Rheumatology/MSK

Question 1

What is primary biliary cirrhosis?

Answer 1

Pruritis, xanthomas, anti-mitochondrial Ab; seen in females

Question 2

What is primary sclerosing cholangitis?

Answer 2

P-ANCA Ab, bike duct inflammation, onion skinning, IBD

Question 3

What is type I autoimmune hepatitis?

Answer 3

Anti-smooth mm. Ab; seen in young women

Question 4

What is type II autoimmune hepatitis?

Answer 4

Anti-LKM Ab

Question 5

What is bullous pemphigoid?

Answer 5

Anti-hemidesmosome Ab, subepithelial skin bullae

Question 6

What is celiac sprue?

Answer 6

Anti-gliaden Ab (can’t eat wheat/ bread products = steatorrhea) assoc. w/ dermatitis herpetifomis

Question 7

What Ab is assoc. w/ CREST Syndrome?

Answer 7

Anti-centromere Ab

Question 8

What is dermatitis herpeteformis?

Answer 8

Vesicles on anterior thigh, Anti-BMZ Ab, Anti-endomysial Ab

Question 9

What is dermatomyositis?

Answer 9

Anti-jo-1 Ab; Myositis with a rash; Assoc. w/ occult malignancy

Question 10

What are symptoms of T1DM?

Answer 10

Polyuria, polydipsia, wt. loss, Anti-islet cell Ab, anti-GAD Ab, post-infection, DKA

Question 11

What is drug Induced lupus(and causative drugs)?

Answer 11

Anti-histone-Ab;

Drugs:
Hydralazine 
Isoniazid 
Phenytoin
Penicillamine
Procainamide
Ethosuximide

Question 12

What is gastritis type A?

Answer 12

Anti-parties cell, an strophic gastritis adenocarcinoma

Question 13

What is goodpasture’s?

Answer 13

Anti-GBM Ag, attacks the lungs and kidneys, can progress to RPGN and death

Question 14

What is Graves’ disease?

Answer 14

Anti-TSHr Ab, hyperthyroid exopthalmos, pretibial myxedema

Question 15

What is Hashimotos?

Answer 15

Anti-microsomal Ab/anti-TPO, hypothyroid

Question 16

What is ITP (immune thrombocytopenic purpura)?

Answer 16

Anti-platelet Ab, anti-GP IIB/IIIA Ab

Question 17

What is MCTD (mixed connective tissue disease)?

Answer 17

Anti-RNP Ab

Question 18

What is mononucleosis?

Answer 18

Heterophile Ab positive; teenager w/ sore throat, lymphadenopathy, splenomegaly, “kissing disease”

Question 19

What is MPGN type II?

Answer 19

Anti-C3 convertase Ab= C3 nephritic factor

Question 20

What is paroxysmal hemolysis?

Answer 20

Donate landsteiner Ab; bleed when cold

Question 21

What is pemphigus vulgaris?

Answer 21

Anti-desmosome Ab (skin sloughs off when touched) starts in oral mucosa

Question 22

What is pernicious anemia?

Answer 22

Anti-IF Ab, via. B12 deficiency = megaloblastic anemia

Question 23

What is polyarteritis nodosa?

Answer 23

P-ANCA Ab; attacks gut, kidneys and nervous system; assoc. w/ Hep. B infection. There is no pulmonary environment

Question 24

What is post-strep. GN?

Answer 24

ASO Ab, Nephritic w/ complement deposition; after 3 weeks post-infection

Question 25

What is RA?

Answer 25

Rheumatoid factor present pain and swelling, worse in the morning, anti-citrullinated peptide protein Ab's

Question 26

What is scleroderma?

Answer 26

Anti-Scl70 Ab (anti-Topol), fibrosis, tight skin, masked faces

Question 27

What is Sjogrens?

Answer 27

Anti-SSA Ab, dry eyes, dry mouth, arthritis

Question 28

What is SLE?

Answer 28

Anti-dsDNA; Anti-Smith, Anti-cardiolipin Ab. | Malar rash, photosensitivity, oral ulcers, RF positive, VDRL positive but not infected, FTA-ABS to confirm

Question 29

What is SLE Cerebritis?

