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Musculoskeletal and Connective Tissue > Anatomy and Physiology 2 > Flashcards

Anatomy and Physiology 2 Flashcards

1
Q

IBS - 2 dz’s

A

crohns and ulcerative colitis

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2
Q

What is the classic triad of reactive arthritis

A

conjunctivitis and anterior uveitis, urethritis and arthritis

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3
Q

What are the common perpetrating infections for Reiters syndrome

A

Post GI infxn or chlamydia

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4
Q

epi of SLE

A

female between 14 and 45, mostly black

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5
Q

What are the most common symtpoms of SLE

A

fever, fatigue, weight loss, nonbacterial verruucous (Liebman-Sacks) endocarditis, hilar adenopathy, Raynauds

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6
Q

What are common features of lupus

A

wire-loop lesions in kidney with immune complex deposition, death from renal failure and infxns

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7
Q

What do lupus pts falsely test positive for syphillis

A

false positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin

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8
Q

What is the primary screening test for lupus

A

ANA - sensitive but not specific

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9
Q

What is a very specific test for lupus

A

Anti ds DNA - poor prognosis

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10
Q

What test if specific for lupus but doesn’t indicate prognosis

A

Anti Smith

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11
Q

What is the test for drug induced lupus

A

anti-histone

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12
Q

What does I’M DAMN SHARP stand for

A

immunoglobulins, malar rash, discoid rash, ANA, mucositis (oropharyngeal ulcers), neurologic disorders, serositis (pleuritis, pericarditis), hematologic disorders, arthritis, renal, photosensitivity

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13
Q

immune mediated, widespread, non-caseating granulomas - dz, affected population and elevated serum level

A

sarcoidosis, black females, ACE

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14
Q

What associations go along with sarcoidosis

A

restrictive lung disease, bilateral hilar lymphadenopathy, erythema nodosum, Bell’s palsy

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15
Q

What is contained within epithelial granulomas of pts with sarcoid

A

schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies

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16
Q

What causes hypercalcemia in pts with sarcoid

A

elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages

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17
Q

Sarcoid TX

A

steroids

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18
Q

Pain and stiffness in shoulders and hips, fever malaise and weight loss - no weakness, pts over 50, associated with HA and jaw pain

A

polymyaglia rheumatica associated with temporal (giant cell) arteritis

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19
Q

What are defining lab findings for polymyalgia rheumatica and what is the TX

A

elevated ESR and nl CK - prednisone

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20
Q

progressive symmetric proximal muscle weakness cause by CD8+ T cell induced injury to myofibers - dz, most common area of involvement and pathgnomonic histological finding

A

polymyositis - shoulders, perifasicular inflammation

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21
Q

heliotrope rash “shawl and face” rash, Gotton’s papules, “mechanic’s hands”

A

dermatomyositis

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22
Q

What are the lab findings and TX in dermatomyositis

A

inc CK, inc aldolase, and positive ANA and anti Jo-1 - steroids

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23
Q

Dermatomyositis places the pt at inc risk for what malignancy in particular

A

lung

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24
Q

What is the most common NMJ disorder, what causes it and what are common symptoms

A

Myasthenia gravis, autoAb against ACH receptors causing ptosis, diplopia, general weakness,

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25
Q

MG is associated with what neoplasm

A

thymoma

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26
Q

What causes the symptoms of MG to worsen, and what is used to diagnose

A

muslce use, nerve stim/compound muscle test

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27
Q

Administration of what kind of compound causes reversal of symptoms and what is used to distringuish under from over dosing

A

ACH esterase inhibitors, edrophonium test - improvement of sx after edro means the patient is underdosed

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28
Q

What syndrome of the NMJ is a paraneoplastic syndrome and what are the antibodies directed against

A

lamber eaton, presynaptic Ca channels, dec ACH release leading to proximal muscle weakness

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29
Q

What cancer in particular are associated with LE syndrome, what happens to symptoms with muscle use or ACH esterase inhibs

A

small cell cancer of the lung, improve with muscle use, no change with ACHE inhibs

