Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

LOCO2 > R2 LOCO3 > Flashcards

R2 LOCO3 Flashcards

1
Q

Which region of the muscle tissue connects the muscle fibre to the tendon?

A

Endomysium is around each muscle fibre & blends into tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Whats the difference between tendinitis and tendinosis? [2]

A

Tendinitis: acute inflammation of tendon, does not have microscopic tendon damage

Tendinosis: chronic inflammation of tendon; characterised by disorganised fibres and a hard, thickened, scared and rubbery appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is difference in structure between normal tendon and tendon with tendinosis? [2] Why is this clinically significant [1]

A

Normal structure: tendon allows contraction of muscle to cause movement of skeletal system

Tendinosis: disorganiesd collagen means that stresses are not transmitted efficiently: can lead to full thickness tear

Note the disorganise collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Achilles tendinitis

Which physiological process may occur during the healing process? [1]

A

Form heterotopic calcified regions (formation of extraskeletal bone in muscle and soft tissues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where in the tendon does tendonitis usually occur? [1]

A

Tendonitis usually occur in the middle of the tendon as this is the weakest spot [1]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain the pathophysiology of heterotopic bone [3]

A

Fibroblasts, osteoblasts and chondroblasts come from same precursors

Tendon fibroblast differentiate into chondrocytes / hypertrophic chondrocyte and osteoblasts via COX-2

Pro-inflammtory cytokines like prostaglandin E2 induces osteoblasts to differentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe how healing compares when undergo unloading by temporary paralysis versus overloading by active mobility or exercise for:

  • tendon-bone healing
  • flexor tendon healing
A

Complete unloading by temporary paralysis:
* Beneficial for tendon-bone healing
* Detrimental for flexor-tendon healing

Overloading by active mobility or exercise:
* Detrimental for tendon-bone healing
* Beneficial for flexor-tendon healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

State which is more beneficial for shorter [1] or longer [1] tendons

Unloading by temporary paralysis

Overloading by active mobility or exercise

A

Short: Unloading by temporary paralysis / cast immobilisation

Long:loading by active mobility or exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the different types of enthesis in body [2]

A

Fibrous
* tendon extends all way up to bone: collagen bundles extend all the way to periosteum & become calcified
* Both are made from type 1 collagen

Fibrocartilaginous: when want to dissapate the stress
* Small section of fibrocartilage at attachment site
* Fibrocartilage calcififies at insertion
* Helps stiffen the tendon / ligament and creates a gradual change in mechanical properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name two locations of fibrous enthesis ligaments [2]

Name three locations of fibrocartilage enthesis ligaments [2]

A

Fibrous enthesis
* spring ligament
* periodontal ligament

Fibrocartilage enthesis
* rotator cuff muscles
* achilles tendon
* plantar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of enthesis is depicted? [1]

A

Fibrous enthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define sharpey fibres [1]

A

Sharpey’s fibres: are a matrix of connective tissue consisting of bundles of strong predominantly type I collagen fibres connecting periosteum to bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Label A

A

sharpey fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

State the 4 zones of the fibrocartilage enthesis [4]

A
  1. Tendon proper
  2. Fibrocartilage
  3. Mineralised fibrocartilage
  4. Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is name for inflammed enthesis? [1]

A

Enthesitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe enthesitis pathogenesis:

Normal enthesitis insertion occurs at a location with lots of which structure? [1]

How does this influence enthesitis pathogenesis? [3]

A

Normal enthesis inserts into porous bone at a location with lots of small transcortical vessels (TCV)

Mechanical trauma; TCVs become inflammed:
* Vasodilation
* Efflux of immune cells (neutrophils)
* Osteoblasts form bone at enthesis - causes bone to be formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Enthesitis is associated with which three conditions? [3]

A

Ankylosing spondylitis
Psoriatic arthritis
IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you differentiate between enthesophytes and osteophytes? [2]

A

Enthesophytes: originate from insertion of the joint capsule, ligament or tendons: no articular border involvement

