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(***) (U-World) All Subjects > Sports Injuries and Rheumatology > Flashcards

Sports Injuries and Rheumatology Flashcards

1
Q

colchicine used to treat _____

inhibits ____________, which disrupts chemotaxis, phagocytosis, degranulation, and also reduces formation of LTB4

A

gout

microtubular polymerization

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2
Q

young boy with fever and bone pain =

primarily affects the _______ of _____ bones

A

hematogenous osteomyelitis

metaphysis

long

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3
Q

normal infant at birth, progresses to lethargy, poor feeding, constipation, hypotonia, puffy face, umbilical hernia, protruding tongue, large anterior fontanelle, irreversible intellectual disability risk =

common cause

why delayed

A

congenital hypothyroidism

iodine deficiency

maternal T4 still active

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4
Q

osteocytes send signals and exchange nutrients and waste products within neighboring lamellae via _____

A

gap junctions

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5
Q

_________ is a benign childhood disorder marked by severe arthritis in adult life. This _____ disorder is caused by deficiency of ___________. Accumulated homogentisic acid causes pigment deposits in connective tissue through the body, notable blue black deposits in the sclerae and ear cartilage. Urine in these patients turns _____ when exposed to air

A

Alkaptonuria

AR

homogentistic acid dioxygenase

black

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6
Q

couple, similar pruritic papulopustural rash, back recently from vacation, most likely =

G negative rod, oxidase positive, produces green pigment, almost always culprit

bug also implicated in

A

hot tub folliculitis

P aeruginosa

burn victims

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7
Q

the _____ receptor initiate the extrinsic pathway of apoptosis. Mutations here or at the ____ligand can prevent apoptosis of autoreactive lymphocytes, thereby increasing the risk of AI disorders such as SLE

A

Fas

Fas

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8
Q

C tetani produces the ______ tetanospasmin that blocks the release of inhibitory NTs from inhibitory motor interneurons in the CNS. Tetanus is prevented by immunization with ______ that triggers the production of antitoxin antibodies.

A

exotoxin

toxoid

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9
Q

3 year old, pushes up from squat, enlarged calves =

due to a mutation affecting _________

inheritance =

truncated version of dystrophin =

A

Duchenne muscular dystrophy; Gower’s sign

dystrophin, sarcolemma cytoskeleton linker protein

X linked p21

Becker muscular dystrophy

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10
Q

sitting up from supine involves external abd. obliques, rectus abdominis, and

A

Iliopsoas

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11
Q

aortic dissection, mitral valve prolapse, spontaneous pneumothorax from apical blebs, ectopia lentis, joint hypermobility, marfan body type =

protein affected is ________ and is an extracellular glycoprotein that acts as a scaffold for _____

If affected protein was collagen =

A

Marfan syndrome

fibrillin-1

elastin

Ehlers-Danlos

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12
Q

headaches, visual and muscular symptoms, enlarged temporal artery, elevated ESR =

associated =

production of ______ correlates closely with severity of disease. Treatment with monoclonal antibody _____ is effective

A

Giant Cell Arteritis (temporal)

polymyalgia rheumatica

IL6

tocilizumab

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13
Q

Substance X causes an increase in serum calcium and URINE phosphate =

receptors found on ________

causes them increase production of ______ and MCSF

also decreases the release of _______, which will increase bone turnover

calcitonin effect is ______ of this

A

PTH

osteoblasts

RANK-L

OPG

opposite

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14
Q

Achondroplasia is due to a point mutation in ______ which causes exaggerated inhibition of ______

A

FGFR3

endochondral ossification

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15
Q

cafe-au-lait spots, precocious puberty, hyperthyroidis, mutliple osteolytic appearing lesion of hip and pelvis (fibrous dysplasia) =

Gene =

causes

A

McCune-Albright Syndrome

GNAS

Persistent activation of Gs/cAMP

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16
Q

during skeletal muscle contraction, calcium is released from the SR and binds _________, thereby allowing the binding of actin to myosin

