Anat/MSK/Skin

Question 1

ulnar nerve injury can present with

Answer 1

• sensory loss in medial 1.5 digits of hand
• ulnar claw deformity

motor deficits on

• wrist adduction
• wrist flexion
• finger abduction/adduction
• flexion of 4th and 5th digits

Question 2

musculocutaneous nerve injury presents with

Answer 2

• loss of sensation over lateral forearm

- paralysis of forearm flexors at the elbow

Question 3

axillary nerve injury presents with

Answer 3

• loss sensation over lateral upper arm

- deltoid weakness

Question 4

median nerve injury presents with

Answer 4

-palmar sensory loss involving most of 1st-3rd digits

motor deficits in:

• wrist flexion/abduction
• flexion of 2nd/3rd digits
• flexion/opposition of thumb

may have preacher’s hand when attempting to make fist bc weakness of thenar and flexor digitorum profundus muscles of 2nd/third digits

Question 5

radial nerve injury results in

Answer 5

• sensory loss of posterior arm and forearm, dorsolateral hand, dorsal thumb
• wrist drop (bc radial nerve innervates extensor compartment of forearm)

Question 6

what muscle passes thru greater sciatic foramen?

-function?

Answer 6

piriformis

-external hip rotation

Question 7

Marfan syndrome is due to defect in

Answer 7

fibrillin-1

Question 8

anterior humerus dislocation assoc with injury to ___ nerve. what symptoms result?

Answer 8

axillary nerve

deltoid paralysis
decr sensation over lateral shoulder

Question 9

organisms that can cause Reactive arthritis

what are the classic symptoms of Reactive arthritis

Answer 9

can’t see (conjunctivitis)
can’t pee (urethritis)
can’t climb a tree (arthritis)

ShY ChiCS

Shigella
Yersina
Chlamydia
Campylobacter
Salmonella

Question 10

McCune-Albright syndrome

• cause
• symptoms

Answer 10

activating mutation in G protein / cAMP / AC pathway

triad:

• fibrous dysplasia of bone
• endocrine dysfnction
• cafe-au-lait spots

Question 11

what type of collagen in osteoid

Answer 11

Type I collagen

Question 12

obturator nerve injury

• nerve root
• causes of injury
• sensory deficit
• motor deficit

Answer 12

L2-L4
anterior hip disloc, iatrogenic (pelvic surg)

circular area of inner thigh
thigh adduction

Question 13

femoral nerve injury

• nerve root
• causes
• sensory deficit
• motor deficit

Answer 13

L2-L4
pelvic fracture
mass involving iliopsoas/iliacus muscle (eg hematooma, abscess)

anterior and medial thigh
medial leg

thigh flexion
leg extension

Question 14

common peroneal injury 
-nerve root
-causes
-motor deficit
sensory deficit

Answer 14

L4-S3
fibula neck fracture
nerve compression at fibular neck

lateral lower leg and dorsum of foot

foot eversion
durosiflexion
toe extension

Question 15

tibial nerve injury

• nerve root
• causes
• sensory deficit
• motor deficit

Answer 15

L4-S3
knee trauma

dorsum (bottom) of foot

foot inversino
plantar flexion
toe flexion

Question 16

superior gluteal nerve injury

• nerve root
• deficits
• causes

Answer 16

L4-S2
iatrogenic (eg posterior hip dislocation or buttocks injection)
no sensory deficit
thigh abduction

Question 17

inferior gluteal nerve injury

• nerve root
• deficit
• causes

Answer 17

L5-S2

causes same as superior gluteal–iatrogenic eg posterio hip dislocation or buttocks injection

no sensory deficit

thigh extension

Question 18

Gottron papules are seen in?

Answer 18

Dermatomyositis

is like polymyositis, but also with cutaneous involvement (and perimysial inflamm)
proximal muscle weakness–eg difficulty climbing stairs, combing hair, elev muscle enzymes

Question 19

MOA bisphosphonates?

• used for what
• list an exampl drug

Answer 19

inhibit osteoclast-mediated bone resorption

• similar structure as pyrophosphate. They attach to hydroxyapatite binding sites on bony surface. OC that resorb the bone take up the bisphosphonated and can’t adhere to bony surface to continune resoprtion
• decrease OC proton prod, induce OC apoptosis and decr development/recruitment of OC precursors

alendronate, risedronate

osteoporosis

Question 20

anti-cyclic citrullilnated peptide antibodies associated with?

