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Rheumatology > Goljan facts > Flashcards

Goljan facts Flashcards

1
Q

Pathological fractures at birth, deafness, and blue sclera. What is the treatment?

A

OI–> Bisphosphanates= increase bone mineralization

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2
Q

Impaired proliferation of cartilage at growth plate causing normal sized head with short limbs. What is the genetics?

A

AD mutation in FGFR 3 gene

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3
Q

“Marble bone” disease causing TOO much bone that is brittle caused by deficiency of osteoclasts?

A

Osteopetrosis

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4
Q

PT with pathological fractures, Anemia, visual and hearing loss due to nerve compression. Dx?

A

Osteopetrosis

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5
Q

Most common route and site of spread of osteomyelitis?

A

Hematogenous

METAPHYSIS

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6
Q

MCC of osteomelitis?

A

S. aureus

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7
Q

MCC of osteomyelitis in SCD patients?

A

Salmonella

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8
Q

Hematogenous spread of lung infection to vertebral column?

A

TB osteomyelitis= POTT’s disease

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9
Q

Osteomyelitis caused by puncture of foot through rubber footwear?

A

P. aeruginosa

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10
Q

What are sequestra and involucrum?

A

Sequestra–> Dead bone

Involucrum–> Reactive bone formation

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11
Q

What is a consequence of Draining sinus tracts associated with Osteomyelitis?

A

SCC

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12
Q

Pt with Fever, bone pain, and CT showing dead bone with a rim of bone formation. MCC?

A

Osteomyelitis= S. aureus

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13
Q

Loss of both organic bone matrix and minerals with associated Decreased thickness of Cortical and trabecular bone?

A

Osteoporosis

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14
Q

Diagnosis of osteoporosis is done by?

A

Dual photon absorptiometry

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15
Q

What are the MCC of avascular necrosis?

A

Corticosteroids
Alcohol
SCD

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16
Q

MC site of avascular necrosis?

A

Femoral head and condyle

*Scaphoid bone

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17
Q

Pt w. localized pain that is exacerbated with movement, MRI showing increased density known as “double line sign” of bone?

A

Avascular necrosis

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18
Q

Trauma–> ischemia–> separation of cartilage from bone –> articular epiphysis fails MC in Distal Femur?

A

Osteochondritis dissecans

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19
Q

Men >50 yo, targets pelvis + femur and ENLARGED skull, possibly caused by viruses?

A

Paget’s disease

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20
Q

Weak, thick, mosiac bone, with high vascularity, increased ALK, Bone pain. What are other complications of this disease?

A

Osteogenic Sarcoma
High OUTPUT Heart Failure
Hearing Loss

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21
Q

Increased Hat size?

A

Pagets disease== increased Skull size during osteoblastic phase

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22
Q

Defect in Osteoblastic differentiation and maturation?

A

Fibrous dysplasia

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23
Q

Medullary bone replacement by fibrous tissue and cyst formation most commonly in RIBS and femur?

A

Fibrous dysplasia

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24
Q

Fibrous dysplasia involving many bones (polyostotic) + Cafe au lair spots + precocious puberty?

A

Albright syndrome

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25
Q

Most common benign tumor of bone?

A

Osteochondroma

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26
Q

Bone tumor in Epiphysis of Distal femur or proximal Tibia?

A

Giant Cell tumor of bone

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27
Q

Negatively birefringent–> Yellow= Parallel = ?

A

Monosodium urate crystals

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28
Q

Positively birefringent–> Blue= parallel = ?

A

Calcium pyrophosphate crystals

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29
Q

10-30 yo Male pt w/ an outgrowth of his Distal femur?

A

Osteochondroma

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30
Q

Medullary tumor in Small tubular bones of Hand/ Feet Dx?

A

Enchondroma

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31
Q

Male pt with mass in the Facial bones and hx of multiple GI polyps?