Answer 29

Anti-neuronal Ab; Anti-ribosomal Ab

Question 30

What is Vitiligo?

Answer 30

Anti-melanocyte Ab; white patches on skin

Question 31

What is warm hemolysis?

Answer 31

Anti-Rh Ab; bleeds at body temperature

Question 32

What is Wegner's?

Answer 32

c-ANCA Ab; attacks ENT, Lungs, and kidney

Question 33

What is HSP?

Answer 33

IgA Disease - 2 or 3 days post-common cold or GI infection. Leads to Berger's

Question 34

What is Berger's?

Answer 34

IgA disease, 2 weeks post vaccination; serum sickness

Question 35

What is Alport's?

Answer 35

IgA disease; 2 weeks after diarrhea, HSP and polio

Question 36

Where is CK-MB found?

Answer 36

Heart

Question 37

Where is CK-MM found?

Answer 37

Muscle

Question 38

Where is CK-MB found?

Answer 38

Brain

Question 39

Why should you wait 30 mins after a meal before swimming?

Answer 39

All blood is shunted to GI for digestion, digestion depletes ATP stores; No ATP = no muscle movement

Question 40

How does neurogenic muscle disease present?

Answer 40

Distal weakness and fasciculations

Question 41

How does myopathy muscle disease present?

Answer 41

Proximal weakness and pain

Question 42

What is a light chain composed of?

Answer 42

Actin

Question 43

What is a heavy chain composed of?

Answer 43

Myosin

Question 44

What band of sarcomere does not change length?

Answer 44

The A band

Question 45

Where are T-tubules located?

Answer 45

Cardiac mm: at the z-line | Skeletal mm: at the A-I junction

Question 46

What is duchenne's muscular dystrophy?

Answer 46

Caused by a dystrophin frame shift; defective Dystrophin patient will have a Gower sign and calf pseudohypertrophy

Question 47

What is Becker Muscular Dystrophy?

Answer 47

Dystrophin Missense; milder form of DMD | Symptoms present after 5yo

Question 48

What is seen with Myotonic Dystrophy?

Answer 48

Bird's beak Face; can't let go when shaking hands

Question 49

What is Myasthenic Syndrome/Lambert-Eaton?

Answer 49

Patients will tell you that they get stronger as the day goes by; stronger with EMG (electromyography) Assoc. w/ small cell CA

Question 50

What is Myasthenia Gravis?

Answer 50

Anti-ACh post-synaptic Ab; PT ~20-30yo, weaker as day goes on (dysarthria, ptosis, dysphagia) Periotic exacerbations get stronger w/ Edrophonium Weaker with EMG (electromyography); must rule out thymoma

Question 51

What is MS?

Answer 51

Production of Anti-myelin Ab MC in 20-40yo women, vision disturbances, spasticity (UMNs), decreased sensation, symptoms wax and wane - each MS attack gets worse

Question 52

What is Metachromatic Leukodystrophy?

Answer 52

Arylsulfatase A deficiency; a child who presents similar to MS

Question 53

What is ataxia telangiectasia?

Answer 53

IgA deficiency; PT has spider veins

Question 54

What do you see in Friedrick's Ataxia?

Answer 54

Retinitis pigmentosa, scoliosis

Question 55

What is adrenal leukodystrophy?

Answer 55

Carnitine acyltransferase (CAT-1), defective adrenal failure (XR); long-chain FA stuck in cytoplasm

Question 56

What is Guillain-Barre?

Answer 56

Ab's damage multiple peripheral nerves (acute inflammatory polyneuropathy); patients present with ascending paralysis 2 weeks post-UTI

Question 57

What is ALS?

Answer 57

Descending paralysis seen in middle aged men with fasciculations; no sensory problems

Question 58

What is Werdnig-Hoffman?

Answer 58

Fasciculations in newborn due to failure of anterior horns to develop

Question 59

What is polio?

Answer 59

Asymmetric fasciculations in kids; presents 2 weeks post- gastroenteritis

Question 60

What is choreoathetosis?

Answer 60

Dance-like movements; wringing of hands, quivering/unsteady voice

Question 61

What is Atonic Cerebral Palsy?

Answer 61

No mm. Tone - floppy