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Step 1 MSK, Skin, and Connective Tissue-First Aid 2017 > Anatomy and Physiology > Flashcards

Anatomy and Physiology Flashcards

1
Q

Extends from lateral femoral condyle to anterior tibia

A

ACL

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2
Q

Incomplete fracture extending partway through width of bone

A

Greenstick fracture

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3
Q

Common injury in contact sports from lateral force applied to a planted leg

A

“Unhappy triad”

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4
Q

“Unhappy triad” consists of injury to what structures

A

ACL, MCL, and medial meniscus

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5
Q

Which meniscus in the knee is more commonly injured in “Unhappy triad”

A

Lateral meniscus

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6
Q

Extends from medial femoral condyle to posterior tibia

A

PCL

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7
Q

Rotator cuff muscles

A

Supraspinatus, Infraspinatus, Teres minor, Subscapularis

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8
Q

Innervation for supraspinatus muscle

A

Suprascapular nerve

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9
Q

Most common rotator cuff injury

A

Supraspinatus muscle

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10
Q

How is supraspinatus injury assessed

A

Empty/full can test

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11
Q

Action of supraspinatus

A

Abduction of arm to 15 degrees

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12
Q

Innervation for infraspinatus

A

Suprascapular nerve

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13
Q

Muscle commonly injured in pitching injury

A

Infraspinatus

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14
Q

Action of infraspinatus

A

Laterally rotates arm

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15
Q

Innervation to teres minor

A

Axillary nerve

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16
Q

Action of teres minor

A

Adducts and laterally rotates arm

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17
Q

Innervation of subscapularis

A

Upper and lower subscapular nerve

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18
Q

Action of subscapularis

A

Medially rotates and adducts arm

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19
Q

Muscle that abducts arm from 15 to 100 degrees

A

Deltoid

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20
Q

Innervation to deltoid

A

Axillary nerve

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21
Q

Abducts arm to more than 90 degrees

A

Trapezius

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22
Q

Innervation to trapezius

A

Accessory nerve

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23
Q

Abducts arm to more than 100 degrees

A

Serratus anterior

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24
Q

Innervation to serratus anterior

A

Long thoracic nerve

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25
Q

Repetitive flexion of elbow causes what injury

A

Golfer’s elbow

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26
Q

Golfer’s elbow is what injury

A

Medial epicondylitis

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27
Q

Repetitive extension of elbow causes what injury

A

Tennis elbow

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28
Q

Tennis elbow is what injury

A

Lateral epicondylitis

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29
Q

What is the most commonly fractured carpal bone

A

Scaphoid

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30
Q

Complications of scaphoid fracture

A

Avascular necrosis and nonunion

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31
Q

Mechanism of avascular necrosis and nonunion in scaphoid fractures

A

Retrograde blood supply

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32
Q

Dislocation of what wrist bone may cause acute carpal tunnel syndrome

A

Lunate

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33
Q

90 degree flexion of wrist causing tingling

A

Phalen maneuver

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34
Q

Percussion to wrist causing tingling

A

Tinel sign

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35
Q

Classically seen in cyclist due to pressure from handlebars

A

Guyon canal syndrome

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36
Q

Guyon canal syndrome

A

Compression of ulnar nerve at wrist or hand

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37
Q

Entrapment of median nerve causing paresthesia, pain, and numbness in distribution of median nerve

A

Carpal tunnel syndrome

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38
Q

Axillary nerve spinal levels

A

C5-C6

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39
Q

Musculocutaneous nerve spinal levels

A

C5-C7

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40
Q

Radial nerve spinal levels

A

C5-T1

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41
Q

Median nerve spinal levels

A

C5-T1

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42
Q

Ulnar nerve spinal levels

A

C8-T1

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43
Q

Recurrent branch of median nerve spinal levels

A

C5-T1

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44
Q

Nerve commonly injured in anterior dislocation of humerus

A

Axillary nerve

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45
Q

Nerve commonly injured in upper trunk compression

A

Musculocutaneous nerve

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46
Q

Nerve commonly injured in carpal tunnel syndrome and wrist laceration

A

Median nerve

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47
Q

Nerve commonly injured in fracture of surgical neck of humerus

A

Axillary nerve

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48
Q

Nerve commonly injured in supracondylar fracture of humerus

A

Medial nerve

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49
Q

Nerve commonly injured in midshaft fracture of humerus

A

Radial nerve

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50
Q

Nerve commonly injured in fracture of medial epicondyle of humerus

A

Ulnar nerve

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51
Q

Nerve commonly injured in superficial laceration of palm

A

Recurrent branch of the median nerve

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52
Q

Nerve commonly injured in fracture of hamate from fall on outstretched hand

A

Ulnar nerve

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53
Q

Bone fractured from fall on outstretched hand commonly injuring ulnar nerve

A

Hook of hamate

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54
Q

Ape hand and Pope’s blessing are common presentations of what nerve injury

A

Median nerve

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55
Q

Flattened deltoid with loss of sensation over deltoid muscle and lateral arm indicates injury to what nerve

A

Axillary nerve

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56
Q

Loss of elbow, wrist and finger extension indicates injury to what nerve

A

Radial nerve

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57
Q

Loss of sensation over posterior arm/forearm and dorsal hand indicates injury to what nerve

A

Radial nerve

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58
Q

Loss of wrist flexion, flexion of lateral fingers, and thumb opposition indicates injury to what nerve

A

Median nerve

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59
Q

Loss of opposition, abduction and flexion of thumb with no loss of sensation indicates injury to what nerve

A

Recurrent branch of the median nerve

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60
Q

Nerve commonly injured due to crutches or sleeping with arm over chair

A

Radial nerve

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61
Q

Loss of wrist flexion, flexion of medial fingers, abduction and adduction of fingers with loss of sensation over medial 1-1/2 fingers indicates injury to what nerve

A

Ulnar nerve

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62
Q

Loss of sensation over Thenar eminence and dorsal and palmer aspects of lateral 3-1/2 fingers with proximal lesion indicates injury to what nerve

A

Median nerve

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63
Q

Loss of flexion to lumbricals of 2nd and 3rd digits

A

Median nerve

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64
Q

Saturday night palsy is injury to what nerve

A

Radial nerve

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65
Q

Loss of action to medial 2 lumbricals indicates injury to what nerve

A

Ulnar nerve

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66
Q

Lateral traction on neck during delivery causing adduction, medial rotation, extension and pronation of arm may injure to what part of the brachial plexus

A

Upper trunk

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67
Q

Nerve roots in upper trunk of brachial plexus

A

C5-C6

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68
Q

Upward force on arm during delivery may injure what part of the brachial plexus

A

Lower trunk

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69
Q

Nerve roots in lower trunk of brachial plexus

A

C8-T1

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70
Q

Erb palsy or “waiter’s tip” is injury to what part of the brachial plexus

A

Upper trunk

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71
Q

Muscles affected with injury to upper trunk of brachial plexus

A

Deltoid, supraspinatus, infraspinatus, biceps brachii

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72
Q

Klumpke palsy is injury to what part of the brachial plexus

A

Lower trunk

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73
Q

Nerve roots in lower trunk of brachial plexus

A

C8-T1

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74
Q

Compression of lower trunk and subclavian vessels causes which syndrome

A

Thoracic outlet syndrome

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75
Q

Axillary node dissection after mastectomy or stab wounds can injure what nerve

A

Long thoracic nerve

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76
Q

Grabbing a tree branch to break a fall can damage what part of the brachial plexus