A

Troponin C

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17
Q

postural skeletal muscles such as soleus and ______ contain predominantly __________ that derive ATP primarily from oxidative (aerobic) metabolism and have l myoglobin rich, glycogen poor fibers with many mitochondria

A

paraspinal muscles

Type I

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18
Q

bone mass in adulthood is determined by peak bone mass and the rate of bone loss. __________ women have higher bone density and a lower risk of fractures than other women

A

African American

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19
Q

acute joint pain, swelling, erythema, restricted ROM, fever =

best evaluated with ________ and should be sent for crystal analysis, cell count, gram stain, and culture

A

acute synovitis

arthrocentesis and synovial fluid analysis

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20
Q

recurrent skin and mucosal bacterial infections, no pus, poor wound healing, delayed umbilical cord separation, peripheral leukocytosis with neutrophilia =

due to absence of _____

inheritence

often infected with _____ or g(-) rods

A

Leukocyte adhesion deficiency

CD18

AR

S aureus

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21
Q

knee pain with repetitive or prolonged kneeling =

obesity or overuse knee pain along medial knee =

pain between distal femur and quads, caused by a direct blow or repetitive quadriceps activity like running =

A

prepatellar bursitis

anserine bursitis

suprapatellar bursitis

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22
Q

episodes of gouty arthritis with increased serum uric acid levels, prophylactic therapy is _________ such as allopurinol or febuxostat

first line therapy during attack =

A

XO inhibitors

NSAIDs

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23
Q

childhood osteomyelitis =

sickle cell osteomyelitis =

pott disease osteomyelitis

DM, impaired mobility, or recent trauma or surgery osteomyelitis -

A

S aureus

salmonella

TB

polymicrobial

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24
Q

early muscular dystrophy in distal muscle biopsy

late

A

true hypertrophy

fibrofatty muscle replacement

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25
Q

polyarthritis, morning stiffness, systemic symptoms, progressive joint pain in the hands that gets better as day goes on =

first line DMAR

can cause oral ulcers, alopecia, pancytopenia, hepatoxicity, and pulmonary fibrosis

A

RA

methotrexate

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26
Q

_________ such as alendronate and risedronate are the preferred initial treatment of osteoporosis and chemically resemble

A

bisphosphates

pyrophosphate

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27
Q

gaseous gangrene at a penetrating injury =

usually associated with late onset _______ and transient watery diarrhea with abdominal discomfort

A

clostridium perfringens

food poisoning

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28
Q

the ______ is anatomic space in teh wrist defined by the carpal bones on the dorsal aspect and the _________ (flexor retinaculum) and can compress the _____ nerve causing carpal tunnel syndrome (1st 3 digits and radial half of 4th)

A

carpal tunnel

transverse carpal ligament

median

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29
Q

first line treatment for GCA =

A

glucocorticoids

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30
Q

MG is associated with abnormalities of the _____, which, along with the _______ glands arises from the 3rd pharyngeal pouch

A

thymus

inferior parathyroid

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31
Q

________ is characterized by stiffness and fusion of axial joints and inflammation at the site on insertion of tendons into bone. Involvement of the ____ and ribs can limit __________, leading to hypoventilation, thus __________ should be monitored closely

A

Ankylosing spondylitis

thoracic spine

chest wall expansion

chest wall expansion

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32
Q

during wound healing, excessive MMP activity and myofibroblast accumulation in the wound margins can result in _______, most often in the palms, soles, anterior thorax, and at serious burn sites

A

contracture

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33
Q

inability to exten right wrist and several fingers, history of asthma, high Eosinophils, serum ANA/anti myeloperoxidase + =

mononeuritis multiplex due to

A

eosinophilic granulomatosis with polyangitis (CHurg Strauss)

involvment of epineural vessels

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34
Q

the ________ originates from the anterior surface of the transverse processes and lateral surface of the vertebral bodies at ________. IV drug users can develop _______ abscess at this muscle and it can seed the L spine