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30
Q

excessive fibrosis and collagen deposition throughout the body, common in skin manifesting as puffy taut skin with absence of wrinkles

A

scleroderma

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31
Q

Besides the skin, what other organ systems are commonly affected by scleroderma and who is primarily affected

A

renal, pulm, CV, GI - 75% female

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32
Q

How is diffuse scleroderma characterized

A

widespread skin involvment, rapid progression, early visceral involvement

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33
Q

What antibodies is diffuse scleroderma associated with

A

Anti Scl70, anti DNA topoisomerase I antibody

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34
Q

What is CREST syndrome and what antibody is it associated with

A

calcinosis, raynauds, esophageal dysmotility, sclerodactyly, telangiectasia - anti centromere antibody

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35
Q

Flat discloration <1cm seen in tinea versicolor

A

macule

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36
Q

Macule greater than 1cm

A

patch

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37
Q

elevated skin lesion <1cm seen in acne vulgaris

A

papule

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38
Q

papule > 1cm seen psoriasis

A

plaque

39
Q

small fluid containing blister seen in chickenpox

A

vesicle

40
Q

transiet vesicle seen in hives

A

wheal

41
Q

large fluid containing blisters seen in bullous pemphigoid

A

bulla

42
Q

irregular raised lesion resulting from scar tissue hypertrophy - follows trauma to skin, common to african americans see in T. pertenue (yaws)

A

keloid

43
Q

blister containing pus

A

pustule

44
Q

dried exudates from a vesicle, bulla or pustule seen impetigo

A

crust

45
Q

inc thickness of stratum corneum seen in psoriasis

A

hyperkeratosis

46
Q

hyperkeratosis with retention of nuclei in stratum corneum seen in psoriasis

A

parakeratosis

47
Q

separation of epidermal cells

A

acantholysis

48
Q

epidermal hyperplasia (inc spinosum)

A

acanthosis

49
Q

inflammation of the skin

A

dermatitis

50
Q

Warts, soft, tan-colored, cauliflower type lesions, epidermal hyperplasia, hyperkeratosis, koilocytosis

A

verrucae

51
Q

warts on hands

A

verrucae vulgaris

52
Q

warts on genitals

A

condyloma acuminatum, caused by HPV

53
Q

common mole, benign

A

nevocellular nevus

54
Q

hives, intensely pruritic wheals that form after mast cell degranulation

A

urticaria

55
Q

freckle, normal number of melanocytes, inc melanin pigment

A

ephelis

56
Q

pruritic eruption, commonly on skin flexures, of associated with asthma, allergic rhinitis

A

atopic dermatitis, eczema

57
Q

papules and plaques with silvery scaling, especially on knees and elbows - acanthosis with parakeratotic scaling (nuclei sill in stratun corneum, nail pitting and arthritis

A

psoriasis

58
Q

what changes are seen in stratum spinosum and granulosum in psoriasis

A

inc spinosum, dec granulosum

59
Q

What is the Auspitz sign

A

in psoriasis, bleeding spots when scales are scraped off

60
Q

flat, greasy, pigmented, squamous epithelial proliferation with keratin-filled cyts (horn cysts) - looks pasted on

A

seborrheic keratosis

61
Q

Where do sebhorrheic keratosis lesions occur and in who

A

head, trunk, extremities - common benign neoplasm in older persons

62
Q

What is the sign of Leser - Trelat

A

sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions, GI or lymphoid

63
Q

normal melanocyte number with dec melanin production due to inactivity of tyrosine

A

albinism

64
Q

What development failure can results in albinism

A

NC migration

65
Q

irregular areas of complete depigmentation - condition and cause

A

vitiligo, dec number in melanocytes

66
Q

hyperpigmentation associated with pregnancy or OCP

A

melasma (chloasma)

67
Q

Very superfiicial skin infection, honey colored crusting, very contagious - condition and organisms

A

impetigo, s aureus, s pyogenes

68
Q

acute painful spreading infxn of dermis and subQ tissues - condition and orgs

A

cellulitis - s aureus, s pyogenes

69
Q

deep tissue injury, crepitus from methane and CO2 production “flesh eating bacteria” - condition and orgs

