MSK Flashcards

1
Q

Embryology of MSK system

A

Mostly from mesoderm
Mesoderm separates-
paraxial -> somites -> scleromyotypes and dermomyotypes
Scleromyotpoes -? vertebral column
dermomyotome -> dermal and muscle
derm and lateral lum bud forms

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2
Q

What cells differentiate into one and cartilage

A

Mesenchymal cells

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3
Q

Histology of muscles

A

Striated muscle
Cross sections alternate from light and ark banking (Actin and myofibril)
Z discs - in-between z discs are sarcomere

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4
Q

SLE - pathophysiology

A

Autoimmune dysfunction involving -
B cells
dendritic cells
Autoantibodies
T cells
proinflammatory cytokines

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5
Q

Diagnosis criteria of SLE - 4 out of 11

A

malar rash
discoid rash
photosenitivity
oral ulcers
arthritic
serositis
proteinurina
seizures or psychosis
haematological disorder
anti-dna anti Sm or APA
Positive ANA

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6
Q

Management of SLE

A

Non-pharmacological - UV light avoidance, bone health, monitoring of renal, vaccinations of pneumoccous and influenza
NSAIS
Hydrochloroquine
Methotrexate
Rituximab

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7
Q

Which HLA is Behchets disease ass. with

A

HLA-B5

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8
Q

What is bEHCET’S DISEASE

A

Autoimmune
Uveitis
Oral and genital ulcers
Erythema nodosum

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9
Q

Juvenile idiopathic arthritis

A

Chronic arthritis affecting one or more joints which persist for longer than 6 weeks

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10
Q

What is common type of JIA

A

Oligoarticular (<4 joints involved)

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11
Q

JIA Pathophysiology

A

Imbalance of regulatory T cells, TH17 and TH1 of adaptive immunity
Cytokines and matriculates metalloproteinases lead to joint damage

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12
Q

JIA investigations

A

Clinical diagnosis

ESF, ferritin
ana
RF
HLA-B27

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13
Q

Systemic JIA

A

thrombocytosis
lymphocytosis

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14
Q

Management of JIA

A

NSAIDS
Steroid injections
methotrexate
Adalimumbar
Tocilizumab
Tofacitinib

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15
Q

How often do you need eyes screened in JIA

A

Screened for anterior uveitis as soon as possible after diagnosis
Bi-monthly screens for six months then by screening every 3 to 4 months up to age 12

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16
Q

Is chronic anterior uveitis in oligoartiuclar JIA bilateral or unilateral

A

bilateral in 70% of cases

17
Q

How many joints does polyarticular JIA involved?

A

5 joints or more

18
Q

Signs and symptoms of polyarticular JIA

A

Symmetrical
Small joints of hands and feet as well as large
minimal systemic symptoms
RF +ve
RF -ve

19
Q

Ehthesitis-related arthritis

A

Teenage boys
Asymeetrical arthritis of lower-limbs
Acute anterior uveitis
HLA B27

20
Q

Systemic-onset juvenile idiopathic arthritis

A

Stills disease
Prominent systemic features at onset in addition to one or more joints
High fever that spikes daily with a salmon coloured rash

21
Q

Risk factors of DDH

A

Breech
Family Hx
Fixed foot deformities
Multiple pregnancies
Female
Spina bifida

22
Q

Pahtophysiology of DDH

A

DDH occurs during fatal development when the femoral head is not fully in contact with acetabulum
Girls more likely due to circulating maternal hormone relaxin - increases laxity of ligaments

23
Q

What is ortolans test

A

Hips and knees flexed,
Abduct hips - ?dislocate anterioly

24
Q

Barlow test

A

Hips adducted and flexed at 90 degrees,
Gentle pressure placed on knees through femur to see if femoral head will dislocate posteriorly

25
What is the galaezzi sign
Hips and knees flexed at 90 degrees 3- 6motnhs Unilateral femoral shortening suggested by different knee heights
26
Ewing's sarcoma where?
Most common in shaft of femur, tibia or humerus In diaphysis NOT METAPHYSIS
27
Which enzymes separate strands of DNA or RND
helicases
28
Polyarteritis nodosa
Vasuclitis that affects renal arteries -> chronic renal failure Cna occur 2nd to hep B
29
Singns and symptoms of polyarteritis nodes
HTN thrombosis infarction aneurysms necrotising arteritis
30
What does a renal biopsy show in polyarteritis nods
necrotising proliferative glomerulonephritis with crescentic formation ANCA +Ve in 50% cases
31
Erb's palsy level of maximal plexus injury
C5 - C6
32
What antibiodies causes congenital heart block
anti-Ro antiLo
33
Difference between SLE and drug-induced lupus
DIL - anti-single strand DNA, anti-histones >95% in cases DIL - sudden onset of symptoms post medication use Medications - antifungal AED
34
Where are buckle fractures most commonly seen?
Distal metaphysic