A

Psoas major

T12-L5

S aureus

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35
Q

foot is everted and dorsiflexed after injury

injury to =

sensory loss on =

A

tibial nerve, puncture at popliteal fossa

plantar surface of foot

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36
Q

_______ of the hands is characterized by osteophyte formation leading to hard bony enlargement of the ______ (heberden nodes) and __________ (Bouchard nodes) brief morning stiffness may be present and patients are usually older, compared to RA patients who have prolonged morning stiffness, proximal joint involvement, and are younger

A

Osteoarthritis

DIP

DIP

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37
Q

first line for gout attack =

if patient has PUD =

A

NSAID

Colchicine

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38
Q

abrupt onset fever, arthralgias, rash, ANA+, after TB therapy =

due to

A

Drug induced lupus erthematosus

slow liver acetylators

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39
Q

rhomboid shaped crystals, symptoms of gout but in the knee, synovial fluid analysis reveals elevated WBC with neutrophilic predominance =

crystals contain

A

pseudogout

calcium pyrophosphate

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40
Q

SLE: malar or discoid butterfly rash, gradual symtom onset, joint renal, serosal or neuronal involvement

Labs: anemia, leukopenia, thrombocytopenia
+______, +______ and +_________, increased immune complexes and ____ C3 and C4

Anti CCp+ =

Anti-mitochondrial antibodies + =

HLA B27 + =

A

ANA

AntidsDNA

Anti Smith

low

RA

primary biliary cirrhosis

seronegative spondyloarthropathies

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41
Q

bisphosphates attach to _______ binding sites on bony surfaces to inhibit __________ by mature ________

A

hydroxyapatite

bone resportion

osteoclasts

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42
Q

_____ occurs with increased frequency in patients with activating mutations involving phosphoribosyl pyrophosphate synthetase due to increased production and degradation of purines

A

gout

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43
Q

first line of therapy for gout

they inhibit COX and exert a broad anti-inflammatory effect that includes inhibition of _____

A

NSAIDs

neutrophils

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44
Q

the quadriceps muscle group is connected to the patella, which is in turn attached to the ________ by the patellar ligament. Repetitive quardriceps contraction can lead to ________ which is characterized by focal pain and swelling at this location

A

Tibial tuberosity

Osgood schlatter

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45
Q

____ is produced by Th2 cells, it facilitates growth and of cells and Th2 lymphocytes and stimulates the anti body isotype switch to IgE

A

IL4

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46
Q

________ is a virulence factor found in the peptidoglycan wall of S aureus that binds the Fc portion of IgG, leading to impaired complement activation, opsonization, and phagocytosis

man with pain swelling erythemia in leg after suffering minor cut

A

Protein A

cellulitis

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47
Q

polycythemia vera plus episodic knee pain, redness, swelling, non compliant with treatments =

synovial fluid contains

due to

A

gout

needle shaped, (-) birefringent crystals

increased uric acid production from cell turnover

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48
Q

preceding genitourinary infection or enteritis, followed by arthritis

extraarticular symptoms

lab?

A

reactive arthritis (sterile)

conjunctivitis, urethritis

HLA-B27

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49
Q

older man, bone pain, elevated alkphos is either ______ or _______.

biopsy showing a _____ pattern of lamellar bone is diagnostic for ________. The initial phase of this disorder is characterized by an increase in ______ activity

the second phase is mixed _______-_______ activity

the 3rd phase is the osteosclerotic phase which is _________ and presents with the mosaic pattern and prominent _______

A

osteoblast metastases or Paget disease of Bone

Mosaic

PDB

Osteoclast

osteoclastic-osteoblastic

Osteoblast dominant

cement lines

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50
Q

subcutaneous mycosis with no relevant history

fungus =

from =

A

sporotrichosis

Sprothrix Schenckii

thorn prick

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51
Q

use of a monoclonal antibody (infliximab) or venom antitoxins followed by joint pain and pruritic skin rash with fibrinoid necrosis and neutrophil infiltration =

type of reaction

other lab

A

serum sickness

Type III HS

low C3/C4 due to deposition of circulating immune complexes

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52
Q

bone specific alkphos reflects

tartrate resistent acid phosphatase, urinary hydroxyproline, and urinary doxypyridinoline reflect