Osteophytes: orginate from border of articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you treat enthesitis:

  • If mechanical? [2]
  • If Inflammatory [5]
A

Mechanical:
* RICE
* NDSAIDs

Inflammatory:
* Sulfasalazine
* Methotrexate
* Anti-TNF therapy (restricted use for severe autoimmune enthetitis)
* Local radiotherapy
* Corticosteroid injection
* Hyperosmolar dextrose (initiates proliferation of intrinsic fibroblasts - race to repair damage c.f. osteoblasts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which drug class is used for ankylosing spondylitis enthesitis? [1]

A

Anti-TNF treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the names for arteries that supply tendons (of the hands)? [1]

A

Vincular arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name two tenosynovitis conditions [2]

A

De Quervain’s tenosynovitis

Trigger finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Explain pathophysiology of De Quervien tenosynovitis [3]

A

Fibrosis and narrowing of tendon sheath: extensor retinaculum

Around anatomical snuffbox

Causes tendons and sheath rubbing over radial styloid process

Thickening and narrowing of tendon sheath

Lymphocyte inflammation

24
Q

State and describe the name for test of De Querviens tensynovitis [1]

A

Finkelstein test:

  • Patient resting their forearm on a surface in a neutral position with the wrist hanging off and unsupported
  • The examiner holds the patient’s thumb and passively flexes the thumb into the palm, causing the wrist to adduct (ulnar deviation), putting **strain on the APL and EPB tendons. **
  • If this causes pain at the radial aspect of the wrist, the test is positive, indicating De Quervain’s tenosynovitis.
25
Describe pathophysiology of trigger finger
Enlargement of tendon within sheath
26
Treatment for tenosynovitis? Treatments [4] Surgery - for trigger finger [1] and De Quervains [1]
Treatment: * RICE * Splinting * Anti-inflam * Corticosteroids Surgery: * TF: **cut annular ligament** * DQ: **shave styloid processs or cut sheath**
27
Describe pathophysioloy of SLE [1]
Antibodies agaisnt a wide range of self antigens: * **Anti-nuclear antibodies (ANA):** intranuclear and cytoplasmic proteins (95% are positive) * Anti-Histone * Anti-Ro * Anti-La * (loads of antibodies due to B cell hyperactivity)
28
Describe lesions seen in SLE [1]
**Discoid lesions**
29
Describe the arthritis seen in SLE patients [1]
**Jaccoud arthropathy**: due to tendinitis Can move back into the correct position.
30
DMARD treatments for SLE? [4]
**Cylcophosphamide** **Mycophenolate mofetil** **Methotrexate** **Tacrolimus**
31
Describe two biological DMARDs for SLE? [2]
**Belimubab:** inhibits BAFF (B cell activating factor) **Rituximab**: CD20 blocker
32
Describe the role of Langerhan cells [3]
**Dendritic cell** - spine-like projections Efficient at **presenting antigen to CD4+ helper T-cell** Pick up antigens that enter the skin and **transport them to the lymph node** | Staining dendritic cells n epidermis in a patient with skin infection.
33
Describe pathway of mast cell degranulation after exposure to an antigen [3]
**APC** picks up the antigen and **presents to the T cell**. **Th2** produces **IL4 & IL5**, which activates the **B cells** to make **IgE**, which then activate the **mast cell** and **degranulation occurs** IgE producition- produced after a second exposure.
34
What do mast cells release into systemic circulation? [4]
histamine, leukotrienes, prostaglandins, platelet aggregating factor
35
Histamine is important as it causes which symptoms seen in an allergic reaction? [6[
Smooth muscle contraction Vessel leak and oedema Bronchospasm Arteriole dilatation causing headache and hypotension Modulation of immune response via H2 receptors
36
Name an allergen produced by dust mice [3] How does it cause damage to airway epithelium? [1]