A

necrotizing fasciitis, anaerobic bacteria or S. pyogenes

70
Q

exotoxin destroys keratinocyte attachments in the stratum granulosum, fever, generalized erythematous rash with sloughing of the upper layers of the dermis - newborns and children

A

Staph scalded skin syndrome

71
Q

white painless plaques on the tongue that cannot be scraped off - dz, population, implicated virus

A

hairy leukoplakia, HIV population, EBV mediated

72
Q

potentially fatal autoimmune disorder with IgG antibody against desmosomes

A

pemphigus vulgaris

73
Q

What does IM reveal in pemphigus vulgaris

A

antibodies around cells of the epidermis in a reticular or netlike pattern

74
Q

What does acantholysis show in pemphigus vulgaris

A

intraepidermal bullae involving the skin and oral mucosa

75
Q

What is a positive Nikolsky’s sign

A

in pemphis vulgaris, separation of epidermis upon manual stroking of skin

76
Q

Autoimmune disorder with IgG antibody against hemidesmosomes - dz, IM, other findings

A

bullous pemphigoid, linear immunofluorescence, eosinphils within blisters, similar to but less severed thatn pemphigus vulgaris- spares oral mucosa, negaitve nikolsky’s sign

77
Q

pruritic papules and vesicles, deposits of IgA a the tips of dermal papillae, associated with celiac

A

dermatitis herpetiformis

78
Q

Associated with M. pneumonia, HSV, sulfa drugs, B lactams, phenytoin, cancers and autoimmune dz - skin disorder and description

A

erythema multiforme, can be macules, papules vesicles, target lesions,

79
Q

fever, bulla formation and necrosis, sloughing of skin and high mortality - syndrome and associations

A

stevens johnson syndrome - associated with adverse drug reactions, more severe version called toxic epidermal necrolysis

80
Q

pruritic, purple, polygonal papules - sawtooth infiltrate of lymphocytes at dermal-epidermal jxn, associated with hep C

A

lichen planus

81
Q

premalignant lesions caused by sun exposure, small rough, erythematous or brownish papules - cutaenous horns - name and risk of carcinoma

A

actinic keratosis, risk proportional to epithelial dysplasia

82
Q

hyperplasia of stratum spinosum, associated with hyperinsulinemia (cushings, DM) and visceral malignancy

A

acanthosis nigcricans

83
Q

inflammatory lesions of subQ fat, usually on anterior shins, associated with coccidioidomycosis, histoplasmosis, TB, leprosy, streptoccocal infxn, sarcoid

A

erythema nodosum

84
Q

herald path followed by days later christmas tree distribution - multiple papular eruptions; remits spontaneously

A

pityriasis rosea

85
Q

first few weeks of life, grows rapidly and regresses spontaneously at 5 to 8 yrs of age

A

strawberry hemangioma

86
Q

appreas in 30s to 40s, does not regress

A

cherry hemangioma

87
Q

skin cancer associatd associated with excessive exposure to sunlight and arsenic

A

squamous cell carcinoma

88
Q

What is a precursor to squamous cell carcinoma

A

actinic keratosis

89
Q

where does squamous cell carcinoma of the skin typically appear, what is the histo, prognosis, and associations

A

hands and face, ulcerative red lesion, locally invasive bur rare metastasis, associated with chronic draining sinuses and keratin pearls

90
Q

What variant of squamous cells carcinoma of the skin grows rapidly and regresses spontaneously

A

keratoacanthoma

91
Q

locally invasive but rarely mets skin cancer, rolled edges, with central ulceration - cancer and gross path

A

basal cell carcinoma, pearly papules, commonly with telangiectasias

92
Q

What kind of nuclei do basal cell tumors have

A

palisading

93
Q

What is the tumor marker for melanoma, who is at risk, what correlates with risk of metastasis and what is the gross path

A

S100, associated with sunligh exposure, fair skinned at risk, depth of tumor correlates with risk of mets, dark with irregular borders

94
Q

What is the precursor to melanom

A

dysplastic nevus

Musculoskeletal and Connective Tissue (4 decks)

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