A

osteblastic activity

osteoclastic activity

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53
Q

Na+ and Cl- are located

K+ is located

Calcium is located

A

extracellular

intracellular

extracellular

54
Q

nausea, abdominal pain, and diarrhea, being treated for gout, side effects of =

affects =

A

colchicine

cytoskeleton

55
Q

flat topped, violaceous papules over the joints of teh fingers, heliotrope rash characteristic for______ especially in the presence of proximal muscle weakness and elevated muscle enzymes

Antibody

papules called

A

dermatomyositis

Anti-Jo-1

Gottron papules

56
Q

________ muscle assists in abduction of the arm and stabilization of the GH joint. The tendon is vulnerable to injury due to impingement between the acromion and the head of the humerus. Most common cause of rotator cuff syndrome

A

Supraspinatus

57
Q

intubated, skeletal muscle relaxant given, arrhythmia develops and serum potassium is really high, drug used =

hyperkalemia most likely in

can also cause

A

succinylcholine

burns, myopathies, crush injuries, denervating injuries/disease

malignant hyperthermia

58
Q

variable clinical expressions in affected family members can occur due to _______, which is the coexistence of distinct versions of mitochondrial genomes in an individual cell

lactic acidosis and ragged skeletal muscle fibers indicate

________ inherited

A

hereoplasmy

mitochondrial myopathy

maternally

59
Q

SERMs used for decreasing the risk of bone fractures and breast cancer =

A

Raloxifene

60
Q

+ Lachman or anterior drawer

A

Anterior cruciate ligament

61
Q

GCA is characterized by ______ of the media

A

granulomatous inflammation

62
Q

anticonvulsants, aromatase inhibitors, medroxyprogesterone, GnRH agonists, proton pump inhibitors, glucocorticoids, unfractionated heparin, thiazolidinediones all increase risk of

A

osteoporotic fractures

63
Q

sickle cell disease, young, left hip and pelvic pain, no fever, decreased rotation, extension, abduction =

due to

also caused by

A

avascular necrosis

thrombotic/embolic occlusion from sickle cell or decompression sickness

glucocorticoids

64
Q

XO catalyzes 1 of 2 major ___________inactivating pathways. Allopurinol competitvely inhibits _____, which results in increased conversion of this substance to its active metabolite

A

azathioprine

XO

65
Q

minor trauma, erythema overlying skin, swelling and edema pain out of proportion to examination findings =

due to =

if coagulase positive and catalase positive

other bacteria involved

treatment

A

necrotizing fasciitis

strep pyogenes (group A), PYR positive

S aureus

clostridium perfringens

surgical debridement

66
Q

frontal bossing, femoral and tibial bowing, softened skull bones, immigrants from heavily sun exposed area to less sun exposed, infant =

due to =

A

Rickets

insufficient Vitamin D and excess unmineralized osteoid matrix

67
Q

fever and facial rash in child, acute symmetric arthropathy in parent looks like RA but negative labs =

characteristics

A

parvovirus B19

ssDNA virus

68
Q

_____________ is a leukocytoclastic vasculitis following ______, cephalosporin, sulfonamides, phenytoin, and allopurinol use. The rash is nonblanching, palpable purpura on the lower extremities and consists primarily of

A

Cutaneous small vessel vasculitis

penicillins

neutrophils

69
Q

the _____ band is the region of the sarcomere that contains only thick myosin filaments, while the _____ band contains only thin actin filaments. The ___ band contains an area where they overlap

A

H band

I band

A band

70
Q

inability to externally rotate the shoulder after traumatic injury to it from behind

A

infraspinatus injury

71
Q

peroneal nerve damage due to fracture of the neck of the fibula results in loss of ______ sensation and _______

A

dorsal foot

foot drop

72
Q

trendelenburg indicates weakness in glute med on _____ side of hip drop. Can be due to injection in the _____ part of the buttock, risking injury to the _____ nerve. If injections are given in the ______ or _______ regions, the sciatic nerve is at risk

