NEURO 2 / MSK

Question 1

descending motor signals, crosses at medulla

Answer 1

corticospinal tract

Question 2

ascending touch and proprioception, crosses at medulla

Answer 2

dorsal column/medial lemniscus tract

Question 3

ascending pain and temperature, crosses in spinal cord

Answer 3

anterolateral/spinothalamic tract

Question 4

Syringomyelia:
deficit?
tx?

Answer 4

• bilateral “cape-like” loss of ALS (pain/temp)
• ipsilateral corticospinal (motor)

syringosubarachnoid shunt

Question 5

Brown-Sequard syndrome:
typical presentation?
deficit?

Answer 5

stab wound → spinal cord hemisection

• ipsilateral loss of DCML and CS (touch, proprioception, motor)
• contralateral loss of ALS (pain/temp)

Question 6

Transverse myelitis:
presentation/deficit?
tx?

Answer 6

viral infx causes loss of function of entire spinal cord at a single level → bilateral loss of CS/DCML/ALS below level of lesion + sphincter dysfunction

high dose steroids

Question 7

Trigeminal neuralgia:

tx?

Answer 7

carbamazepine

Question 8

Lesion:
Wernicke aphasia?
Broca aphasia?
Conduction aphasia?
Global aphasia?

Answer 8

Wernicke aphasia: superior temporal gyrus lesion

Broca aphasia: inferior frontal gyrus lesion

Conduction aphasia: both gyri lesion

Global aphasia: arcuate fasciculus lesion

Question 9

HLA-B27 =

Answer 9

psoriatic arthritis, ankylosing spondylitis, IBD, Reiter syndrome

Question 10

HLA-DR2 =

Answer 10

SLE

Question 11

HLA-DR3 =

Answer 11

SLE, sjogren

Question 12

HLA-DR4 =

Answer 12

RA, mixed CT disease

Question 13

C-ANCA =

Answer 13

Wegener

Question 14

P-ANCA =

Answer 14

Churg-Straiss, microscopic polyangiitis

Question 15

Anti-CCP =

Answer 15

RA

Question 16

anti-centromere =

Answer 16

CREST

Question 17

Anti-desmosome =

Answer 17

pemphigus vulgaris

Question 18

Anti-dsDNA =

Answer 18

SLE

Question 19

Anti-endomysial =

Answer 19

celiac sprue

Question 20

Anti-hemidesmosome =

Answer 20

bullous pemphigoid

Question 21

Anti-histone

Answer 21

drug-induced lupus

Question 22

Anti-Jo-1 =

Answer 22

polymyositis, dermatomyositis

Question 23

Anti-microsomal =

Answer 23

Hashimoto

Question 24

Anti-mitochondrial =

Answer 24

1’ biliary cirrhosis

Question 25

anti-peroxidase =

Answer 25

Hashimoto

Question 26

anti-smooth muscle =

Answer 26

autoimmune hepatitis

Question 27

anti-thyroglobulin =

Answer 27

Hashimoto

Question 28

anti-TSH

Answer 28

Graves

Question 29

Anti-U1-RNP =

Answer 29

mixed CT disease

Question 30

SLE: type __ HS presentation?

Answer 30

3 ``` "I’M DAMN SHARP" --> ↑IgG Malar rash Discoid rash ANA Mucositis (throat ulcers) Neurologic d/o Serositis (pleuritis, pericarditis) Hematologic d/o Arthritis Renal d/o (“wire loops”) Photosensitivity ```

Question 31

How does drug-induced lupus differ from SLE? Etiology?

Answer 31

no kidney or CNS involvement Hydralazine, INH, Procainamide, Phenytoin

Question 32

Felty syndrome =

Answer 32

RA + neutropenia + splenomegaly

Question 33

Pseudogout: pathophys? dx?

Answer 33

calcium pyrophosphate deposits in joints arthrocentesis (rhomboid-shaped, weakly • positively birefringent blue crystals)

Question 34

Gout: pathophys? dx?

Answer 34

cold, stress, EtOH, red meat → hyperuricemia → MSU deposits in joint Dx arthrocentesis (needle-shaped, negatively • birefringent yellow crystals)

Question 35

Polymyositis: presentation? dx? tx?

Answer 35

hip and shoulder muscle weakness ± pain Dx ↑CK, anti-Jo-1, muscle bx Tx steroids

Question 36

``` Dermatomyositis: presentation? dx? tx? complications? ```

Answer 36

hip and shoulder muscle weakness ± pain, skin rashes (heliotrope rash, Gottron papules, V sign, shawl sign) Dx ↑CK, anti-Jo-1, muscle bx Tx steroids ovarian cancer

Question 37

``` Polymyalgia rheumatica: presentation? dx? tx? complications? ```

Answer 37

hip and shoulder muscle pain w/o weakness, profound morning stiffness Dx ↑ESR (CK is normal) Tx steroids Complications: aortic aneurysms, temporal arteritis

Question 38

Seronegative spondyloarthropathies =

Answer 38

Psoriatic arthritis, Ankylosing spondylitis, IBD, Reiter syndrome **all have inflammatory oligoarthritis, negative RF, HLA-B27 association