A

Lower trunk

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77
Q

Functional deficits seen in winged scapula

A

Inability to anchor scapula to thoracic cage leading to inability to abduct arm above horizontal plane

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78
Q

Inability to abduct arm above the horizontal is injury to what nerve and muscle

A

Long thoracic nerve and serratus anterior

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79
Q

Atrophy of intrinsic hand muscles, ischemia, pain and edema due to vascular compression is seen in what syndrome

A

Thoracic compression syndrome

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80
Q

Mechanism of thoracic compression syndrome

A

Compression of lower trunk and subclavian vessels

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81
Q

Conditions that commonly cause thoracic compression syndrome

A

Pancoast tumors and cervical rib

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82
Q

Most common shoulder dislocation

A

Anterior dislocation

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83
Q

Blood vessel most commonly injured in anterior shoulder dislocation

A

Posterior circumflex artery

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84
Q

Function of lumbricals

A

Flexion of MCP, extension of PIP and DIP joints

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85
Q

Ulnar claw is seen with what nerve injury

A

Distal ulnar nerve injury

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86
Q

Pope’s blessing is seen with what nerve injury

A

Proximal median nerve injury

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87
Q

What is the deficit in distal ulnar nerve injury

A

Cannot extend 4th and 5th fingers

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88
Q

What is the deficit in proximal median nerve injury

A

Cannot flex 1st, 2nd, and 3rd fingers

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89
Q

Median claw is seen in what nerve injury

A

Distal median nerve injury

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90
Q

OK gesture is seen in what nerve injury

A

Proximal ulnar nerve injury

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91
Q

What is the deficit in distal nerve injury

A

Cannot extend 1st, 2nd, and 3rd fingers

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92
Q

What is the deficit in proximal ulnar nerve injury

A

Cannot flex 4th and 5th digits

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93
Q

Hand cannot do what in proximal median and ulnar nerve injuries

A

Flex fingers (make a fist)

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94
Q

Hand cannot do what in distal median and ulnar nerve injuries

A

Extend fingers (open hand)

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95
Q

Which Thenar muscle receives dual innervation

A

Flexor pollicis brevis

  1. superficial head - median nerve
  2. deep head - ulnar nerve
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96
Q

What are the Thenar muscles

A

Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis

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97
Q

What nerve mainly innervates the Thenar muscles

A

Median nerve

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98
Q

What nerve mainly innervates the Hypothenar muscles

A

Ulnar nerve

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99
Q

What are the Hypothenar muscles

A

Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi

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100
Q

Function of palmar interossei muscles

A

Adduct muscles (PAD)

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101
Q

Function of dorsal interossei muscles

A

Abduct muscles (DAB)

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102
Q

Nerve for sensory to sole of foot

A

Tibial

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103
Q

Nerves roots to tibial nerve

A

L4-S3

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104
Q

Nerve for motor to triceps surae, plantaris, popliteus, and flexor muscles of foot

A

Tibial

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105
Q

Function of Tibial nerve

A

Invert and Plantarflex foot (TIP)

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106
Q

Inability to flex toes with loss of sensation on sole of foot indicates injury to what nerve

A

Tibial nerve

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107
Q

Loss of sensation to dorsum of foot indicates injury to what nerve

A

Common peroneal nerve

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108
Q

Nerve roots to common peroneal nerve

A

L4-S2

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109
Q

Foot eversion at rest with loss of inversion and plantarflexion indicates injury to what nerve

A

Tibial nerve (L4-S3)

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110
Q

Function of Peroneal nerve

A

Evert and Dorsiflex foot (PED)

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111
Q

Inability to stand on tippy toes indicates injury to what nerve roots

A

L4-S3

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112
Q

Foot drop indicates injury to what nerve roots

A

L4-S2

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113
Q

Nerve for motor to biceps femoris, tibialis anterior, and extensor muscles of foot

A

Peroneal nerve

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114
Q

Inversion and plantarflexion at rest with foot drop while walking indicates injury to what nerve

A

Peroneal nerve (L4-S2)

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115
Q

Nerve for sensory to suprapubic region

A

Iliohypogastric

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116
Q

Nerve roots to Iliohypogastric nerve

A

T12-L1

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117
Q

Abdominal surgery can result in damage to what nerve

A

Iliohypogastric

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118
Q

Knee trauma or Baker cyst can result in damage to what nerve

A

Tibial nerve

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119
Q

Knee trauma or Baker cyst presents with what deficits

A

Foot eversion at rest with loss of plantarflexion

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120
Q

What does the sciatic nerve split into

A

Common peroneal and tibial nerves

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121
Q

Nerve roots to sciatic nerve

A

L4-S3

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122
Q

Sensory to posterior thigh

A

Sciatic nerve (L4-S3)

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123
Q

Common cause of sciatic nerve injury

A

Herniated disc

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124
Q

Common cause of common peroneal nerve injury

A

Trauma or compression of lateral aspect of leg

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125
Q

Fibular neck fracture damages what nerve

A

Common peroneal nerve

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126
Q

Nerve for motor to semitendinosus, semimembranosus, biceps femoris, and adductor magnus

A

Sciatic nerve

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127
Q

Burning or tingling sensation in surgical incision site radiating to inguinal and suprapubic region indicate injury to what nerve

A

Iliohypogastric (T12-L1)

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128
Q

Nerve commonly injured in laparoscopic surgery

A

Genitofemoral nerve

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129
Q

Findings in genitofemoral nerve damage

A

Decreased anterior thigh sensation below inguinal ligament and absent cremasteric reflex

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130
Q

Nerve commonly damaged with tight clothing and obesity

A

Lateral femoral cutaneous nerve

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131
Q

Nerve roots to genitofemoral nerve

A

L1-L2

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132
Q

Nerve for sensory to anterior thigh and medial leg

A

Femoral nerve

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133
Q

Nerve roots to femoral nerve

A

L2-L4

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134
Q

Common cause of injury to obturator nerve

A

Pelvic surgery

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135
Q

Decreased medial thigh sensation and adduction indicates injury to what nerve

A

Obturator nerve

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136
Q

Nerve roots to obturator nerve

A

L2-S4

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137
Q

Decreased anterior and lateral thigh sensation indicates injury to what nerve

A

Lateral femoral cutaneous nerve

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138
Q

Nerve roots to lateral femoral cutaneous nerve

A

L2-L3

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139
Q

Nerve for motor to adductor longus and brevis, gracilis, pectinus and adductor magnus