A

opposite

supermedial

superior gluteal

inferolateral

inferomedial

73
Q

symmetrical proximal muscle weakness, increased difficulty climbing stairs, getting up from chair, carrying heavy objects =

elevated ______ enzmes, antibody

_______mononuclear infiltrate of ________ with patchy necrosis and increased expression of MHC I

A

polymyositis

muscle enzymes, Anti Jo-1

endomysial, CD8+

74
Q

patellar fracture due to direct impact on the anterior aspect of the, patients will have inability to _______

A

extend knee against gravity

75
Q

clubbing of the digits due to lung diseases like _______

A

bronchiectasis

76
Q

thin acting filaments are bound to structural proteins at the _______, whereas thick myosin filaments are bound to structural proteins at the

A

Z line

M line

77
Q

anterior lateral displacement of the humerus in a supracondylar humeral fracture, most likely to be injured

superficial supracondylar fracture

posterior displacement of proximal humerus (falling on flexed elbow)

anterior medial displacement =

A

Radial nerve

basilic vein

ulnar nerve

median nerve

78
Q

the most common elbow injury in children, sudden traction on the outstretched and pronated arm of a child, distressing to try to move the elbow =

also called =

ligament damaged

A

radial head subluxation

nursemaids elbow

annular ligament

79
Q

patients with SLE can have autoantibodies directed against _______, which remove introns from RNA transcripts

A

snRNPs (anti-Smith)

80
Q

Low estrogen states cause osteoporosis by decreasing osteoprotegerin production, increasing ______ production, and increasing RANK expression in osteoclast precursors, leading to increased __________

A

RANK-L

bone resorption

81
Q

young adult african american with cough, dyspnea, bilateral hilar adenopathy with noncaseating granulomas =

present with _________ that is caused by parathyroid hormone independent formation of 1,25dihydroxyvitamin D by _________, which leads to increased intestinal absorption of calcium

A

sarcoidosis

hypercalcemia

activated macrophages

82
Q

T tubules are extension of the ______ and ensure coordinated ________ of all myofibrils. No T tubules leads to ________

A

sarcolemma

contraction

uncoordinated contraction

83
Q

the resting membrane potential is due to a high ______ efflux and some _________ influx

A

Potassium

sodium

84
Q

blue sclera, history of severall fractures after minimal trauma, suggests :

due to a deficiency in

inheritence

primary impariment

A

osteogenesis imperfecta

collage type I

AD

bone matrix formation

85
Q

proximal muscle weakness, cranial nerve involvement, autonomic symptoms, mass in the upper lung lobes

A

Lambert Eaton Myasthenic Syndrome

86
Q

older, LE pain, numbness, paresthesia, weakness, worse standing or walking upright, relieved by walking uphill, leaning on a stroller/shopping cart (lumbar flexion) =

due to hypertrophy of

A

lumbar spinal stenosis

ligamentum flavum

87
Q

radial nerve injury on the lateral side of the arm, cant extend wrist, artery also injured that runs with it?

A

deep brachial (profunda brachii)

88
Q

small joints, cervical spine subluxation, prolonged morning stiffness and assoicated fatigue =

antibodies

A

RA

Anti-CCP (cyclic, citrullinated peptide)

89
Q

pathologic _____ can be caused by decreased physical workload, loss of innervation, decreased blood supply, inadequate nutrition, absent endocrine stimulation, aging, or mechanical pressure

A

atrophy

90
Q

selective COX2 inhibitors such as _______ relieve pain with a lower risk of bleeding and ______ than NSAIDs

A

celecoxib

gastric ulceration

91
Q

__________ of the humerus classically follow a blow to an externally rotated and abducted arm. There is typically a flattening of the deltoid muscle and insensitivity to overlying skin to pinprick. This is due to damage to the -________ nerve, which innervates the deltoid and tere minor muscles along with skin over the lateral shoulder

