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STEP2 > Derm/MSK > Flashcards

Derm/MSK Flashcards

1
Q

Where is knee pain located in Pes Anserine Pain syndrome?

aka Pes Anserine Bursitis

A

MEDIAL pain / MEDIAL bursitis

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2
Q

Describe the Noble test.

A

pt lies on side

experiences pain when doctor applies pressure to the LATERAL side of a flexed knee

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3
Q

A + NOBLE test indicates what knee condition?

A

Iliotibial band syndrome (ITBS)

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4
Q

A sessile growth with a cartilage CAP on a bone is mnemonic for what bone tumor?

A

= Osteochondroma

  • sessile = pendunculated = mushroom like growth
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5
Q

Osteo-chondroma is a BENIGN bone tumor that grows on what area of the bone?

A

Metaphysis

(M)ushroom (M)etaphysis

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6
Q

Any bone tumor that ends in -SARCOMA will present with what symptoms?

A

B symptoms!

  • fevers
  • pain thats worse at night
  • elevated inflammatory markers
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7
Q

Chrondro-SARCOMA is the malignant form of osteo-chrondroma and presents at what age?

A

> 50yo

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8
Q

Chrondro-SARCOMA is associated with what bone condition seen in older males?

A

Pagets disease of the bone

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9
Q

“Moths eating Popcorn” is mnemonic for what bone malignancy?

A

Chondro-SARCOMA

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10
Q

Ewing SARCOMA affects what area of the bone?

A

Diaphysis

diameter of the wing

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11
Q

Ewing SARCOMA presents with what finding on Xray?

A

Onion skinning + Codmans triangle

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12
Q

Osteo-SARCOMA presents with what finding on Xray?

A

SUBURST appearance of lytic bone lesions and/or Codman triangles

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13
Q

Osteo-SARCOMA presents at what age?

A

Bi-modal

10 & 30 yo

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14
Q

Osteo-SARCOMA is located to what area of the bone?

A

metaphysis

Sun(burst) & Moon (metaphysis)

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15
Q

Osteo-SARCOMA is associated with which occular malignancy?

Which childhood malignancy syndrome?

A

Retinoblastoma

Li-Fraumeni syndrome (Sarcoma, Breast, Adrenal, & Leukemia malignancies)

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16
Q

what benign bone disease looks JUST like chondro-SARCOMA but has no B symptoms?

A

chrondoBLASToma

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17
Q

ChondroBLASToma occurs at what area on the bone?

A

Epiphysis

(E)PIC (B)last

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18
Q

A diabetic with back pain (and elevated ESR/CRP) =

A

vertebral osteomyelitis!!

aka Spondylitis, Spondylodiscitis

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19
Q

what is the definitive confirmatory test for vertebral osteomyelitis?

A

CT-guided aspiration biopsy

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20
Q

which bullae/blistering condition bullows below the epidermis to attack hemidesmosomes?

what autoantibody & complement is found?

A

BULLOUS pemphigoid

linear deposits of IgG and C3 along the basement membrane.

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21
Q

what bullae/blistering condition affects OLD ppl by making them itchy?

A

BULLOUS pemphigoid

Old like bull

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22
Q

which bullae/blistering condition has a positive nikolsky sign & mucosal involvement?

A

Pemphigus vulgaris; they rub away bc they are flaccid & painful (unlike bullous which is tense/itchy)

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23
Q

how do you know a patient with severe burn wounds has skin infection by looking at temp?

A

hypothermia (95 F) + oligouria + leukocytosis

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24
Q

what is the cause of complex regional pain syndrome?

what are the 3 clx features?

A

trauma (fracture, surgery, etc)

DEC temp, burning pain, weakness, edema

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25
Q

what is the tx for complex regional pain syndrome?

A

physical and occupational therapy (learn to cope with pain)

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26
Q

which 3 veins are the ONLY originators of DVT & Pulmonary embolisms?

A

PROXIMAL deep veins: Iliac, Femoral, Popliteal

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27
Q

which burn victims need Serial arterial blood gas analysis?

A

inhalation + burn victims.

dont bother with serial blood gas unless that pt isnt breathing properly

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28
Q

a circumferential / “encircling” burn is mnemonic for what incoming condition?

how do you monitor this pt?

A

compartment syndrome

serial pulses & capillary fillings

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29
Q

koplik spots is mnemonic for ___

A

measles, mumps, rubella

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30
Q

wells criteria for DVT.

at what point is it high test probability > dx w/ US?

A
  • active cancer
  • Hx DVT
  • Hx of immobilization (bed ridden/surgery)
  • clx signs (entire leg swollen, pain, fever, +Homan)
  • > 2 = perform an US to dx
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31
Q

Why dont you run a d-dimer on post op patients?

A

It will always be false positive. therefore D-dimer on post op pts is a contraindication

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32
Q

how do obturator nerve injuries happen?

loss of sensation is localized to ____

A

pelvic (ring) fractures

medial thigh

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33
Q

what does an urticarial rash/hives look like on a patient?