A

Obturator nerve

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140
Q

Nerve commonly injured in pelvic fracture

A

Femoral nerve

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141
Q

Nerve for motor to quadriceps, iliopsoas, pectinus and sartorius

A

Femoral nerve

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142
Q

Findings in femoral nerve injury

A

Decreased thigh flexion and leg extension

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143
Q

Nerve for motor to gluteus maximus

A

Inferior gluteal

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144
Q

Nerve roots to inferior gluteal

A

L5-S2

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145
Q

Nerve for motor to gluteus medius, gluteus minimis and tensor fascia latae

A

Superior gluteal

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146
Q

Nerve roots to superior gluteal

A

L4-S1

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147
Q

Nerve commonly injured in posterior hip dislocation

A

Inferior gluteal nerve

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148
Q

Nerve commonly injured in stretch injury during childbirth

A

Pudendal nerve

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149
Q

Side lesion is located in Trendelenburg sign/gait

A

Contralateral to the side of dropped hip

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150
Q

Most common cause of superior gluteal nerve injury

A

Iatrogenic during IM injection to upper medial gluteal region

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151
Q

IM injections should be given in what gluteal region to avoid injuring superior gluteal nerve

A

Superolateral quadrant

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152
Q

Difficulty climbing stairs, rising from seated position or loss of hip extension indicate injury to what nerve

A

Inferior gluteal nerve

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153
Q

Nerve for motor to external urethral and anal sphincters

A

Pudendal nerve

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154
Q

Muscles that abduct hip

A

Gluteus medius, gluteus minimis

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155
Q

Nerve for sensory to perineum

A

Pudendal nerve

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156
Q

Muscles that adduct hip

A

Adductor magnus, longus, and brevis

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157
Q

Muscles that extend hip

A

Gluteus maximus, semitendinosus, semimembranosus

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158
Q

Fecal or urinary incontinence with decreased sensation to perineum indicate injury to what nerve

A

Pudendal nerve

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159
Q

Nerve roots to pudendal nerve

A

S2-S4

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160
Q

Muscles that flex hip

A

Iliopsoas, rectus femoris, tensor fascia latae, pectineus

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161
Q

Muscles that internally rotate hip

A

Gluteus medius, gluteus minimis, tensor fascia latae

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162
Q

Muscles that externally rotate hip

A

Iliopsoas, gluteus maximus, piriformis, obturator

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163
Q

Function of gluteus medius

A

Abduct and internally rotate hip

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164
Q

Function of gluteus minimis

A

Abduct and internally rotate hip

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165
Q

Function of gluteus maximus

A

Extend and externally rotate hip

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166
Q

Function of semitendinosus

A

Extend hip

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167
Q

Function of semimembranosus

A

Extend hip

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168
Q

Function of iliopsoas muscle

A

Flex and externally rotate hip

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169
Q

Function or rectus femoris

A

Flex hip

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170
Q

Function of tensor fascia latae

A

Flex and internally rotate hip

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171
Q

Function of pectineus

A

Flex hip

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172
Q

Function of piriformis

A

Externally rotate hip

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173
Q

Function of obturator muscle

A

Externally rotate hip

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174
Q

Intervertebral disc generally herniate in which direction

A

Posterolaterally

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175
Q

In an L3/L4 disc herniation which nerve is usually affected

A

L4 (inferior nerve)

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176
Q

Disc level damaged in weakness of plantar flexion, difficulty in toe-walking with decreased Achilles reflex

A

L5-S1

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177
Q

Disc level damaged in weakness of knee extension with decreased patellar reflex

A

L3-L4

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178
Q

Disc level damaged in weakness of dorsiflexion with difficulty in heel-walking

A

L4-L5

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179
Q

Artery commonly damaged with long thoracic nerve

A

Lateral thoracic artery

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180
Q

Artery and nerve commonly damaged in surgical neck of humerus fractures

A

Axillary nerve and Posterior circumflex artery

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181
Q

Artery and nerve commonly damaged in midshaft humerus fractures

A

Radial nerve and deep brachial artery

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182
Q

Artery and nerve commonly damaged in distal humerus or cubital fossa trauma

A

Median nerve and Brachial artery

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183
Q

Artery and nerve commonly damaged in popliteal trauma

A

Tibial nerve and Popliteal artery

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184
Q

Artery and nerve commonly damaged in posterior to medal malleolus trauma

A

Tibial nerve and Posterior tibial artery

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185
Q

Triad of 1 T-tubule + 2 terminal cisternae is in what type of muscle

A

Skeletal

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186
Q

Action potential depolarization opens what type of channels allowing NT release

A

Presynaptic voltage-gated Calcium channels

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187
Q

What leads to muscle cell depolarization in the motor end plate

A

Postsynaptic ligand binding

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188
Q

Depolarization travels along the muscle down what structure

A

T-tubule

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189
Q

Dyad of 1 T-tubule + 1 terminal cisterna is found in what type of muscle

A

Cardiac

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190
Q

The dihydropyridine receptor is coupled to what, allowing release of calcium from sarcoplasmic reticulum

A

Ryanodine receptor

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191
Q

How are the dihydropyridine and ryanodine receptor coupled?

A

Mechanically coupled

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192
Q

What does binding of calcium to troponin cause in myocytes

A

Moves tropomyosin exposing myosin-binding groove on actin filaments

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193
Q

Myosin releasing ADP and Pi leading to displacement of myosin on the actin filament is what?

A

Power stroke

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194
Q

Which band in muscle contraction remains the same

A

A-band

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195
Q

What bands in muscle contraction shrink

A

H, I, Z bands

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196
Q

Sarcomere extends from which two bands

A

I-band to I-band

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197
Q

The center of the sarcomere is what band

A

M-line

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198
Q

The thick filaments are composed of what protein

A

Myosin

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199
Q

Thin filaments are composed of what protein

A

Actin

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200
Q

What causes detachment of myosin head from actin filament

A

Binding of a new ATP molecule

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201
Q

Hydrolysis of bound ATP causes myosin head to adopt which position

A

High-energy position (cocked)

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202
Q

What gives type 1 muscle fibers its red color

A

Increased mitochondria and myoglobin concentrations

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203
Q

Which muscle fibers increase in proportion after weight, resistance training, or sprinting

A

Type 2 (fast twitch) muscle fibers

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204
Q

What gives type 2 muscle fibers their color

A

Decreased mitochondria and myoglobin concentrations

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205
Q

Fast twitch muscle fibers use energy through what process

A

Anaerobic glycolysis

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206
Q

What muscle fibers increase in proportion after endurance training

A

Type 1 (slow twitch)

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207
Q

Slow twitch muscle fibers use energy through what process

A

Oxidative phosphorylation

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208
Q

In smooth muscle, membrane depolarization opens what channels

A

L-type voltage-gated Calcium channels

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209
Q

What does calcium bind to in smooth muscle

A

Calmodulin

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210
Q

What does calcium-calmodulin complex activate

A

Myosin-light-chain kinase (MLCK)

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211
Q

What is the function of MLCK

A

Phosphorylate myosin-light-chain for muscle contraction

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212
Q

How is muscle contraction stopped in smooth muscle

A

Dephosphorylation of myosin-light-chain by myosin-light-chain phosphatase (MLCP)

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213
Q

Increase in NO in smooth muscle leads to what?

