?

Answer 13

Pagets
Retinoblastoma
Bone infarcts (osteomyelitis)

Question 14

X-ray shows Codman’s triangle + sunburst appearance?

Answer 14

Osteosarcoma

Question 15

12 yo with pelvic pain. Biopsy shows small blue cells in “onion skin appearing bone?”

Answer 15

Ewing’s sarcoma= t(11;22)

*<15yo + Neuroectodermal

Question 16

pt with hx of colonic polyps develops a benign growth of the facial bone?

Answer 16

Gardner’s syndrome

1. FAP
2. Osteomas
3. Multiple fibromas

Question 17

16 yo boy with bone pain relieved by Aspirin. X-ray shows radiolucent focus surrounded by sclerotic bone?

Answer 17

Osteoid Osteoma

Question 18

What kind of HS is RA?

Answer 18

T3HS == IgM against IgG -> activates C5a-> PMNs come

Question 19

What antibodies are associated with RA?

Answer 19

Anti-IgG - Rheumatoid factor
Anti-citrullinated peptide
HLA-DR4

Question 20

Pannus vs Osteophyte?

Answer 20

Pannus= RA
osteophyte= Osteoarthritis

Question 21

Pt with chronic RA can develop?

Answer 21

Sjogrens
Rheumatoid nodules = Fibrinoid necrosis
2nd Amyloidosis= SAA

Question 22

What is the Rx for Sjogrens symptoms?

Answer 22

Cholinergic agonist== Cevimelin

Question 23

What things are associated with increased risk for GOUT?

Answer 23

HGPRT def = Lesch nyhan 
PRPP excess
Thiazide diuretics = Low Uric acid excretion 
Leukemia/Lymphomas
Von Gierke's Dz= Lactic acidosis 
ETOH

Question 24

Needle shaped, negatively (yellow) birefringent crystals are?

Answer 24

MSU= Gout
**Chronic= Tophus

Question 25

Rhomboid + Positively (blue) birefringent crystals are?

Answer 25

Calcium Pyrophosphate = Pseudogout

Question 26

What are the seronegative (-RF) HLA-B27 associated spondlyoarthropathies?

Answer 26

``` Psoriatic = "pencil in a cup" Ankylosing = Bamboo spin, Uveitis, Aortic Regurg, Restrictive lung dz IBD = accompany Ankylosing spondylitis Reiters= Conjunctivitis, Uveitis, arthritis (post Chlamydia) ```

Question 27

Osteomyelitis in children vs Adults?

Answer 27

``` Children= metaphysis (high BF) adults = Epiphysis ```

Question 28

Bone biopsy of Osteomyelitis shows?

Answer 28

``` Sequestra = necrotic bone Involucrum = New bone ```

Question 29

Rx for AA female with erythema nodosum, restrictive lung dz, high ACE levels, and biopsy shows Asteroid bodies?

Answer 29

Sarcoidosis --> STEROIDS

Question 30

Muscle weakness + Endomesial CD8 inflammation?

Answer 30

Polymyositis * *Inc CK * *Rx= Steroids

Question 31

Signs and symptoms of Dermatomyositis?

Answer 31

``` Malar rash Gottron's papules heliotrope rash= Under the eyes Perimysial CD4 inflammation **inc CK + Anti-Jo1 antibodies Rx= Steroids ```

Question 32

Pt with recent trauma to arm has an x-ray showing a suspicious mass @ site of injury?

Answer 32

Myositis ossifcans == Muscle--> Bone METAPLASIA

Question 33

Anti-centromere vs anti-topoI antibodies?

Answer 33

Anti-Scl-70 (topoI)= Scleroderma | Anti-Centromere= CREST syndrome

Question 34

When is epidermal hyperplasia of the Spinosum layer seen?

Answer 34

Acanthosis nigricans

Question 35

Pregnant women complains of getting hyperpigmentation of the the face?

Answer 35

Melasma= normal | **also seen with OCP (estrogen related)

Question 36

Condyloma accuminatum vs Condyloma lata?

Answer 36

``` accuminatum= HPV Lata = 2nd syphilis ```

Question 37

Person randomly develops a bunch of "stuck on" lesions?

Answer 37

Seborrheic keratosis= associated with GI malignancy

Question 38

``` Erythemas: ? Chronicum migrans= Marginatum= Multiforme= nodosum? ```

Answer 38

``` migrans= Lymes dz (think head= bells palsy) Marginatum= Rheumatic fever Multiforme= Infections/drugs (sulfa/mycoplasma) Nodosum= inflammation of subq Fat (infections) ```

Question 39

pruritic plaque with fine white lines on surface. Polyglonal shaped lesion is biopsied and showes Sawtooth lymphocytic infiltrates @ dermal-epidermal junction?

Answer 39

Lichen Planus= Lots of Ps

Question 40

Pt comes in with a patch on the neck that a week later followed by a patches climbing up his back?

Answer 40

Pityraisis rosea= SELF limiting

Question 41

UVA vs UVB?

Answer 41

``` A= aging + drug photosensitivity B= burn ```

Question 42

Anagen vs Telogen phases of hair growth?

Answer 42

``` Telogen= Resting Anagen = Growing ```

Question 43

Pt with well circumscribed area of hair loss?

Answer 43

Alopecia Areata

Question 44

Telogen affluvium?

Answer 44

Post partum self-limiting hair loss

Question 45

Hyper/hypopigmentation of skin caused by a "spaghetti & meatball" looking organism under KOH?

Answer 45

Tinea vesicolor= Malasthenia furfur

Question 46

Pt with a S-100+ cancer that also has a BRAF kinase mutation?

Answer 46

Melanoma | Rx= vemurafenib (TKi)