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Miller's Biology Flashcards

1
Q

high strain cells in healing

A

fibroblasts -> fibrous union

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2
Q

cells that respond to medium strain, low oxygen in bone healing

A

chondroblasts -> cartilage

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3
Q

cells that respond to low strain, high oxygen in bone healing

A

osteocyte/osteoblast -> bone healing/formation

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4
Q

What secretes sclerostin?

Function of sclerostin?

A

Osteocytes

inhibits osteoblasts via Wnt pathway

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5
Q

PTH effect on sclerostin

A

increases

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6
Q

Calcitonin effect on sclerostin

A

decreases

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7
Q

Osteoclast cell of origin

A

macrophage lineage

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8
Q

molecules involved in osteoclast attachment to bone

A

integrins to vibronectin (RGD sequence)

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9
Q

major proteolytic enzyme in bone resorption

A

cathepsin K

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10
Q

mutation in Cathespine K causes

A

Pyknodysostosis

Cath’rine Pyknod the wrong profession so we stole her distal phalanges (represents distal phalanx osteolysis)

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11
Q

mutation in carbonic anhydrase causes

A

osteopetrosis

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12
Q

what does calcitonin act on

what is effect

A

acts on receptor on osteoclast to decrease its activity

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13
Q

secreted by tumor cells to cause osteolysis

A

IL 1

PTHrP

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14
Q

tensile strength to bone

A

collage

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15
Q

gives compressive strength to bone

A

proteoglycans

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16
Q

single most important factor determining bone healing

A

blood supply

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17
Q

cartilaginous extracellular matrix is degraded in fracture healing by

A

MMP13

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18
Q

increases mechanical strenth of callus and produces nano motion

A

LIPUS

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19
Q

how is cancellous graft incoroporated

A

creeping substitution

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20
Q

cell of origin for calcitonin

A

clear cells of thyroid

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21
Q

physis zone of rickets

A

zone of provisional calcification

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22
Q

PHEX gene mutation

A

X linked familial hypophosphatemic rickets

cannot absorb phosphate

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23
Q

rickets and patient is totally bald

A

Vit D dependent rickets

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24
Q

medications that disrupt bone mineralization

A 
prednisone
PPIs
seizure meds
SSRIs
heparin
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25
Q

clonazepam can cause osteoporsis via

A

increase in sclerostin

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26
Q

1 compression fx increases risk of hip fx by

A

5x

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27
Q

avg year of bisphosphonate use leading to atypical subtroch fx

A

4 years

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28
Q

osteoporosis med CA in Pagets

A

teriparatide (forteo)

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29
Q

progression of nerve recovery sx’s

A 
sympathetic activity
pain 
temp 
touch proprioception
motor
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30
Q

most prominent proteoglycan in tendon

A

decorin

bglycan

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31
Q

initial collagen in tendon healing

A

III

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32
Q

proteoglycan that regulates tendon diameter

A

decorin

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33
Q

tendon is weakest at what point in healing process

A

7-10 days

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34
Q

stress equation

A

Force/Area

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35
Q

strain equation

A

change in length/original length

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36
Q

maximum stress a material can sustain before breaking

A

ultimate strength

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37
Q

diff btw yielf point and fx point

A

ductility - how much it can bend before breaking

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38
Q

molecule of ligament that allows for toe region

A

elastin

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39
Q

instant center of motion in wrist

A

capitate

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40
Q

mutation causing defective sulfate transporter

A

Diastrophic Dysplasia

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41
Q

Genetic Defect in SOX9

A

Campomelic Dysplasia

  • short long bones
  • bowed femurs
  • all die at infancy: hear, kidney, lung defective
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42
Q