A

Increase in cGMP activating MLCP causing smooth muscle relaxation

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214
Q

Type of bone formation in bones of axial skeleton, appendicular skeleton and base of skull

A

Endochondral ossification

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215
Q

What is required for endochondral ossification to occur

A

Cartilage bone model made by chondrocytes

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216
Q

Type of bone formed directly without cartilage

A

Membranous bone

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217
Q

What does the cartilage bone model on endochondral ossification get converted to next

A

Into woven bone and then lamellar bone by osteoblasts and osteoclasts

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218
Q

A person with achondroplasia has a defect in what type of bone formation

A

Endochondral ossification

219
Q

Type of bone that occurs after fractures and in Paget disease

A

Woven bone

220
Q

What type of environment is required for osteoblast to function

A

Alkaline environment

221
Q

Function of osteoblast

A

Build bone by secreting collagen and catalyzing mineralization

222
Q

What activates osteoblasts

A

Increased ALP and alkaline environment

223
Q

How are osteoclast made

A

From mesenchymal stem cells in periosteum

224
Q

Function of osteoclast

A

Dissolve bone by secreting H+ and collagenases

225
Q

How are osteoclasts made

A

From fusion of monocyte/macrophage lineage precursors

226
Q

What type of environment is required for osteoclasts to function

A

Acidic environment

227
Q

At what levels does PTH exert anabolic effects

A

Low, intermittent levels

228
Q

What condition do chronically increased PTH levels cause

A

Osteitis fibrosa cystica

229
Q

What PTH levels cause catabolic effects on bone

A

Chronically high PTH levels

230
Q

What effect do low estrogen levels have on bone

A

Osteoporosis

231
Q

What does estrogen cause during puberty

A

Closure of epiphyseal plate

232
Q

What inhibits apoptosis in osteoblasts and induces apoptosis in osteoclasts

A

Estrogen

233
Q

Failure of longitudinal bone growth and membranous ossification leading to short limbs and large head

A

Achondroplasia

234
Q

Constitutive activation of what inhibits chondrocyte proliferation

A

Fibroblast growth factor receptor 3 (FGFR3)

235
Q

What is the inheritance pattern of achondroplasia

A

Autosomal dominant with full penetrance

236
Q

What is the most common cause of dwarfism

A

Achondroplasia

237
Q

Screening for osteoporosis is recommended at what age

A

> 65 years

238
Q

What T-score value indicates osteoporosis

A

T-score of less than or equal to 2.5 or fragility fracture of hip or vertebra

239
Q

Medical conditions that may cause osteoporosis

A

Hyperparathyroidism, hyperthyroidism, multiple myeloma or malabsorption syndromes

240
Q

Drugs that may cause osteoporosis

A

Steroids, alcohol, anticonvulsants, anticoagulants, thyroid replacement therapy

241
Q

Most common cause of osteoporosis

A

Decreased estrogen levels

242
Q

Lab values associated with osteoporosis

A

Normal serum calcium and phosphate

243
Q

What part of bone loss is seen in osteoporosis

A

Trabecular (spongy) and cortical bone lose mass and interconnections

244
Q

Treatment for osteoporosis

A

Bisphosphonates, Teriparatide, SERMS, denosumab

245
Q

Monoclonal antibody used in osteoporosis

A

Denosumab

246
Q

Mechanism of action of bisphosphonates like alendronate

A

Inhibit osteoclast bone resorption

247
Q

Prophylactic to prevent osteoporosis

A

Weight-bearing exercise, adequate calcium and vitamin D intake

248
Q

Risk factors associated with osteoporosis

A

Female, increased age, smoking and glucocorticoid use

249
Q

Failure of normal bone resorption due to defective osteoclasts causing thickened, dense bones prone to fractures

A

Osteopetrosis

250
Q

Complications of osteopetrosis

A

Pancytopenia and extramedullary hematopoiesis

251
Q

Treatment for osteopetrosis

A

Bone marrow transplant (curative)

252
Q

What do defective osteoclasts in osteopetrosis cause

A

Overgrowth and sclerosis of cortical bone

253
Q

Cause of pancytopenia in osteopetrosis

A

Bone fills marrow space

254
Q

Neurological complications of osteopetrosis

A

Cranial nerve impingement and palsies

255
Q

Cause of cranial nerve impingement and palsies in osteopetrosis

A

Narrowed foramina

256
Q

Enzyme defective in osteopetrosis

A

Carbonic anhydrase II

257
Q

How are osteoclasts impaired in osteopetrosis

A

Cannot generate acidic environment necessary for bone resorption

258
Q

Vitamin D deficiency in adults causes what disease

A

Osteomalacia

259
Q

Vitamin D deficiency in children causes what disease

A

Rickets

260
Q

Defective mineralization of osteoid or cartilaginous growth plates

A

Osteomalacia - kids

Rickets - adults

261
Q

Common lab findings in osteomalacia/rickets

A

Low vitamin D, calcium, and phosphorus

High PTH and ALP

262
Q

Common findings in osteomalacia

A

Osteopenia and pseudofractures

263
Q

Epiphyseal widening, metaphyseal cupping/fraying, genu varum, bead-like costochondral junctions, and craniotabes

A

Common findings in rickets

264
Q

Cells involved in lytic stage of Paget disease

A

Osteoclasts

265
Q

Lab findings in Paget disease

A

High ALP

Normal serum calcium, phosphorus, and PTH levels

266
Q

Treatment for Paget disease of bone

A

Bisphosphonates (-dronates)

267
Q

Paget disease increases risk of what complication

A

Osteogenic sarcoma

268
Q

Mosaic pattern of woven and lamellar bone with long chalk-stick fractures is seen in what disease

A

Paget disease of the bone

269
Q

Cells involved in Quiescent stage of Paget disease

A

Minimal osteoclast/osteoblast activity

270
Q

Cells involved in Sclerotic state of Paget disease

A

Osteoblasts

271
Q

Cells involved in Mixed stage of Paget disease

A

Osteoblasts + Osteoclasts

272
Q

Cardiovascular complication in Paget disease

A

High-output heart failure from increased blood flow from increased AV shunts

273
Q

Most common site of osteonecrosis

A

Femoral head

274
Q

Cause of avascular necrosis to femoral head

A

Insufficiency of medial circumflex femoral artery

275
Q

Caisson or decompression sickness is a risk factor for what

A

Avascular necrosis

276
Q

Lab values in osteopetrosis

A

High serum calcium

Normal phosphorous, ALP, PTH

277
Q

Brown tumors due to fibrous replacement of bone, subperiosteal thinning indicate what disease

A

Osteitis fibrosa cystica

278
Q

Lab values in primary hyperparathyroidism

A

High serum calcium, ALP, PTH

Low phosphorus

279
Q

Lab values in secondary hyperparathyroidism

A

Low serum calcium

High phosphorus, ALP, PTH

280
Q

Common cause of primary hyperparathyroidism

A

Idiopathic, parathyroid hyperplasia, adenoma, carcinoma

281
Q

Common cause of secondary hyperparathyroidism

A

CKD (low phosphorus excretion and production of activated vitamin D)

