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Musculoskeletal, skin, and connective tissue > Anatomy and physiology > Flashcards

Anatomy and physiology Flashcards

1
Q

Dislocation of what wrist bone leads to acute carpal tunnel syndrome?

A

Lunate

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2
Q

What wrist bone is most likely to be fractured?

A

Scaphoid

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3
Q

What wrist bone is most susceptible to necrosis due to retorgrade blood supply?

A

Scaphoid

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4
Q

What is the most common sports injury due to lateral force applied to planted leg?

A

Unhappy triad (Lateral meniscus tear is the most common knee injury)

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5
Q

What is the unhappy triad

A

ACL, MCL, and Medial meninscus tear

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6
Q

Where is a baker cyst?

A

Popliteal area

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7
Q

Lateral epicondylitis comes from over use of what motion?

A

Repetitive extension

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8
Q

Medial epicondylitis comes from over use of what motion?

A

Repetitive flexion

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9
Q

Name four causes of carpal tunnel syndrome

A

Overuse, pregnancy, hypothyroidism, RA

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10
Q

Gunyon canal syndrome

A

Ulnar nerve compression (cyclists)

Bikers race down gunyon canal

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11
Q

Mneumonic for brachial plexus roots

A 
3 Muskateers (Musculoskeletal) C5 C6 C7
Assassinated (Axillary) C5, C6
5 rats (radial) C5-T1
5 mice (median) C5-T1
and 2 unicorn (ulnar)-C8, T1
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12
Q

Mnuemonic for brachial plexus

A

Randy Travis Drinks Cold Beers

Roots, trunks, divisions, cords, branches

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13
Q

Axillary nerve damage caused by what injury?

A

Fractured surgical neck of humerus

Anterior dislocation of humerus

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14
Q

Axillary nerve damage presentation?

A

Deltoid damage–>can’t abducted arm past 15 degrees

Loss of sensation over deltoid muscle and lateral arm

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15
Q

Musculocutaneous nerve damage caused by what injury?

A

Upper trunk compression

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16
Q

Musculocutaneous nerve damage presentation?

A

Can’t flex/supinate the forearm

Sensory loss over lateral forearm

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17
Q

Median nerve damage caused by what injury?

A

Supracondylar fracture of humerus (proximal lesion)
Carpal tunnel syndrome
Wrist laceration (distal)

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18
Q

Median nerve damage presentation?

A

Loss of wrist and lateral finger flexion

Loss of sensation over thenar eminence and dorsal/palmar aspects of lateral 3.5 fingers

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19
Q

Ulnar nerve damage caused by what injury?

A

Medial epicondyle of humerus

Hook of the hamate

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20
Q

Ulnar nerve damage presentation?

A

Loss of wrist flexion
Loss of medial finger flexion
Can’t adduct or abduct fingers (interossei)

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21
Q

Erb palsy

A

Waiters tip-C5, C6
internal rotation and adduction of arm
flexion of wrist
Occurs during delivery of big baby or trauma of an adult

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22
Q

Klumpke palsy

A

C8-T1
Humpty klumpty (falls off a wall and grabs a tree branch to break his fall) or upward form on arm during delivery
total claw hand

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23
Q

Thoracic outlet syndrome

A

claw hand+ compression of subclavian vessels (can be due to pancoast tumor or cervical rib)

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24
Q

Winged scapula

A

Lesion of long thoracic nerve- C 5, 6, 7 brings the arms to heaven

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25
Q

Thenar and hypothenar eminence do what?

A

Oppose, Abduct, and Flex (OAF)

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26
Q

TIP and PED mneumonics

A

Tibial n-inverts and plantarflexes

Peroneal n-everts and dorsiflexes

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27
Q

Gene associated with achondroplasia

A

FGFR3 activation–>inhibition of chrondocyte proliferation

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28
Q

Osteopetrosis

A

Failure of normal bone resorption due to defective osteoclasts
Bone marrow transplant may be curative because osteoclasts are derived from monocysts

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29
Q

Paget disease

A

Increase in osteoblast and osteoclast activity
Normal lab values except an increase in Alk phos.
Increased risk of osteosarcoma
Mosaic, chaotic pattern of bone remodeling

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30
Q

Most common site of osteonecrosis?