A

a red Confluent rash

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34
Q

what are the ways to get urticaria besides an allergic reaction?

A

INFECTIONS w/ virus, parasite, bacteria&raquo_space;> post infection urticaria

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35
Q

Papillary dermal IgA deposition is mnemonic for what rash

A

dermatitis herpetiformis= IgA deposits in the dermal layer

celiac disease

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36
Q

Trichophyton rubrum

A

Tinea corporis (ring worm)

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37
Q

who is at higher risk for diffuse trichophyton rubrum infections?

A

diabetes & HIV

38
Q

Epidermal keratinocyte hyperproliferation is a typical feature of ______

A

psoriasis

39
Q

bullous pemphigoid and pemphigus vulgaris are Type ___ HS rxn rashes?

A

Cutaneous cytotoxic reaction (Type 2)

40
Q

polyarthritis nodosa should be considered in young adults presenting with ____ or ______.

A

stroke

MI

PAN = T3HS rxn = complexes deposited in blood vessels> stenosis> stroke/MI

41
Q

conditions caused by defects in:

Type 1 collagen
Type 2 collagen
Type 3 collagen
Type 4 collagen
Type 5 collagen
A

Type 1 collagen = osteogenesis imperfecta
Type 2 collagen = cartilage probs
Type 3 collagen = Vascular ehlers danlos (aortic dissection, ruptures AAA, subarachnoid hemorrhage)

Type 4 collagen = alport syndrome
Type 5 collagen = classic elhers danlos

42
Q

Redness and profuse watery discharge that starts in one eye and rapidly spread to the other is dead give away for what eye complication?

what ear findings are seen?

A

pink eye (EPIDEMIC keratoconjuctivitis)

Unilateral preauricular lymphadenopathy

43
Q

what are the clx features of lichen sclerosis in women, children, & men (yes everyone gets it ;) )

A

ALL: severely itchy, white plaques on vulva & anus (anal fissures)

women = figure 8 of vulva and anus + dyspaurenia

men = penile white plaque lesions + phimosis (cant retract foreskin)

child = figure 8 + constipation (pain from anal fissures)

44
Q

risk factors for avascular necrosis

A

SLE, steroid use, alcohol use, SCD

45
Q

what is the age range for transient synovitis? this is very important to remember.

A

< 10 yo

TENsient synovitis

46
Q

what always precedes transient synovitis (hint: this is the reason why its transient)

A

URT infection

47
Q

what is the pathophys of avascular necrosis? (hint: this is the reason there is no leukocytosis or systemic signs)

A

decrease blood flow to the bone

48
Q

legg cathe perthe is a subtype of

A

avascular necrosis

49
Q

what does seronegative mean?

what are the seronegative arthritides?

A

negative for RF

ankylosing spondylitis, reactive/postinfectious arthritis, psoriatic arthritis

50
Q

what are seronegative arthritides strongly positive for?

A

ANA & HLA-B27 !!

51
Q

what is the classic style of reactive/post infectious arthritis joint pain?

A

asymmetric & migratory = 1 joint at a time

52
Q

Arthritis after a gastritis or UTI/cervicitis/urethritis?

A

post infectious/reactive arthritis

53
Q

what are the 4 types of juvenile idiopathic arthritis?

A

Seronegative polyarticular juvenile idiopathic arthritis

Oligoarticular juvenile idiopathic arthritis

Systemic juvenile idiopathic arthritis

Psoriatic JIA

54
Q

what gender & age gets oligoarticular juvenile idiopathic arthritis ?

A

FEMALE (4:1)

TODDLERS (2-4 yo little girls)

55
Q

how many joints does Oligoarticular juvenile idiopathic arthritis affect?

which joints are affected most?

A

< 4 joints bc Oligo means few/not many

Weight bearing joints like knee, ankle, wrist

56
Q

what important skin PE findings in systemic juvenile idiopathic arthritis sets it apart from the other 2 (oligo & poly)?

A

Systemic will present with salmon pink rash rash in addition to the arthritis

57
Q

how many joints does systemic juvenile idiopathic arthritis affect?

why this #?

A

< 1 joint !!

only affects 1 joint bc its too busy causing all those systemic issues (fever, rash, lymphadenopathy)

58
Q

how many joints does polyarticular juvenile idiopathic arthritis affect?

which joints are affected most?

A

> 5 joints bc Poly means MANY

teeny tiny joints in the fingers and hands only

59
Q

which juvenile idiopathic arthritis (s) present with uveitis?

A

oligioarticular JIA

seronegative polyarticular JIA

psoriatic JIA

60
Q

what is the age cut off for JIA?

how long does arthritis have to last to be considered JIA?

A

< 16 yo

must last > 6 weeks

61
Q

what is keratoconjunctivitis sicca?

A

dry eyes

62
Q

what is the pathophys of a radial head subluxation?

what are the clx findings in a child with radial subluxation?