282
Q

Lab values in hypervitaminosis D

A

High calcium, phosphorus

Low PTH

283
Q

Most common benign bone tumor

A

Osteochondroma

284
Q

Bony exostosis with cartilaginous cap on metaphysis of long bone in young male < 25 years

A

Osteochondroma

285
Q

Locally aggressive benign bone tumor with soap bubble appearance on x-ray

A

Giant cell tumor

286
Q

Common location of giant cell tumor

A

Epiphysis of long bones (near knee)

287
Q

Bone tumor that arises mostly at distal femur and proximal tibia that has cells expressing RANKL

A

Giant cell tumor

288
Q

One of the most common malignant bone tumors

A

Osteosarcoma

289
Q

Common location of osteosarcoma

A

Metaphysis of long bones near knee

290
Q

Treatment for osteosarcoma

A

Surgical en bloc resection and chemotherapy

291
Q

Bone tumor with bimodal distribution and Codman triangle or sunburst pattern on x-ray

A

Osteosarcoma

292
Q

Bone tumor common in boys < 15 years that appears in diaphysis of long bones with anaplastic small blue cells on biopsy

A

Ewing sarcoma

293
Q

Translocation associated with Ewing sarcoma

A

t(11;22) causing fusion protein EWS-FLI-1

294
Q

Bone tumor with onion skin periosteal bone reaction that is extremely aggressive with early metastases, but responsive to chemotherapy

A

Ewing sarcoma

295
Q

Bone tumor derived from neuroectoderm and onion skin appearance on diaphysis of long bone

A

Ewing sarcoma

296
Q

Benign cartilage tumor of small bones of hands and feet

A

Chondroma

297
Q

Malignant cartilage tumor in pelvis or central skeleton

A

Chondrosarcoma

298
Q

Common cause of osteoarthritis

A

Mechanical wear and tear of articular cartilage

299
Q

Cells that mediate degradation and inadequate repair in osteoarthritis

A

Chondrocytes

300
Q

Treatment for osteoarthritis

A

Acetaminophen, NSAID, intra-articular glucocorticoids

301
Q

Joint disease that presents with pain, swelling, and morning stiffness lasting > 1 hour, improving with use

A

Rheumatoid arthritis (RA)

302
Q

Common cause of RA

A

Pannus formation which erodes articular cartilage and bone

303
Q

Risk factors for RA

A

Female, HLA-DR4, smoking, silica exposure

304
Q

Treatment for RA

A

NSAIDs, glucocorticoids, disease modifying agents, biologic agents

305
Q

Biologic agents used for treatment of RA

A

TNF-alpha inhibitors

306
Q

Disease modifying agents used for treatment of RA

A

Methotrexate, sulfasalazine, hydroxychloroquine, leflunomide

307
Q

RA involves which joints of the hand

A

MCP, PIP and wrist

308
Q

Joint findings in osteoarthritis (OA)

A

Osteophytes, joint space narrowing, subchondral sclerosis, and cysts

309
Q

Joint disease that presents with pain in weight-bearing joints after use and improving with rest

A

OA

310
Q

Joint disease that presents with symmetric joint involvement, systemic symptoms and extra-articular manifestation

A

RA

311
Q

Synovial fluid findings in RA

A

Inflammatory with neutrophils and protein

312
Q

Cervical subluxation, ulnar finger deviation, swan neck, and boutonniere are common findings in which joint disease

A

RA

313
Q

Joint disease that presents knee cartilage loss beginning medially, asymmetric joint involvement with no systemic symptoms

A

OA

314
Q

Synovial fluid findings in OA

A

Non-inflammatory with WBC count < 2000

315
Q

Wrist joints affected in OA

A

DIP, PIP, 1st CMC

316
Q

What is positive rheumatoid factor

A

IgM antibody that targets IgG Fc region

317
Q

What test is more specific for RA

A

Anti-citrullinated peptide antibody

318
Q

Monosodium crystals causing acute inflammatory monoarthritis

A

Gout

319
Q

Medications that exacerbate uric acid

A

Thiazide diuretics

320
Q

Lab findings in gout

A

Needle-shaped crystals, appear yellow under parallel light and blue under perpendicular light

321
Q

Acute treatment for gout

A

NSAIDs, glucocorticoids, colchicine

322
Q

Chronic treatment for gout

A

Xanthine oxidase inhibitors

323
Q

Xanthine oxidase inhibitors

A

Allopurinol, febuxostate

324
Q

Conditions associated with gout

A

Lesch-Nyhan syndrome, von Gierke disease, PRPP excess, tumor lysis syndrome

325
Q

Condition with rhomboid, weakly positive birefringent under polarized light crystals

A

Calcium pyrophosphate deposition disease

326
Q

Acute treatment for Calcium pyrophosphate deposition disease

A

NSAIDs, colchicine, glucocorticoids

327
Q

Prophylaxis for Calcium pyrophosphate deposition disease

A

Colchicine

328
Q

Autoimmune destruction characterized by destruction of exocrine glands by lymphocytic infiltrate

A

Sjogren’s syndrome

329
Q

Complications associated with Sjogren’s syndrome

A

Dental caries, MALT lymphoma, parotid enlargement

330
Q

Confirmation of Sjogren’s syndrome

A

Labial salivary gland biopsy

331
Q

Antiribonucleotide antibodies associated with Sjogren’s syndrome

A

Anti-Ro and Anti-La

332
Q

Inflammatory joint pain with decreased tear production and presence of antinuclear antibodies (ANA) indicates what disease

A

Sjogren’s syndrome

333
Q

Common causes of septic arthritis

A

S. aureus, Streptococcus and N gonorrhoeae

334
Q

Synovial fluid findings in septic arthritis

A

Purulent synovial fluid with WBC count > 50,000

335
Q

Triad of polyarthralgia, tenosynovitis, and dermatitis indicate what?