Answer 20

RA

Question 21

list 4 seronegative spondyloarthropathies

-often associated with what HLA type

Answer 21

• ankylosing spondylitis
• reactive arthritis
• arthritis assoc with IBD
• psoriatic arthritis

HLA-B27 (MHI class)

Question 22

majority of blood supply to femoral head/neck comes from

Answer 22

medial femoral circumflex and its branches

injury to these vessels due to displaced femoral neck fx can cause osteonecrosis of femoral head

Question 23

how do glucocorticoids exert their anti-inflammatory response?

how do they depress the immune response

Answer 23

anti-inflamm:
inhibi phospholipase A2 -> decr prostaglandin and leukotriene synthesis

immune:
inhibit transcription of multiple cytokines and adhesion proteins, reducing luekocyte recruitment and activation

Question 24

MOA Denosumab

-what is it used for

Answer 24

binds RANKL and inhibits binding to RANK (a receptor on oc precurosrs)

reduces osteoclast differentiation and survival

Question 25

what are recombinant PTH analogs for - name and example drug - MOA

Answer 25

osteoporosis stimulates maturation of pre-osteoblasts increases GI calcium absorption and renal tubular calcium absorption teriparatide

Question 26

what Ab is specific for SLE

Answer 26

anti-ds DNA

Question 27

what Ab are found in drug induced lupus? list 4 drugs that commonly cause

Answer 27

anti-histone Procainamide isoniazid hydralazine D-penicillamine

Question 28

what Ab are found in Sjogren syndrome? | -symptoms

Answer 28

anti-ro/SSA anti-La/SSB dry eyes, dry mouth parotid gland enlargement incr risk non-Hodgkin lymphoma

Question 29

what is antiphospholipid syndrome | -what features

Answer 29

causes hypercoagulable state may suffer recurrent miscarriage paradocially increased PTT despite propensity toward thrombosis

Question 30

what Ab is specific for systemic sclerosis

Answer 30

anti-DNA topoisomerase (Scl-70)

Question 31

lateral epicondylitis - what muscle's tendon involved? - function of this muscle?

Answer 31

extensor carpi radialis brevis and extensor digitorium, which originate on the lateral epicondyle involved in wrist extension

Question 32

what muscles involved in forearm flexion? (3)

Answer 32

- biceps brachii - brachialis - brachioradialis

Question 33

De Quervain tenosynovitis - symptoms - cause

Answer 33

overuse of abductor pollicus longus and brevis thumb and wrist pain

Question 34

most common location for hematogenous osteomyelitis in adults?

Answer 34

vertebral body (not in long bones bc adult epiphyses have closed) in general the condition is more common in children

Question 35

hematogenosu osteomyelitis in children usually affects where? why?

Answer 35

metaphysis of long bones bc slower blood flow and capillary genestrae in this region

Question 36

best spot to give butt injection

Answer 36

superomedial quandrant

Question 37

trendelenburg gait - what is it - cause

Answer 37

hip drops when that foot is lifted off the ground due to injury to CONTRAlateral superior gluteal nerve or gluteus medius muscle

Question 38

Ehler's danlos can be caused by mutation in what? what results from this mutation, specifically?

Answer 38

procollagenase peptidase impaired cleavage of terminal propeptides in the extracellular space. the collage is soluble, does not properly crosslink

Question 39

cause of albinism

Answer 39

melanocytes don't make melanin bc absent/defective tyrosinase

Question 40

vitiligo cause

Answer 40

loss of melanocytes

Question 41

what nerve mediates cough reflex | -where is this nerve located

Answer 41

internal laryngeal nerve (of CN X) above the vocal cordsm just under piriform recess

Question 42

Meniere disease - symptoms - cause

Answer 42

vertigo, unilateral tinnitus and sensorineural hearing loss increased volume and pressure of endolymph in vestibular apparatus thought to be due to decreased endolumph absorption

Question 43

what nerve can be injured in thyroid surgery | -what happens?

Answer 43

recurrent laryngeal nerve (branch of CN X) unilateral injury -> hoarseness bilateral injury -> inspiratory stridor and resp distress due to complete vocal cord paralysis

Question 44

most common location of orbital blowout fractures

Answer 44

medial or inferior orbital walls (due to thin bone bordering the ethmoid and maxillary sinuses)

Question 45

surgery for undescended testicle involves pulling testicle out through what canal? -what forms this canal

Answer 45

through the superficial inguinal canal superficial inguinal ring is physiologic opening in external abdominal oblique (deep inguinal ring is a physiologic opening in transversalis fascia)

Question 46

gonadal artery arises from

Answer 46

abdominal aorta