A

traction of the arm with pull the radial head out from under the annular ligament that holds it in place.

elbow flexion ++ forearm protonation

63
Q

how do you treat radial subluxation?

A

Manual reduction via either:

supination of the forearm
hyperprotonation forearm

64
Q

why do you NOT order a xray for a child with radial subluxation?

A

NO XRAY bc NO FRACTURE

65
Q

what is the classic presentation of a rosacea rash?

what triggers rosacea rash?

A

red telangiectia & pustules

triggered by INC body temp (heat, alcohol, stress, spicy food, nicotine)

66
Q

what organ does rosacea involve besides the skin?

A

EYE> ocular rosacea

67
Q

what rash is pathognomonic for CHRONIC Sarcoidosis?

what does it look/feel like?

A

Lupus pernio (looks just like a malar rash but is NEGATIVE for ANA markers= NOT sle)

nonpruritic, painless violaceous skin plaques and/or nodules on the nose and cheeks

68
Q

Lupus vulgaris is pathognomonic for what disease?

what are the characteristics of the rash?

A

TB!!

painful nodules that ulcerate

the only LUPUS rash = malar, discoid; any rash that starts with “lupus” is NOT true SLE

69
Q

what muscle does the inferior gluteal nerve innervate?

what is the function of this muscle?

A

Inf gluteal n innervates the Gluteus MAXIMUS muscle

gluteus maximus muscle causes thigh EXTENSION

70
Q

damage to what nerve > positive trendelenberg sign

what muscles does it innervate?

A

damage to the SUPERIOR gluteus n

innervates gluteus medius & minimus

71
Q

what imaging do ALL rheumatoid arthritis and Down Syndrome pts need before undergoing general anesthesia for surgery?

why?

A

RA & Downs pts need LATERAL XRAYS of the extended and flexed cervical spine (C1 & C2)

RA & Downs pts suffer from alanto(CI) ataxial(C2) instability EARLY in the diseases.

the position of the neck is hyper-extended when anesthesia is used during surgery» subluxation of C1–C2> cervical spinal cord injury

72
Q

what are the rash characteristics in scarlet fever?

A
  • begins on NECK> trunk & groin
  • Pastia lines (LINEAR rash in groin, underarm, and elbow creases)
  • 7–10 days after resolution of rash you get skin peeling (desquamation)
73
Q

another name for Fifth disease.

what is the causative organism?

A

Erythema infectiosum

Parvovirus

74
Q

another name for sixth disease.

what is the causative organism?

A

Roseola Infantum or Exanthem subitum (from Latin: “subitus” = sudden) describes a “sudden exanthem” (upon fever cessation).

Human Herpes Virus 6 (HHV6)

75
Q

what is the only abnormal CBC finding in Pagets disease ?

A

increased serum alkaline phosphatase is often the only abnormal marker of bone metabolism

(calcium, phosphate, and parathyroid hormone are NORMAL)

76
Q

what tool is used to dx acute compartment syndrome?

A

MANOMETRY = measures pressure/movement

77
Q

what radiculopathy causes weak patellar reflex?

A

L4

78
Q

what radiculopathy causes weak achilles tendon reflex?

A

S1

79
Q

what radiculopathy causes weak heel walk/ankle dorsiflexion?

A

L5

80
Q

what radiculopathy causes weak tippy toe walk/plantar flexion?

A

S1

81
Q

what radiculopathy causes weak leg extension?

A

L4

82
Q

what radiculopathy causes weak hip flexion?

A

L3

83
Q

S1 gives sensation to :

A

lateral foot

84
Q

L3 gives sensation to :

A

ant lateral thigh & medial leg

85
Q

L4 gives sensation to :

A

knee/patella & medial foot

86
Q

L5 gives sensation to :

A

section between 1st & 2nd toes

87
Q

what nerve roots cause Diminished sensation of the anus and genitalia?

A

L3-S5= cauda equina syndrome

88
Q

fluctuant fluid over the patella =

A

Pre-patellar bursitis

89
Q

what actions/professions cause Pre-patellar bursitis?

A

overuse/trama via frequent kneeling (carpenter, plumbing, mechanics)

90
Q

CHRONIC Inflammatory Demyelinating Polyneuropathy (CIDP) is a subtype of ______ that presents just like it, BUT onset greater than 2 months instead of acute.

what autoantibodies are positive in CIDP

A

GB syndrome

Positive GM1 ganglioside autoantibodies

CIDP looks JUST like GB syndrome but pt will have symptoms for >2 months

91
Q

what does Tinea Capitis look like?

how do you get it?

A

bald patches (alopecia) with hair trying to regrow

ALWAYS in children who share hats/combs/pillows

92
Q

what is the PE maneuver to dx AC joint injury?

what is the next step in management?

A

pain with adduction of the affected arm across the other side of the pts body

immediate Xray!!!

FYI: AC injuries occur when pts fall onto an adducted/bent arm (biking, horse back riding)

STEP2 (12 decks)

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