**Der P1** is an enzyme allergen from the **faecal pellets** of the dust mite. Der P1 **breaks down components** of **tight junctions** which helps it to **cross mucosa.** Binds to mast cells and causes **degranulation**
37
Describe anaphylaxis occurs [2]
Generalised: antigen released into blood stream, binds to IgE on basophils: massive release of inflammatory mediators- bronchospasm and **circulatory collapse**
38
How can you treat resistant urticaria and asthma?
**Omalizumab**: binds free IgE in the serum, forming trimers and hexamers
39
What is Pemphigus Vulgaris? [2]
autoimmune disease caused by **antibodies directed against desmoglein 3**, a cadherin-type **epithelial cell adhesion molecule** **Antibody and complement** binds to **desmoglein 3**: causes **acantholysis** (loss of coherence between epidermal cells due to the breakdown of intercellular bridges)
40
Treatment of Pemphigus Vulgaris? [3]
**Oral steroids** Immunosuppresion: **mycophenolate mofetil** or **azathioprine** **Rituximab** (targeting CD20 on B cells)
41
Describe the features of Immune Complex Mediated Vasculitis [4]
**Antigen and antibody form an immune complex** This causes **production of proteins and aggregation** of **platelets** into **micro thrombi** This results in: * **Deposition** of **fibrin** * **Leaky vessel** and **extravasation** of blood and oedema. * The **proteases** degrade **vessel BMZ** * **Necrosis** of the **vessel wall**
42
How does Cutaneous Manifestations of Vasculitis differ if its: Early, Established or Severe?[3]
**Early** - erythema and oedema **Established** - palpable purpura **Severe** - ulceration and necrosis
43
Name this disease [1]
**Leukocytoclastic Vasculitis**: Blood induced- there are black and necrotic areas on the legs.
44
Allergic Contact Dermatitis pathogenesis? [3]
**Promotion of Th1 response:** * Secretion of **IL2, IL3, GM-CSF, IFNg and TNF** * This promotes a **macrophage** rich **response** * Causes **inflammation to the skin** around **48 hours to 72 hours** after the challenge
45
Describe formation of granulomas
**Clonal T-cell expansion** Secretion of Th1 cytokines: **IL-2, IFN-g, TNF** causes the creation of macrophages
46
New drug class treatments for AA and Vitiligo? [1] Name an example drug [1]
**JAK Inhibitors** E.g **Ruxolitinib**
47
Two potential AEs of JAK inhibitors? [2]
Thromboembolic events Cancer related events
48
Omalizumab works by reducing which molecule? [1]
**IgE**
49
Pemphigus Vulgaris occurs due to autoantibodies directed at a cadherin-type epithelial cell adhesion molecule called what? [1]§
**Desmoglein 3**
50
Oral steroids; mycophenolate mofetil or azathioprine and / or Rituximab would be used to treat which skin condition? [1]
**Pemphis vulgaris**
51
Allergic contact dermatitis is caused by an Th1 response causing an increase in: neutrophils lymphocytes macrophages killer cells
**macrophages**
52
Allergic contact dermatitis is caused by which type of response Th1 Th2 Th17 Th5
Allergic contact dermatitis is caused by which type of response **Th1**
53
Granuloma formation is a which type of hypersensitivity reaction? Type 1 Type 2 Type 3 Type 4
**Type 4**
54
This person with a tattoo has an adverse reaction. This occurs due to Mast cell-mediated inflammation Antibody-mediated inflammation Immune complex mediated inflammation Delayed hypersensitivity Automimmunity
Immune complex mediated inflammation
55
Ruxolitinib is a JAK inhibitor used to treat [2] Vitiligo Phemphis vulgaris Leukocytoclastic vulgaris Urticaria
Ruxolitinib is a JAK inhibitor used to treat **Vitiligo** **Phemphis vulgaris** Leukocytoclastic vulgaris Urticaria
56
Omalizumab is used to treat Vitiligo Phemphis vulgaris Leukocytoclastic vulgaris Urticaria
**Urticaria**
57
Granuloma formation is caused by which type of response Th1 Th2 Th17 Th5
**Th1**

LOCO2 (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions