Flashcards - MSK
Rheumatoid Factor
IgM against Fc of IgG
Reiter Syndrome Triad
arthritis, urethritis, conjunctivitis
Dermatomyositis antibodies
ANA, anti-Jo-1
Paget Disease - Ca, Phos, Alk Phos labs
osteoclast dysfunction - normal calcium, normal phosphate, elevated alk phos
Erb-Duchenne/Waiter’s tip
upper trunk - C5-C6
Klumpke Palsy/Claw Hand
lower trunk - C8-T1
Winged Scapula
Long thoracic nerve C5-C7
Damage to Axillary (C5-C6) nerve causes
humeral neck fracture, anterior shoulder dislocation - loss of arm abduction > 15 degrees, loss of sensation over deltoid and lateral arm
Gout crystal
monosodium urate - negative birefringence needle shaped
Pseudogout crystal
Chondrocalcinosis - Calcium pyrophosphate dihydrate - weak positive birefringence rhombus-shaped
collagen type I
bone, tendon - osteogenesis imperfecta
collagen type II
hyaline cartwoledge
collagen type III
rethreecular - ehlers-danlos
collagen type IV
four to the floor - basement membrane - allports, goodpastures
osteopetrosis
poor osteoclast function - thick weak bones, thrombocytopenia - may benefit from bone marrow transplant
Rickets/osteomalacia
defect in mineralization of ostoid from decreased Vit D
Paget’s treatment
calcitonin, bisphosphonate
Gardner syndrome
osteoma with FAP
overexpression of MHC I on sarcolemma with CD8 infiltration
polymyositis
polymyositis pathogenesis
muscle autoantigens taken up by macs, presented to CD4+ –> IFN-gamma –> IL-1, TNF-alpha
tumor with cartilage cap, continuous with bone marrow
osteochondroma
osteosarcoma
osteoblasts, metaphysis of long bones, “sunburst”
osteomyelitis bone type
metaphysis
ewing sarcoma
t(11:22), “onion skin” - inside medullar cavity, layering of new bone - diaphysis
osteolytic punched out lesions
metastatic prostate cancer
small round blue cells resembling lymphocytes
ewing sarcoma
PRPP synthetase mutation
increased uric acid from purine metabolism - predisposes to gout
guyon’s canal
site of ulnar nerve injury - near hook of hamate and pisiform
Lupus inducing drugs
hydralazine, procainamide - acetylated in liver, slow-acetylators are more predisposed
collagen synthesis
pre-pro-alpha-chains cleaved –> pro-alpha chains –> Vit C dependent hydroxylation of proline/lysine –> glycosylation of galactose/glucose to lysine –> procollagen triple helix –> excreted out of RER/cell –> terminal propeptides cleaved by N/C procollagen peptidases –> tropocollagen –> collagen spontaneously assembles –> covalent crosslinks formed by lysyl oxidase
osteoclast lineage
monocytes
RANK/ligand
interaction of RANK and ligand result in development of mature multinucleated osteoclasts. osteoprotegerin reduces this interaction - stimulated by PTH and MCSF
perimysial inflammation (CD4+),w/ perifasicular atrophy
dermatomyositis
deoxypyridinoline
measure of osteoclast activity, hydroxyproline is less reliable
pyrophosphate
component of hydroxyapatite - bisphosphanates are analogues
humeral head fracture/anterior dislocation of humerus nerve
axillary nerve (C5-C6)
midshaft fracture of humerus nerve
radial nerve (C5-T1) + deep brachial artery - wrist drop, loss of sensation over posterior arm/forearm and dorsal hand
supracondylar fracture of humerus nerve
median nerve (C5-T1) - ape/pope hand (while making fist) - loss of wrist flexion, thumb opposition, lumbricles, sensation over thenar eminence
radial head subluxation nerve
deep radial nerve - annular ligament
medial epicondyle facture of humerus nerve
ulnar (C8-T1)
fibular fracture nerve
common peroneal nerve (decreased dorsiflexion, eversion and sensation over dorsum of foot)
bisphosphonate
induces osteoclasts to undergo apoptosis
femoral head fracture
medial femoral circumflex artery –> avascular necrosis
foot drop
common peroneal/fibular nerve palsy
femoral nerve palsy
pelvic fracture/ilopsoas mass - decreased flexion of thigh/extension of leg, sensation over anterior thigh down to medial calf
tibial nerve palsy
trauma to knee - decreased foot inversion, plantar flexion, sensation over sole of foot
popliteal fossa artery/nerve
tibial nerve/popliteal artery
posterior to medial malleolus nerve/artery
tibial/posterior tibial
An Interesting Zoo Must Have Mammals
Actin in I-band attaches Z-line, Myosin in H-band attaches M-line
amyotrophic lateral sclerosis
defect in superoxide dismutase
wrist bones
Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium. (So Long To Pinky, Here Comes The Thumb).
medial epicondylitis
golfers elbow
musculocutaneous palsy
C5-C7 - loss of forearm flexion, supination, sensation over lateral forearm
osteitis fibrosa cystica
due to hyperparathyroid -
primary - “brown tumors”, idiopathic
secondary - compensation for ESRD
codman triangle or sunburst
elevation of periosteum - osteosarcoma (metaphysis) - retinoblastoma, Li Fraumeni, Pagets
giant cell tumor
epiphyseal - osteoclastoma - soap bubble on x-ray, multinucleated giant cells
pencil in cup, dactylitis
psoriatic arthritis - <1/3 of patients with psoriasis
polymyalgia rheumatica
associated with temporal arteritis
Epidermis layers
Come, Let’s Get Sun Burned - stratum Corneum stratum Lucidum stratum Granulosum stratum Spinosum stratum Basale
parakeratosis
hyperkeratosis with retention of nuclei in corneum - psoriasis
spongiosis
epidermal accumulation of edematous fluid in intercellular space - eczema
acantholysis
separation of epidermal cells - pemphigus vulgaris
Auspitz sign
pinpoint bleeding from psoriatic scale removal due to dermal papillae
Erysipelas
well demarcated upperdermis + superficial lymphatic infection, usually from S pyogenes.
ABCDE of melanoma
asymmetry, border irregularity, color, diameter >6mm, evolution
keratoacanthoma
well differentiated SCC, regresses spontaneously, cup shaped tumor
lichen planus
reticular white lines - associated with HCV
myotonic dystrophy
abnormally slow relaxation of muscles - frontal balding and gonadal atrophy