A

Gonococcal arthritis

336
Q

Cause of septic arthritis in older adults and children

A

Staph aureus

337
Q

Cause of septic arthritis in sexually young adults

A

N. gonorrhoeae

338
Q

Treatment for gonococcal arthritis

A

Ceftriaxone plus azithromycin for possible chlamydial infection

339
Q

Xerostomia

A

Decreased salivary production seen in Sjogren’s syndrome

340
Q

Disease more common in males with bamboo spine on x-ray with involvement of sacroiliac joints

A

Ankylosing spondylitis

341
Q

HLA molecule is associated with seronegative spondyloarthritis

A

HLA-B27

342
Q

Disease characterized by conjunctivitis, urethritis, and arthritis

A

Reactive arthritis

343
Q

Common causes of reactive arthritis

A

Shigella, Yersinia, Chlamydia, Campylobacter, Salmonella

344
Q

HLA-B27 associated seronegative spondyloarthritis that presents with uveitis, aortic regurgitation and ankylosis

A

Ankylosing spondylitis

345
Q

Associated with asymmetric and patchy skin psoriasis and lesions with “pencil-in-cup” deformity on x-ray

A

Psoriatic arthritis

346
Q

Respiratory complication of ankylosing spondylitis

A

Restrictive lung disease

347
Q

Diseases characterized by morning stiffness that improves with exercise, strong association with HLA-B27 and presents with dactylitis and uveitis

A

Seronegative spondyloarthritis

348
Q

Common cause of death in SLE

A

Cardiovascular disease, renal disease, infections

349
Q

SLE antibody that is specific with poor prognosis

A

Anti-dsDNA antibody

350
Q

Antibodies sensitive for drug-induced SLE

A

Anti-histone antibodies

351
Q

Complement that is deficient in Lupus nephritis

A

C3, C4

352
Q

Glomerular deposits seen on EM in lupus nephritis

A

Subendothelial with IgG and sometimes C3

353
Q

Light microscopy findings in lupus nephritis

A

Wire-looping of glomerular capillaries

354
Q

Immunofluorescent findings in lupus nephritis

A

Granular appearance

355
Q

Antibodies that are sensitive but not specific for SLE

A

Antinuclear antibodies (ANA)

356
Q

Treatment for SLE

A

NSAIDs, steroids, immunosuppressants, hydroxychloroquine

357
Q

Drugs commonly associated with drug-induced SLE

A

Hydralazine and procainamide

358
Q

Nonbacterial verrucous thrombi on underside of mitral or aortic valve are indications of what disease

A

Libman-Sacks Endocarditis

359
Q

Populations commonly affected by SLE

A

African-American women of reproductive age

360
Q

Common presentation of SLE

A

Malar rash, joint pain, and fever

361
Q

Women positive for ANA and lupus anticoagulant is at risk for what complication

A

Spontaneous abortion

362
Q

Diagnosis of patient with history of thrombosis and anticardiolipin with prolonged PTT

A

Antiphospholipid syndrome

363
Q

Treatment for antiphospholipid syndrome

A

Hydroxychloroquine with SLE and Warfarin plus ASA; possible Rituximab

364
Q

Disease associated with anti-U1 RNP antibodies with features of SLE and/or polymyositis

A

Mixed connective tissue disease

365
Q

Disease associated with anti-beta2 glycoprotein and prolonged PTT not corrected by addition of normal platelet-free plasma

A

Antiphospholipid syndrome

366
Q

Disease characterized by immune-mediated, non-caseating granulomas, elevate ACE levels and CD4+/CD8+ ratio on bronchoalveolar lavage

A

Sarcoidosis

367
Q

Sarcoidosis is more common in what population

A

African-American women

368
Q

Chest x-ray findings in sarcoidosis

A

Bilateral adenopathy and coarse reticular opacities with hilar and mediastinal adenopathy

369
Q

Cause of hypercalcemia in sarcoidosis

A

Increased 1-alpha-hydroxlase-mediated vitamin D activation of macrophages

370
Q

Disease with epithelioid granulomas containing Schaumann and steroid bodies in African-American female

A

Sarcoidosis

371
Q

Treatment for sarcoidosis

A

Steroids if symptomatic

372
Q

Disease associated with giant cell arteritis with increased ESR, CRP, normal CK and does not cause muscle weakness

A

Polymyalgia rheumatica

373
Q

What age group is more commonly affected with Polymyalgia rheumatica

A

Women over 50 years

374
Q

What vasculitides is associated with Polymyalgia rheumatica

A

Giant temporal arteritis

375
Q

Treatment for polymyalgia rheumatica

A

Low-dose corticosteroids

376
Q

Disease that typically presents with pain and stiffness in shoulders and hips, often with malaise, fever, and weight loss in postmenopausal women

A

Polymyalgia rheumatica

377
Q

Disease most commonly seen in premenopausal women associated with paresthesias, poor sleep, non-specific pain and cognitive disturbance

A

Fibromyalgia

378
Q

Treatment for fibromyalgia

A

Regular exercise, antidepressants and anticonvulsants

379
Q

Disease characterized by endomyseal inflammation with CD8+ T cells, with progressive proximal muscle weakness of the shoulders

A

Polymyositis

380
Q

Disease with malar rash, Gottron’s papules, heliotrope rash, shawl and face rash, mechanic’s hands with increased risk of occult malignancy

A

Dermatomyositis

381
Q

Dermatomyositis is associated with what type of T-cells and inflammation

A

Perimysial inflammation and atrophy with CD4+ T-Cells

382
Q

Lab findings associated with polymyositis and dermatomyositis

A

Increased CK, positive ANA, anti-Jo-1, anti-SRP, and anti-Mi-2 antibodies

383
Q

Treatment for polymyositis and dermatomyositis

A

Steroids plus methotrexate

384
Q

Most common NMJ disorder

A

Myasthenia gravis

385
Q

Pathophysiology of Myasthenia gravis

A

Autoantibodies to postsynaptic ACh receptors

386
Q

Diseases associated with myasthenia gravis

A

Thymoma and thymic hyperplasia

387
Q

Diagnosis of myasthenia gravis

A

Edrophonium

388
Q

Presentation of myasthenia gravis

A

Ptosis, diplopia, weakness that worsens with muscle use

389
Q

Treatment for myasthenia gravis

A

Pyridostigmine

390
Q

Pathophysiology of Lambert-Eaton syndrome

A

Autoantibodies to presynaptic calcium channels decreasing ACh release

391
Q

Presentation of Lambert-Eaton syndrome

A

Proximal muscle weakness, dry mouth, impotence that improves with muscle use

392
Q

Disease associated with Lambert-Eaton syndrome

A

Small cell lung cancer

393
Q

Primary disease with decreased blood flow to skin due to arteriolar vasospasms in response to cold or stress

A

Raynaud disease

394
Q

Treatment for Raynaud syndrome

A

Calcium channel blockers

395
Q

CREST syndrome is characterized by what?

A

Calcinosis, Raynaud’s, Esophageal dysmotility, Sclerodactyly, Telangiectasias

396
Q

Raynaud’s syndrome is associated with what diseases?

A

SLE, CREST syndrome, or mixed connective tissue disease

397
Q

Limited form of systemic sclerosis

A

CREST syndrome

398
Q

Disease with triad of autoimmunity, non-inflammatory vasculopathy, and collagen deposition with fibrosis

A

Scleroderma

399
Q

Disease manifesting as puffy, taut skin without wrinkles, fingertip pitting with limited skin involvement and CREST syndrome

A

Limited scleroderma

400
Q

Disease manifesting as puffy, taut skin without wrinkles, fingertip pitting with widespread skin involvement and associated with anti-Scl-70 antibody

A

Diffuse scleroderma

401
Q

Three layers of skin

A

Epidermis, dermis, subcutaneous fat

402
Q

How many layers does the epidermis have

A

5 layers

403
Q

What are the 5 layers of epidermis

A

Corneum, Lucidum, Granulosum, Spinosum, Basale

404
Q

Epithelial junction that prevents paracellular movement of solutes and composed of claudins and occludens

A

Tight junctions

405
Q

Tight junctions are located above what?