Location of Type X collagen in cartilage

A

Calcified zone

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43
Q

Cartilage layer with highest Lubricin

A

Tangential zone

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44
Q

Type A cells of synovium

A

mAcrophage like cells that remove waste and such

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45
Q

What molecule contributes most to joint fluid viscosity

A

Hyaluronic Acid

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46
Q

Nonnewtonian - less viscous with stirring

Thixotropic - flows more easily with shear stress and is shear thinning

A

Synovial fluid

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47
Q

CAuses of Neuropathic Arthritis

A

Charcot (DM)
Syphilis (hip/knee)
Syrinc (shoulder/elbow)
Leprosy

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48
Q

AR defect of homogentisic acid oxidase

A

Ochronosis (Alkaptonuria)

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49
Q

Diabeteis, increase LFT’s, hyperpigemented skin

Mulitple arthritic joints

A

Hemochromatosis (Bronze Diabetes)

- elevated ferritin

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50
Q

crystal with X in it

A

Ca+ Oxalate

51
Q

Positive birefringent

A

Pseudogout - calcium pyrophosphate

52
Q

Normal function of FGF-23

A

decreaese renal reabsorption of PO4 (thus decreases serum phosphate)

53
Q

2 causes of tumoral calcinosis

A

FGF23 defect

Renal disease

54
Q

Synovial biopsy shows macrophages with CHICV RNA “hijacked” and natural killer cells

A

Chikungunya = chronic viral polyarthritis

- RNA alpha virus via mosquitos

55
Q

Arthritis with morning stiffness lasting longer than an hour

56
Q

Mopst sensitive and specific lab testing for RA

57
Q

What is humoral immunity

A

soluble components in the serum that kill microorganisms inactive toxins clump and lyse RBCs increase macrophage phagocytosis

58
Q

Main cell involved in Humoral immunity

A

B cell -> secreste Ig

59
Q

What is rheumatoid factor

A

IgM to IgG

60
Q

ANA + diseases

A

Lupus

Scleroderma

61
Q

Type of reaction

- Aseptic lymphocyte vasculitis-assoc lesion

A

Type IV hypersensitivity

62
Q

Seronegative Spondyloarthropathies

A

Ank Spon
Psoriatic Arthritis
Reactive Arthritis (Reiter’s Syndrome)

63
Q

Most common cause or Reiter’s

A

Chlamydia

Diarrheal Illness: Shigella, Yersinia, Salmonella

64
Q

Most common bug of cellulitis

A

Group A strep

65
Q

Most common bug of necrotizing fasciitis

A

Group A strep (strep pyogenes)

66
Q

Skin finding particular to nec fasciitis

A

non-blanching skin

67
Q

bla gene mutant

A

resistant to penicillin

68
Q

mecA gene

A

provides methicillin resistance

69
Q

Alternative to Vanc for MRSA

70
Q

When to repeat intraop abx

A

1 L blood loss

at 3 hours

71
Q

Heavy EtOH effect on bone

A

decreases
impairs fx healing
inhibits Wnt pathway
decrease fibroblast propduction of collagen type I

72
Q

When to stop RA biologics

A

For the duration of dosing + 1 wk

73
Q

indication that Lupus is severe

A

nephritis/renal issues

74
Q

lysine analog that binds plasminogen

75
Q

how much bacteria do you need to cause an infection

76
Q

Indication that Lupus is severe

A

nephritis/renal issues

77
Q

Abx for human and animal bites

78
Q

How much bacteria do you need to cause an infection

79
Q

culture negative bacteria in osteomyelitis in kid think

- how is it ID’d in the lab

A

Kingella Kingae

- PCR

80
Q

Cytokine that triggers proteolytic enzymes that destroy cartilage in infection

81
Q

Culture negative bacteria in osteomyelitis in kid think

- how is it ID’d in the lab

A

Kingella Kingae

- PCR

82
Q

MSK infection after URI in < 5 yo

A

Kingella Kingae

83
Q

Treatment of gonococcal arthritis

A

Ceftriaxone

84
Q

Intracellular gm - diplococci

A

gonnococcal

85
Q

Lytic lesion in late stage AIDS and cate exposure

A

Bartonella

86
Q

Treatment for Chronic non-bacterial osteomyelitis

A

NSAIDs
aka- Chronic Recurrent Mulitfocal Osteomyelitis
it’s an autoinflammtory bone disease
adult version is SAPHO- synovitis Acne pustulosis hyperostosis osteitis

