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
Q

What is the galaezzi sign

A

Hips and knees flexed at 90 degrees
3- 6motnhs
Unilateral femoral shortening suggested by different knee heights

26
Q

Ewing’s sarcoma where?

A

Most common in shaft of femur, tibia or humerus
In diaphysis
NOT METAPHYSIS

27
Q

Which enzymes separate strands of DNA or RND

A

helicases

28
Q

Polyarteritis nodosa

A

Vasuclitis that affects renal arteries -> chronic renal failure
Cna occur 2nd to hep B

29
Q

Singns and symptoms of polyarteritis nodes

A

HTN
thrombosis
infarction
aneurysms
necrotising arteritis

30
Q

What does a renal biopsy show in polyarteritis nods

A

necrotising proliferative glomerulonephritis with crescentic formation
ANCA +Ve in 50% cases

31
Q

Erb’s palsy level of maximal plexus injury

A

C5 - C6

32
Q

What antibiodies causes congenital heart block

A

anti-Ro antiLo

33
Q

Difference between SLE and drug-induced lupus

A

DIL - anti-single strand DNA, anti-histones >95% in cases
DIL - sudden onset of symptoms post medication use

Medications - antifungal AED

34
Q

Where are buckle fractures most commonly seen?

A

Distal metaphysic