A

Osteoma –> associated with Gardner’s polyposis syndrome

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32
Q

Male, 10-20 yo w. “Radiolucent focus surrounded by sclerotic bone” in cortex of his Proximal femur. Tx of his Nocturnal bone pain is?

A

Osteoid osteoma–> Aspirin

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33
Q

Radiolucent focus surrounded by sclerotic bone?

A

Osteoid–> sclerotic area

Osteoma–> FOCUS

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34
Q

Osteoid Osteoma occurring in Vertebrae and not relieved by Aspirin?

A

Osteoblastoma

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35
Q

Female 30-60 yo pt with Neoplastic mononuclear cells in the epiphysis around Knee. Describe Histology?

A

Giant cell tumor= Multinucleated giant cells

36
Q

Male with growing mass in Pelvic bones that has metastasized to his lungs?

A

Chondrosarcoma

37
Q

Male 10-25yo with growing mass in the Metaphysis around his KNEE, FHx of Blind sister, fibrous dysplasia. What are the MC radiologic findings?

A

Codmans triangle

“Sunburst”–> speculation of calcified tumor

38
Q

What are the risk factor for Osteogenic sarcoma?

A

Pagets disease
Retinoblastoma
Radiation
Fibrous dysplasia

39
Q

Male 10-20 yo with small round blue cell tumor in the Diaphysis of his Femur or Pelvic girdle. MC radiological finding is?

A

Ewing sarcoma–> “Onionskin” appearance

40
Q

“Onionskin” appearance of bone on radiography?

A

Ewing sarcoma

41
Q

What forms of arthritis show “morning stiffness?”

A

RA
SLE
Polymyalgia rheumatica

42
Q

Homogentisic acid deposits in intervertebral disks showing Black color and leading to Osteoporosis. Dx?

A

Alkaptonuria

43
Q

Articular cartilage is made up of?

A

Type II collagen

Proteoglycans

44
Q

Osteophytes/ enlargement of DIP joints are called?

A

Heberdens nodes

45
Q

Osteophytes/ enlargement in PIP joints are called?

A

Bouchards nodes

46
Q

What are the common joint features in Osteoporosis?

A 
Subchondral sclerosis 
Bony spur
Osteophytes 
Joint mice-> cartilage fragments 
NO ANKYLOSIS
47
Q

Noninflammatory joint disease 2nd to neurological disease causing loss of Proprioception?

A

Neuropathic arthropathy

48
Q

Causes of Neuropathic arthropathy?

A

Diabetes Mellitus
Syringomyelia
Tabes dorsalis

49
Q

Disease of Women associated with HLA-DR4?

50
Q

B cells producing antibodies against Fc portion of IgG causes?

A

Rheumatoid factor–> RA

51
Q

Granulation tissue that releases cytokines and destroys articular cartilage?

A

PANNUS–> repair causes Ankylosis

52
Q

Ulnar deviation, Swan neck finger, Boutonniere deformity seen in?

53
Q

Describe joint space in RA?

A

Inflammation
PANNUS
eroding cartilage
Fibrous + BONE ankylosis

54
Q

What are some of the complications of RA?

A 
Chronic pleuritis 
Interstitial Fibrosis (NSIP pattern) 
Anemia of chronic disease 
Carpal Tunnel 
Bakers cysts (popliteal) 
Rheumatoid nodules (Caplan syndrome in LUNGS)
Sjogrens syndrome
55
Q

Initial therapy for RA is?

56
Q

Sjogrens syndrome is associated with developing?

57
Q

Male dominance arthritis caused by Alcohol, high meat diets, treating leukemias?

58
Q

What are some inborn errors of metabolism associated with GOUT?

A

HGPRT deficiency-> Lesch Nyhan syndrome

59
Q

Complications of Gout include?

A

Urate nephropathy
Uric acid stones
HTN

60
Q

Chronic gout leads to the formation of?

A

Tophi–> MSU deposits in soft tissue around joints

61
Q

RF negative, arthritis of Skeleton/spine, Male dominance, Sacroiliitis, HLA-B27?