A

Femoral head (due to infarction of the medial circumflex femoral artery)

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31
Q

Buzz words associated with osteosarcoma

A

Pagets disease is a precursor
Codman’s triangle
Aggressive
Bimodal age distribution

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32
Q

Buzz words associated with Ewing sarcoma

A

Young boys
Diaphysis of long bones, pelvis, scapula, ribs
Small blue cell malignant tumor
t(11:22) translocation–>EWS-FL11 fusion protein

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33
Q

Genetic HLA associated with RA?

A

HLADR4

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34
Q

Most specific antibody test for RA

A

Anti-cyclic citrullinated peptide

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35
Q

Gout is a precipitation of what into the joints?

A

Monosodium urate crystals

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36
Q

Pseudogout is a precipitation of what into the joints?

A

Calcium pyrophosphate crystals

Large joints

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37
Q

Seronegative spondyloarthropathies

A 
PAIR
Psoriatic arthritis
Ankylosing spondylitis
IBD
Reactive arthritis (Reiter syndrome)
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38
Q

Seronegative spondyloarthropathies associted with what gene? demographic? RA+?

A

HLAB27
More common in males
RA -

39
Q

Psoriatic arthritis buzz words

A

sausage fingers
pencil in cup
Asymmetric/patchy involvement

40
Q

Ankylosing spondylitis

A

Chronic inflammation of sacroiliac and spine joints “bamboo spine”
Uveitis (eye)
Aortic regurgitation

41
Q

What seronegative is associated with IBD

A

Ankylosing spondylitits or eripheral arthritis

42
Q

Reactive arthritis, aka? classic triad?

A 
Reiter syndrome (Post GI/chlamydia infections)
Can't see, can't pee, can't bend my knee
43
Q

SLE classic presentation

A

Malar rash, joint pain, fever in female reproductive age and African descent

44
Q

Heart associated dz with SLE

A

Libman-Sacks endocarditis (nonbacterial, valvular vegetations)
Asymptomatic

45
Q

Kidney associated dz with SLE

A

Lupus nephritis: Type III hypersensitivity (Decrease in C3, C4, CH50)

  • Nephritis-diffuse proliferative glomerulonephritis
  • Nephrotic-membranous glomerulonephritis
46
Q

Sensitive (not specific) antibody marker for SLE

A

ANA (antinuclear antibody)

47
Q

Specific antibody marker for SLE

A 
ds DNA (poor prognosis)
smith antibody--SnRPs (not prognostic)
48
Q

Sensitive for drug-induced lupus

A

Anti-histone antibodies

49
Q

SLE treatment

A

NSAIDs, steriods, immunosuppressants, hydroxychloroquine

50
Q

Antiphospholipid syndrome symptoms

A

History of thrombosis
Spontaneous abortion
Lupus anticoagulant, anticardiolipin, anti B2-glycoprotein antibodies
Treat with systemic anti-coagulation

51
Q

Polymyalgia rhuematica

A

Pain and stiffness in large joints such as hips, shoulders (Elevated ESR and CRP)
No muscle weakness (normal CK)
Associated with temporal cell arteritis

52
Q

Polymyositis/Dermatomyositis lab values

A

Elevated CK, +ANA, +anti-Jo1, +anti-SRP, +anti-Mi2

53
Q

Polymyositis symptoms

A

Progressive muscle weakness with endomysial inflammation and CD8+ cells. Most often shoulders

54
Q

Dermatomyositis

A

Same symptoms as polymyositis but with malar rash, gottron papules, heliotrope (periorbital rash)
Perimysial inflammation and atrophy with CD4+ T cells

55
Q

What is Myasthenia gravis associated with?

A

Thymoma and thymic hyperplasia

56
Q

What is Lambert-Eaton myasthenic syndrome associated with?

A

Small cell lung cancer

57
Q

Most common cause of death in scleroderma?

A

Pulmonary sclerosis

58
Q

What antibody is associated with diffuse scleroderma?

A

Scl-70 antibody (anti-DNA topoisomerase I)

59
Q

What antibody is associated with limited scleroderma?

A

Anti-centromere antibody

60
Q

Acanthosis

A

Epidermal hyperplasia (^Spinosum)

61
Q

Albinism

A

Normal melanocyte number, decreased melanin production
Decreased tyrosinase activity or defective tyrosine transport.
Also can be caused by a failure of neural crest cell migration during dev.