A

Adherens junctions

406
Q

Zona occludens

A

Tight junction

407
Q

Adherens junction

A

Belt desmosome or zona adherens

408
Q

Epithelial junction below tight junction, forms a belt connecting actin cytoskeletons of adjacent cells with cadherins

A

Adherens junctions

409
Q

Loss of which adhesion molecule promotes metastasis

A

E-cadherins

410
Q

Pemphigus vulgaris has autoantibodies to which epithelial junction

A

Desmosomes

411
Q

Channel proteins that permit electrical and chemical communication between cells

A

Gap junction

412
Q

Membrane proteins that maintain integrity of basolateral membrane by binding to collagen and laminin in basement membrane

A

Integrins

413
Q

Epithelial junction that provides structural support via intermediate filament interactions

A

Desmosomes

414
Q

Bullous pemphigoid has autoantibodies to which membrane protein

A

Hemidesmosomes

415
Q

Stem cells are located in what layer of the epidermis

A

Stratum basale

416
Q

Which epidermis layer has cells with no nucleus or organelles

A

Corneum (keratin)

417
Q

Flat lesion with well-circumscribed change in skin color < 1 cm

A

Macule

418
Q

Freckle is what type of lesion

A

Macule

419
Q

Macule > 1 cme

A

Patch

420
Q

Elevated solid skin lesion < 1 cm

A

Papule

421
Q

Papule > 1 cm

A

Plaque

422
Q

Small fluid-containing blister < 1 cm

A

Vesicle

423
Q

Large fluid-containing blister > 1 cm

A

Bulla

424
Q

Vesicle containing pus

A

Pus

425
Q

Transient smooth papule or plaque

A

Wheal

426
Q

Flaking off of stratum corneum

A

Scale

427
Q

Dry exudate

A

Crust

428
Q

Increased thickness of stratum corneum

A

Hyperkeratosis

429
Q

Hyperkeratosis with retention of nuclei in stratum corneum

A

Parakeratosis

430
Q

Increased thickness of stratum granulosum

A

Hypergranulosis

431
Q

Epidermal accumulation of edematous fluid in intercellular spaces

A

Spongiosis

432
Q

Separation of epidermal cells

A

Acantholysis

433
Q

Epidermal hyperplasia (increased spinosum)

A

Acanthosis

434
Q

Normal melanocyte number with decreased melanin production

A

Albinism

435
Q

Risk increased in albinism

A

Skin cancer

436
Q

Mechanism of albinism

A

Decreased tyrosine activity or defective tyrosine transport

437
Q

Hyperpigmentation associated with pregnancy or OCP use

A

Melasma

438
Q

Irregular areas of complete depigmentation

A

Vitiligo

439
Q

Cause of vitiligo

A

Destruction of melanocytes

440
Q

Structure consisting of hair, hair follicle, arrector pili muscle, and sebaceous gland

A

Pilosebaceous unit

441
Q

Bacteria that causes acne

A

P. acnes

442
Q

Causes of acne

A

Increased sebum/androgen production, abnormal keratinocyte desquamation and P. acnes

443
Q

Treatment for acne

A

Retinoids, benzoyl peroxide, antibiotics

444
Q

Pruritic eruption commonly on skin flexures associated with atopic diseases

A

Eczema

445
Q

Ig associated with eczema

A

IgE

446
Q

Site of eczema in infants

A

Face

447
Q

Site of eczema in children and adults

A

Antecubital fossa

448
Q

Type IV hypersensitivity reaction that usually follows exposure to allergen

A

Allergic contact dermatitis

449
Q

Cells involved in direct cell cytotoxicity

A

CD8+ T-cells

450
Q

Cells involved in delayed-type hypersensitivity

A

CD4+ T-cells

451
Q

Melanocyte nevus that is a flat macule

A

Junctional nevus

452
Q

Melanocyte nevus that is papular

A

Intradermal nevi

453
Q

Common mole that is benign but melanoma can arise in congenital or atypical moles

A

Melanocyte nevus

454
Q

Melanocyte nevus common in kids

A

Junctional nevus

455
Q

Foreign body inflammatory facial skin disorder characterized by firm, hyperpigmented papules and pustules that are pruritic and painful common in African-Americans

A

Pseudofolliculitis barbae

456
Q

Bacteria associated with pseudofolliculitis barbae

A

Staph and Strep

457
Q

Treatment for pseudofolliculitis barbae

A

Mupirocin and warm compresses

458
Q

Papules and plaques with silvery scaling on knees and elbows

A

Psoriasis

459
Q

Pinpoint bleeding spots from exposure of dermal papillae when psoriatic scales are scraped off

A

Auspitz sign

460
Q

Collection of neutrophils in stratum corneum seen in psoriasis

A

Munro microabscesses

461
Q

Inflammatory facial skin disorder characterized by erythematous papules and pustules, no comedomes and bullous deformation of nose

A

Rosacea

462
Q

Common benign neoplasm in older persons with “stuck on” appearance

A

Seborrheic keratosis

463
Q

Sudden appearance of multiple stuck on lesions should raise concern for what underlying disease

A

Malignancy of GI or lymphoid

464
Q

Sudden appearance multiple seborrheic keratoses

A

Lese-Trelat sign

465
Q

Warts on genitals

A

Condyloma acuminatum

466
Q

Common cause of Condyloma acuminata

A

HPV 6 or 11

467
Q

Soft, tan colored, cauliflower-like papules with epidermal hyperplasia, hyperkeratosis, and koilocytosis

A

Verrucae

468
Q

Pruritic wheals that form after mast cell degranulation

A

Urticaria

469
Q

Rare blood vessel malignancy in head, neck, and breasts common in elderly on sun-exposed areas

A

Angiosarcoma

470
Q

Chemical exposure associated with hepatic angiosarcoma

A

Vinyl chloride and arsenic

471
Q

Benign capillary skin papules found in AIDS patients caused by Bartonella infections

A

Bacillary angiomatosis

472
Q

Skin papule with neutrophilic infiltrate commonly mistaken for Kaposi sarcoma in AIDS patients

A

Bacillary angiomatosis

473
Q

Benign capillary skin papule in elderly that increases with age and does not regress

A

Cherry hemangioma

474
Q

Cavernous lymphangioma of the neck associated with Turner syndrome

A

Cystic hygroma

475
Q

Benign, painful, red-blue tumor under nails from smooth muscle cells of glomus body

A

Glomus tumor

476
Q

Endothelial malignancy associated with HHV-8 and HIV with lymphocytic infiltrate

A

Kaposi sarcoma

477
Q

Polypoid lobulated capillary hemangioma that can ulcerate and bleed associated with trauma and pregnancy

A

Pyogenic granuloma

478
Q

Benign capillary hemangioma of infancy appearing in first few weeks of life, grows rapidly and regresses by 5-8 years old

A

Strawberry hemangioma

479
Q

Honey-colored superficial skin infection associated with Staph or Strep that is high contagious