A

Seronegative Spondyloarthropathy

Ex: Ankylosing spondylitis + Reiters syndrom + Psoriasis + Enterhepatic

62
Q

HLA-B27?

A

Spondyloathritis

63
Q

Male with Sacroiliitis morning stiffness?

A

Ankylosing Spondylitis

64
Q

Longterm consequences of Ankylosing Spondylitis?

A

Bamboo spine–> ankylosis of vertebrae
Aortitis w. Regurgitation
Uveitis –> Blindness

65
Q

Urethritis due to Chlamydia trochomatis, Achilles Tendon periostitis, conjunctivitis, Arthritis?

A

Reiters syndrome

66
Q

Conjunctivitis + Urethritis + Arthritis ?

A

Reiters syndrome

can’t SEE, cant PEE, cant climb TREE

67
Q

Sausage shaped DIP joints, “pencil-in cup” deformity” + nail pitting?

A

Psoriatic arthritis

68
Q

20yo female w. deficient in C5-C9, Knee arthritis, dermatitis?

A

Septic arthritis== Gonococcal

69
Q

FIbers rich in mitochondria, oxidative enzymes, poor ATPase enzymes?

A

Type I = Slow twitch

70
Q

Specailized for fine, skilled movements, poor mitochondria, rich in ATPase and glycolytic enzymes?

A

Type II== Fast twitch

71
Q

Weakness and wasting of pelvic muscles, Gower’s maneuver, Waddling gait. What is the genetics?

A

DMD–> X- recessive–> absent Dystrophin

72
Q

What lab finding is seen in DMD?

A

Increased CK @ birth

73
Q

Male adult pt, unable to relax grip, sagging face/ cant close mouth, testicular atrophy, cataracts. Genetics?

A

AD Tri-nulceatide repeats (CTG)–> Myotonic dystrophy

74
Q

Antibodies against ACh receptors, thymic hyperplasia, endrophium test positive. What are the clinical signs of this disease?

A 
Ptosis--> Upward gaze
Diplopia 
Proximal muscle weakness-> WORSE w. exercise 
Dysphagia for solids + liquids
NO sensory or reflex loss
75
Q

5ps; pain, paresthesia, pallor, paralysis, pulselessness?

A

Compromised blood supply–> COMPARTMENT syndrome

76
Q

Risk factors of Gonococcal arthritis?

A

C5-C9 deficiency
Recent menstruation
Pregnancy or postpartum
SLE

77
Q

Symmetric proximal muscle weakness + heliotrope rash + Elevated muscle enzymes + myopathic changes on EM + biopsy abnormality?

A

Polymyositis or Dermatomyositis

78
Q

Heliotrope rash is high specific for?

A

Dermatomyositis

79
Q

Anti-Jo antibodies?

A

Dermatomyositis or Polymyositis

80
Q

Specific mutation significant for Pg of Osteopetrosis?

A

Carbonic Anhydrase II –> Acidic environment is required for Bone resorption

81
Q

Fractures + leukopenia + hearing impairment + Renal tubule acidosis. Tx?

A

Osteopetrosis–> TRANSPLANT

82
Q

Pigeon breast deformity + Frontal bossing + Beads in the Ribs?

A

RICKETS

Beads= rachitic rosary

83
Q

Decreased Ca++ & phosphorus, increased PTH & ALK?

A

Osteomalacia

84
Q

Activation of Osteoblasts causes and increase in what serum test?

A

ALK –> Alkaline environment is required to LAY down bone

85
Q

Where does Osteomyelitis usually occur in children?

A

Metaphysis–> Growing bone need more Blood at the Metaphysis which brings in the Infection

86
Q

Adults with osteomyelitis will the infection located where?

A

Epiphysis–> blood supply goes through growth plate and takes infection more distal

87
Q

Main causes of avascular necrosis?

A

Trauma/ fracture
SCD
Steroids
Caissons

Rheumatology (4 decks)

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