62
Q

Virtiligo

A

autoimmune destruction of melanocytes

63
Q

Psoriasis

A

Acanthosis with parakeratotic scaling

Auspitz sign-pinpoint bleeding spots

64
Q

Rosacea

A

Erythematous papules and pustules
No comedones
Associated with facial flushing

65
Q

Verrucae

A

Epidermal hyperplasia, hyperkeratosis, koilocytosis–>^N/C ratio, hyperchromatic nucleus etc.

66
Q

Erysipelas

A

Upper dermis and superficial lymphatics infection.
Typically from Staph pyogenes
Well-defined demarcation

67
Q

Necrotizing fasciitis

A

From anaerobic bacteria or staph pyogenes

68
Q

Scaled skin syndrome

A

Staphylococcal exotoxin that destroy attachments in the stratum granulosum only

69
Q

Hairy leukoplakia

A

Irregular, white plaques on tongue that can’t be scrapped off. (vs. thrush which is very scrapable)

70
Q

Pemphigus vulgaris

A

IgG reaction to desmoglein on desmosomes.

+ Nikolsky sign, net like IF pattern , oral mucosa involved

71
Q

Bullous pemphigoid

A

IgG reaction to hemidesmosomes (on BM)
Tense blisters, spare oral mucosa, linear patter on IF
-Nikolsky sign

72
Q

Dermatitis herpetiformis associated with what disease

A

Celiac disease

73
Q

Dermatitis herpetiformis pathology

A

Pruritic pupules, vesicles, and bullae.

Deposits of IgA at tips of dermal papillae

74
Q

Erythema multiforme

A

Associated with infections (Mycoplasma pneumoniae, HSV)

Many target lesions

75
Q

Steven-Johnson syndrome

A

Fever, bullae formation, necrosis, sloughing of skin and high mortality rate.
Targetoid skin lesions like erythema multiforme.
Typically with adverse drug reation can progress to toxic epidermal necrolysis (>30% body surface area)

76
Q

Acathosis nigricans

A

Associated with hyperinsulinemia and visceral malignancy

77
Q

Lichen Planus

A

Pruritic, purple, polygonal, planar, papules, plaques

Reticular white lines on mucosal surfaces

78
Q

Sunburn

A

UVB-burning
UVA-tanning/photoaging
Causes DNA mutation inducing apoptosis of keratinocytes

79
Q

Basal cell carcinoma

A

Most common type of skin cancer.
Often on upper lip.
Pink, pearly nodules with telangiectasias, rolled borders.
H/E=palisading nuclei

80
Q

Squamous cell carcinoma

A

Second most common type of skin cancer.
Lower lip, ears, hands
H/E-Keratin pearls

81
Q

Actinic keratosis

A

Scaly plaque that is a precursor to squamous cell carcinoma

82
Q

Keratoacanthoma

A

Variant of actinic keratosis that grows very rapidly 4-6 weeks and can regress over months

83
Q

Melanoma

A

S-100 marker.

Four types of melanoma often driven by activating mutation in BRAF kinase

84
Q

What do you give people with metastatic or unresectable melanoma in patients with BRAF V600E mutation?

A

Vemurafenib-BRAF kinase inhibitor

85
Q

Nerve and artery in the axilla

A

Long thoracic n., lateral thoracic artery

86
Q

Nerve and artery in the Surgical neck of humerus

A

Axillary n., posterior circumflex artery

87
Q

Nerve and artery in the Midshaft of humerus

A

Radial n., deep branchial artery

88
Q

Nerve and artery in the Distal humerus

A

Median n., Branchial artery

89
Q

Nerve and artery in the popliteal fossa

A

Tibial n., Popliteal artery

90
Q

Nerve and artery in the Poterior to medial malleolus

A

Tibial n., Posterior tibial artery

91
Q

What does NO activate in smooth muscle?

A

Guanylate cyclase

92
Q

What does gunaylate cyclase activate in smooth muscle

A

cGMP

93
Q

What affect does cGMP has on smooth muscle

A

Activates myosin-light chain phosphatase

94
Q

What affected does myosin-light chain phosphastase have on smooth muscle

A

dephosphorylates myosin–>relaxation

Musculoskeletal, skin, and connective tissue (3 decks)

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