87
Q

Rrisk of HIV transmission with single needle stick

88
Q

Single stick tramission risk with hep B

89
Q

Single stick transmission risk with Hep C

90
Q

Anti-centrome ab’s

A

CREST syndrome

91
Q

Anti-histone

A

drug induced Lupus

92
Q

Anti-U

A

mixed connective tissue diseases

93
Q

anti-smith

A

Systemic Lupus

94
Q

how to treat bilateral winging in fascioscapulohumeral muscular dystrophy

A

scapulothoracic fusion

95
Q

2 fertilized eggs that merge together that create one organism

A

chimera- XX/XY = gives rise to remale phenotype

96
Q

Turn on or off gene

  • fibrous dysplasia
  • NF1
A

fibrous dysplasia-> on (somatic mutation NOT inherited)

NF1- turning of tumor suppressor gene

97
Q

only X linked dominant

A

hypophophatemic rickets

98
Q

ortho issue in Down syndrpome

A

Laxity

COL6 on chromosome 21
- collage VI is overexpressed

99
Q

cancer cause by chromosmal deletion

A

Mulitple Myeloma

- chromosome 13 copy is missing

100
Q

which embryologic layer dores msk system come from

101
Q

marker of osteoblast differentiation

A

alk phos

  • the by product of conversion of pyrophosphate (PPi) to phosphate ion which favors ossification
  • via hydrolosys
102
Q

rickets like picture with low alk phos

A

hypophospohatasia

- AR where PPi accumulates and inhibits bone mineralization

103
Q

most potent/abundant osteoblast stimulator

104
Q

gene that guides radial/ulnar limb growth

A

Sonic hedge hog

- hand - high levels is pinky side, low side is thumb side

105
Q

genetic basis for fibular hemimelia

A

poor sonic hedge hog protein

106
Q

genetic basis for postaxial polydactyly

A

sonic hedge hog overexpressed

107
Q

gene stimulates/regulates dorsal/ventral limb pattern growth

108
Q

bone formation method by which distraction osteogenesis works

A

intramembranous

109
Q

first bone to ossify

A

clavicle

- also the last

110
Q

notable enzymes of osteoclasts

A 
Carbonic anhydrase
Chloride channel giving rise to hydrochloric acid
Cathepsin K- dissolves organic matrix
TRAP- a marker for osteoclasts
Vacuolar H+ ATPase
111
Q

Cathepsin K deficiency disease

A

pyknodysostosis

112
Q

enzyme messed up in Morquio

A

galactose sulfatase

113
Q

defect in enzyme function is what inheritance

114
Q

defect in protein function is what inheritance

115
Q

avoid ligamentous procedures in

A

Ehlers Danlos

116
Q

Virchow’s Triad

A

hypercoagability
endothelial damage
stasis

117
Q

Indications for IVC filter

A

CA to anticoagulatio
Failure of anticoagulation
complication from anticoagulation

118
Q

Indications for IVC filter

A

CA to anticoagulation
Failure of anticoagulation
complication from anticoagulation

119
Q

Andexanet

A

antidote for Xarelto

120
Q

recommendation for long plane flights

A

stay hydrated

walk the cabin

121
Q

treatment for ARDS

A

ventilation with PEEP to keep alveoli open

- only intubate if necessary

122
Q

best clinical indicator of inadequate fluid rescitation

best lab for inadequate resus

A

urine output < 30cc/hr

lactate > 2.5

123
Q

best clinical indicator of inadequate fluid resuscitation

best lab for inadequate resus

A

urine output < 30cc/hr

lactate > 2.5

124
Q

earliest sign and most sensitive/specific sign of malignant hyperthermia

A

uneplzined rise in end tidal CO2

ABOS (14 decks)

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