A

Anterior dislocation

axillary

92
Q

vertebral fracture from sitting down in hard chair in a patient with RA, due to

A

chronic glucocorticoid use promoting osteoporosis

93
Q

young man dull back pain, limited anterior spinal flexion, no swelling, narrowing of SI joints, bamboo spine =

strongly associated with

A

ankylosing spondylitis

CLASS I HLA B27

94
Q

aspiring professional athlete with nodular and comedonal acne in 20s =

A

anabolic steroid abuse

95
Q

the Valsalva maneuver increased _____ tone and can be used to abolish _______. The most important muscle in achieving the increased intraabdominal and intrathoracic pressure is the _______

A

vagal

PSVT

rectus abdominis

96
Q

fall on outstretched hand, fracture in the anatomical snuffbox, highest risk for __________ of the ________ bone

A

avascular necrosis

scaphoid

97
Q

during skeletal muscle contraction cycle, ATP binding to myosin causes the __________________

without ATP, a muscle will be fixed in a _________ state called ________

A

release of myosin head from its binding site on actin filament

contracted

rigor mortis

98
Q

patients with GCA require immediate glucocorticoid therapy to prevent

A

ischemic optic neuropathy

99
Q

patient presents with monoarticular arthritis with effusion, decreased ROM, synovial fluid Leukocyte count of >100,000 =

if no trauma, most likely due to

requires

A

septic arthritis

gonococcus infection

antibiotic treatment

100
Q

______, also known as alpha toxin, is the main toin produced by ___________. It function to degrade lecithin, a component of phospholipid memebranes

gas gangrene

A

lecithinase

Clostridium perfringens

101
Q

lateral ankle sprain due to inversion of a plantar flexed foot most commonly involves ______

A

anterior talofibular ligament

102
Q

ligament at the anterior part of the lateral aspect of the medial femoral epicondyle

A

PCL

103
Q

dorsal aspect of hand, carpals from thumb to pinky

top row

bottom row

more medial bone that articulates with the radius

more lateral

A

trapezium, trapezoid, capitate, hamate

scaphoid, lunate, triquetrum

lunate

scaphoid

104
Q

Osteoporosis due to trabecular _______ with _____ interconnections

A

thinning

fewer

105
Q

UE numbness, weakness, tingling in a young pitcher, symptoms worsen with overhead actvities

due to copmression at

A

Thoracic outlet syndrome

scalene muscles

106
Q

young adult with episodic renal, nervous,bloody GI, and myositis/arthritis, transmural inflammation with fibrinoid necrosis, ANA negative =

associated with

A

Polyarteritis nodosa

Hep B

107
Q

______ passes through the greater sciatic foramen and is involved with external hip rotation. Patients with _______ due to muscle injury or hypertrophy compressing the sciatic nerve present with persistent pain in the right buttock and posterior thigh

A

piriformis

piriformis syndrome

108
Q

a _______ abscess can occur as a result of seeding from a distant or adjacent site. Patients can present with fever, back or flank pain, inguinal mass, difficulty walking. Inflammation of the muscle causes pain when the _____ is extended

A

psoas

hip

109
Q

MG is due to _____________ against skeletal myocyte surface ______. ________ similarly involves autoantibodies against ________ in the renal glomeruli and lung alveoli

A

IgG autoantibodies

acetylcholine receptors

Goodpasture Syndrome

BM collagen

110
Q

vertebral osteomyelitis should be suspected in patients with worsening back pain, fever, recent endocarditis or bacteremia (especially S aureus). Also suspected if new neuro findings and fever without back pain. ______ of the spine is the preferred diagnosis

A

MRI

111
Q

in patients with primary osteoporosis not caused by a medical disorder, serum calcium, phosphorus, and PTH are all

A

normal

112
Q

the most commonly fractured bone in young children is

the _____ muscle causes superior displacement of teh medial fragment, while the weight of the arm and pec mjaor cause inferior displacement of the lateral fragment

A

clavicle

SCM

113
Q

mab =

cept =

nib =

A

monoclonal antibody

receptor molecule decoy

kinase inhibitor

114
Q

Rheumatoid factor is an IgM antibody specific for

anticentromere antibodies =

antiphospholipid antibodies =

A

Fc component of IgG

CREST syndrome

SLE, antiphospholipid antibody syndrome (hypercoaguable state with paradoxical PTT prolong)