A

Impetigo

480
Q

Bacteria that causes bullous impetigo

A

Staph aureus

481
Q

Superficial infection of the upper dermis and superficial lymphatics that presents with well-defined demarcation between infected and normal skin

A

Erysipelas

482
Q

Bacteria that causes erysipelas

A

Strep pyogenes

483
Q

Acute, painful, spreading infection of deeper dermis and subcutaneous tissue that starts with a break in the skin or another infection

A

Cellulitis

484
Q

Bacteria that causes cellulitis

A

Strep pyogenes or Staph aureus

485
Q

Collection of pus from a walled-off infection within deeper layers of skin

A

Abscess

486
Q

Bacteria that mostly causes abscesses

A

Staph aureus

487
Q

Deeper tissue infection with pain out of proportion with crepitus causing bullae and purplish skin color

A

Necrotizing fasciitis

488
Q

Cause of crepitus in necrotizing fasciitis

A

Methane and CO2 production

489
Q

Bacteria that causes necrotizing fasciitis

A

Strep pyogenes

490
Q

Skin infection that destroys keratinocyte attachments in stratum granulosum only and characterized by fever, erythematous rash with positive Nikolsky sign

A

Scalded Skin Syndrome (SSS)

491
Q

Cause of SSS

A

Staphylococcus exfoliative toxin

492
Q

Umbilicated papules caused by poxvirus frequently seen in children and may be sexually transmitted in adults

A

Molluscum contagiosum

493
Q

Presents with multiple crops of lesions in varying stages from vesicles to crusts

A

Varicella virus

494
Q

Presents as rash in dermatomal distribution

A

Zoster virus

495
Q

Irregular, white, painless plaque on lateral tongue that cannot be scraped off, is EBV mediated and is common in HIV patients and organ transplant recipients

A

Hairy leukoplakia

496
Q

Scrapable white plaque on tongue associated with HIV patients

A

Oral thrush

497
Q

Component of desmosomes which connect keratinocytes in the stratum spinosum

A

Desmoglein

498
Q

Antibody that targets desmoglein

A

IgG antibody

499
Q

Potentially autoimmune skin disorder with IgG antibody against desmoglein

A

Pemphigus vulgaris

500
Q

Hypersensitivity reaction in pemphigus vulgaris

A

Type II

501
Q

What do keratinocytes resemble in pemphigus vulgaris

A

Row of tombstones

502
Q

What does IF reveal in pemphigus vulgaris

A

Antibodies around epidermal cells in a net-like pattern

503
Q

Pemphigus vulgaris is positive for what sign

A

Nikolsky sign

504
Q

Target of IgG antibody in bullous pemphigoid

A

Hemidesmosomes

505
Q

Description of blisters in bullous pemphigoid

A

Tense blisters with neutrophils that spare oral mucosa

506
Q

What does IF show in bullous pemphigoid

A

Linear pattern at dermal-epidermal junction

507
Q

Description of blisters in pemphigus vulgaris

A

Flaccid intraepidermal bullae caused by acantholysis involving skin and oral mucosa

508
Q

Pruritic papules, vesicles, and bullae around elbows and associated with celiac disease

A

Dermatitis herpetiformis

509
Q

Treatment for dermatitis herpetiformis

A

Dapsone and gluten-free diet

510
Q

What antibodies are deposited at tips of dermal papillae in dermatitis herpetiformis

A

IgA antibodies

511
Q

Presents with macules, papules, vesicles, target lesions with necrotic center associated with drug reactions and infections

A

Erythema multiforme

512
Q

Associated with severe drug reactions characterized by fever, bullae formation, necrosis and targetoid skin lesions with sloughing of skin

A

Steven-Johnson syndrome (SJS)

513
Q

More severe form of SJS with > 30% of body surface involvement

A

SJS-TEN

514
Q

Epidermal hyperplasia with skin thickening and hyperpigmentation in axilla or neck associated with insulin resistance and visceral malignancy

A

Acanthosis nigricans

515
Q

Premalignant skin lesion caused by sun exposure with increased risk of squamous cell carcinoma

A

Actinic keratosis

516
Q

Painful, raised inflammatory lesions usually on shins associated with sarcoidosis, cocci, histo, TB, strep infections, leprosy and IBD

A

Erythema nodosum

517
Q

Pruritic, Purple, Polygonal, Planar Papules and Plaques with Wickham striae and hypergranulosis

A

Lichen planus

518
Q

Skin disorder with saw-tooth infiltrate of lymphocytes at dermal-epidermal junction associated with hepatitis C with mucosal involvement showing reticular white lines

A

Lichen planus

519
Q

Skin disease with “Herald” patch followed by other scaly erythematous plaques in “Christmas tree” pattern

A

Pityriasis rosea

520
Q

UV light that is dominant in sunburns

A

UVB light

521
Q

UV light that is dominant in tanning beds

A

UVA light

522
Q

UV light that is dominant in photoaging

A

UVA light

523
Q

Exposure to UVA and UVB light increases risk of what?

A

Basal cell carcinoma, squamous cell carcinoma, and melanoma

524
Q

Most common skin cancer

A

Basal cell carcinoma

525
Q

Second most common skin cancer

A

Squamous cell carcinoma

526
Q

S-100 positive tumor with significant risk of metastasis

A

Melanoma

527
Q

Tumor that appears as non-healing ulcer with infiltrating growth or a scaling plaque and “palisading” nuclei

A

Basal cell carcinoma

528
Q

Common location of BCC

A

Face and upper lip

529
Q

What conditions increased risk of BCC

A

Albinism and Xeroderma pigmentosum

530
Q

Skin cancer with waxy, pink, pearly nodules commonly with telangiectasias, rolled borders and central crusting or ulceration

A

BCC

531
Q

Common location of SCC

A

Face, lower lip, ears and hands

532
Q

Locally invasive skin cancer that rarely metastasizes

A

BCC

533
Q

Skin cancer with ulcerative red lesions with frequent scales and keratin “pearls”

A

SCC

534
Q

Scaly plaque that is a precursor to SCC

A

Actinic keratosis

535
Q

Variant of SCC that grows rapidly and may regress spontaneously over months

A

Keratoacanthoma

536
Q

Skin cancer associated with excessive sun exposure, immunosuppression, chronically draining sinuses, and arsenic exposure

A

SCC

537
Q

Skin cancer associated with sun exposure, dysplastic nevi with increased risk in fair-skinned persons

A

Melanoma

538
Q

Mutation that drives melanoma

A

BRAF kinase mutation

539
Q

Patients with melanoma who benefit from vemurafenib have what type of mutation

A

BRAF V600E mutation

540
Q

Mechanism of vemurafenib

A

BRAF kinase inhibitor

541
Q

Primary treatment of melanoma

A

Excision with appropriately wide margins

542
Q

Types of melanoma

A

Superficial spreading, Nodular, Lentigo maligna, and Acral lentiginous

543
Q

What characteristic of melanoma correlates with risk of metastasis

A

Depth of tumor (Breslow thickness)

Step 1 MSK, Skin, and Connective Tissue-First Aid 2017 (2 decks)

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