115
Q

________ edema factor is adenylate cyclase that causes massive increases in intracellular cAMP, leading to neutrophil and macrophage dysfxn. The mechanism of action is similar to that of adenylate cyclase toxin produced by

A

bacillus anthracis

bordetella perstussis

116
Q

the ______ system monitors and maintains muscle length, while the ________ is a system that monitors and maintains muscle force and is exquisitely sensitive to increases in muscle tension

A

muscle spindle

Golgi Tendon Organ

117
Q

the __________ is innervated by the thoracodorsal nerve and functions to extend, adduct, and medially (internally) rotate the humerus

A

Latissimus dorsi

118
Q

widespread MSK pain, fatigue, impaired attention/concentration, psychiatric disturbances, symptoms for >3months, no joint or muscle inflammation, normal ESR and CRP, multiple tenderpoints

A

fibromyalgia

119
Q

joint pain and swelling, facial palsy history, hiking trip to northeast US, early flu like symptoms, erythema chornicum migrans =

vector

treatment

A

Borrelia burgdorferi: lyme disease

ixodes tick

doxycycline or penicillin type abx (ceftriaxone)

120
Q

calcinosis, raynauds, esophageal dysmotility, sclerodactyly, telangiectasias

female, nonpitting edema of hands, fingers turn blue in cold, retrosternal burning and regurg when supine

antibody

A

CREST

Anti centromere

121
Q

lateral epicondylitis (____elbow) is caused by oversuse of the extensor carpi radialis brevis and is characterized by angifibroblastic tendinosis at is origin on the lateral epicondyle

involves

A

tennis

wrist extension

122
Q

________ can be injured at the medial epicondyle of the humerus (funny bone) or in Guyons canal near the ________. Patients often have sensory loss over the 5th digit and hypothenar eminence and weakness with wrist flexion adduction, finger abd/add, and flexion of the 4th/5th digits. The _______ may flatten due to muscle atrophy

A

ulnar nerve

hook of the hamate and pisiform bone in the wrist

hypothenar eminence

123
Q

migratory arthritis, high fever, new holosystolic murmur, ASO titer positive in a 12 yr old girl =

great risk of dying from

years or decades later =

A

Acute rheumatic fever

severe pancarditis

mitral stenosis

124
Q

anti jo antibodies in polymyositis are direct against

A

anti-histidyl tRNA synthetase

125
Q

impaired abduction of the shoulder past horizontal, right upper limb weakness and fatigue, winging of scapula on resisted abduction =

woman, most likely hospitalized for

A

long thoracic nerve injury

mastectomy with axillary lymph node removal

126
Q

sustained in repetitive muscle contractions =

due to impaired function of the

most common types are _____, blepharospasm, and writers cramp

A

dystonia

basal ganglia

cervical spasmodic torticollis

127
Q

older man, right tibial pain with increasing intensity, progressive hearing impairment, numerous multinucleated cells on biopsy =

essential for differention of these cells =

A

Paget disease of bone

RANKL

128
Q

_______ inhibitors like Etanercept impair cell mediated immunity. All patients beginning treatment with these drugs should be evaluated for latent

A

TNF-a

TB

129
Q

the _________ and its branches provide the majority of the blood supply to the femoral head. Injury to these vessels due to a displaced femoral neck fracture can cause __________ of the femoral head

A

medial femoral circumflex artery

osteonecrosis

130
Q

the _____ resists force that pushes the knee medially. increased laxity of the knee with valgus stress test indicates injury to this

A

Medial collateral ligament

131
Q

lesions of the femoral nerve can occur due to trauma, compression via hematoma, stretch injury or ischemia. Patients develop weakness of the quadriceps muscles, loss of patellar refelex, and loss of sensation over

A

anterior and medial thigh and medial leg

132
Q

response to DMARDs may take several weeks, while NSAIDs and _________ can provide rapid symptom relief in the interim

A

glucocorticoids

(***) (U-World) All Subjects (20 decks)

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