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MSK Flashcards

1
Q

Layers of the epidermis

A 
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale
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2
Q

includes claudins and occludins

prevents paracellular movement of solutes

A

tight junction

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3
Q

calcium-dependent adhesion proteins

A

cadherins

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4
Q

impaired cartilage proliferation in the growth plate
mutation of FGFR3 (gain of function) -> receptor normally inhibits cartilage proliferation
AD
short extremities with normal sized head (skull) and chest (ribcage) -> intramembranous bone formation not affected (flat bones okay)
mental function, life span & fertility not affected

A

achondroplasia = dwarfism

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5
Q

bone formation of a cartilage matrix which is replaced by bone

A

endochondral bone formation

long bones

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6
Q

Congenital defect of bone formation resulting in structurally weak bone
AD
defect in type I collagen synthesis
multiple bone fx (looks like child abuse?)
Blue sclera -> normally contains type I collagen -> blue due to exposure of the choroidal veins
hearing loss (fx of bones of middle ear)

A

Osteogenesis Imperfecta

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7
Q

Inherited defect of bone resorption (defect in osteoclasts)
thick, heavy bone that fractures easily -> like chalk
due to poor osteoclast function
Bony replacement of marrow causes anemia, thrombocytopenia, leukopenia with extramedullary hematopoiesis
vision impairment -> cranial nerve impingement
hydrocephalus -> narrow foramen magnum
RTA -> mutation in carbonic anhydrase results in decreased resorption of bicarb -> metabolic acidosis
(Note: acidic environment is needed to remove calcium from the bone during resorption)

A

Osteopetrosis

Tx: bone marrow transplant (osteoclasts are derived from monocytes)

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8
Q

Defective mineralization of osteoid
low levels of Vit D, resulting in low serum calcium & phosphate
child presents with:
pigeon-breast deformity -> pull of resp muscles on rib cage
frontal bossing (enlarged forehead)
bowed legs

A

Rickets

In adults, it is called Osteomalacia
weak bone with increased risk of fx
Lab: decreased Ca2+, phosphate; increased PTH & ALP
*whenever osteoblasts are active, ALP is elevated -> create an alkaline environment for osteoid to be laid down

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9
Q

reduction in trabecular bone mass
porous bone with increased risk of fx (hip, distal radius, vertebrae)
most common forms: senile & postmenopausal
measure bone loss with DEXA scan
Labs are normal -> excludes osteomalacia

A

osteoporosis

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10
Q

when does peak bone mass typically occur?

A

age 30

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11
Q

Imbalance of osteoclast and osteoblast function
late adulthood (age 60 yr)
localized process*
Result: thick sclerotic bone that fractures easily
Bx: mosaic pattern of lamellar bone (osteoblast trying to lay down bone but not in balance)
Increased hat size
bone pain from microfractures
hear loss
lion-like facies
high ALP with normal calcium, phosphate, PTH

A

Paget Disease

Tx: calcitonin -> inhibits osteoclasts
bisphosphonates -> induce osteoclast apoptosis
complication: osteosarcoma

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12
Q

Infection of marrow and bone, usually in children
hematogenous spread -> seeds metaphysis
most common cause: Staph aureus
Presentation: bone pain, fever, leukocytosis
XR: lytic focus (abscess) aka sequestrum surrounded by sclerosis aka involucrum

A

osteomyelitis

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13
Q

infection of vertebrae from TB

A

Pott disease

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14
Q

most commonly fractured bone in the wrist

susceptible to AVN

A

scaphoid bone (thumb side of the wrist)

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15
Q

femoral head fracture that disrupts blood supply

A

subcapsular

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16
Q

AVN of ossification centers in children

A

osteochondrosis

Caused by Legg-Calve-Perthes

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17
Q

lilac discoloration of upper eyelids
scaly erythematous eruptions on knuckles, elbows & knees
muscle weakness: getting up from chair or climbing stairs
B cells & CD4 T cells in muscle

A

dermatomyositis

If juvenile onset: rash, abdominal pain, calcinosis

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18
Q 
CD8 T cells and macrophages around & in muscle
symmetric proximal muscle involvement
intracellular deposition of amyloid
no skin involvement
may involve heart, lungs, bvs
A

polymyositis

19
Q

immune mediated loss of AChR
female
ptosis and diplopia
thymic hyperplasia -> improvement after thymectomy

A

myasthenia gravis

20
Q

seen with small cell carcinoma
muscle weakness that improves with repeated use
Fewer ACh vesicles released with action potential
Does not respond to AChE inhibitors

A

Lambert-Eaton myasthenic syndrome

21
Q

decoy receptor made by osteoblasts

short-circuits RANKL

A

osteoprotegrin (OPG)

22
Q

missense mutation of fibrillin
fibrillin in microfibrils normally sequesters TGF-beta, so in this case TGF-beta stays activated, causing damage
dislocation of lens
Cardiac risks: MVP & aortic dissection (cystic media necrosis)

A

marfan syndrome

23
Q

defect in fibrillar collagen
○ Skin is hyperextensible & joints are hypermobile
○ Predisposition to joint dislocation
○ Skin is stretchable and extremely fragile; vulnerable to trauma. Surgical repair is difficult
○ Internal complications also possibly present: colon rupture, large arteries, ocular fragility, rupture of cornea & retinal detachment, diaphragmatic hernia

A

Ehlers-Danlos syndrome

24
Q

Prevents damage to msk system by inhibiting muscle contraction when a muscle exerts too much force

A

Golgi tendon organs (GTO)

It is a negative feedback system that regulates and maintains muscle tension

25
Q

fracture of the distal radius

A

Colles fracture

26
Q

most common adult sarcoma

typically on thigh or retroperitoneum

A

liposarcoma

lipoblasts identified with fat stains

27
Q

benign heart tumor associated with tuberous sclerosis

A

rhabdomyoma

28
Q

pain, numbness, paresthesias of thumb, index finger, 2nd or 3rd finger
thenar atrophy produces “ape hand”

A

carpal tunnel syndrome
Tinel sign
Phalen maneuver

29
Q

atrophy of type I fibers
inability to relax muscles (sustained grip)
see: sagging face, frontal balding, testicular atrophy

A

myotonic dystrophy

muscle wasting and cardiac dysfunction cause death

30
Q

type of hypersensivity reaction associated with myasthenia gravis

A

Type II

antibodies inhibit or destroy ACh receptors

31
Q

gram + anaerobe that produces alpha-toxin (lecithinase)
damages cells membranes & can cause hemolysis
gas gangrene

A

Clostridium perfringens
tx: PCN G + clindamycin
hyperbaric oxygen

32
Q

fibromatous tumor of the anterior abdominal wall in women

associated with previous trauma, FAP & Gardner syndrome

A

desmoid tumor

33
Q

fibromatosis involving palmar fascia
causes contracture of single or mult fingers -> hooklike deformity
assoc with alcoholism, DM, epilepsy

A

Dupuytren contractures

34
Q

dystrophic calcification which is visible on xray

larvae encyst in striated muscle

A 
trichinella spiralis
undercooked pork, bear & seal
periorbital edema
splinter hemorrhages in nails
tx: albendazole
35
Q

neurotoxin binds to spinal afferent fibers and inhibits release of glycine and GABA in spinal cord
sustained motor stimulation of voluntary muscles

A

clostridium tetany
begins with stiffness in the jaw that is painful
vaccine: tetanus toxoid

36
Q

septic arthritis after UG infection

affects wrists and ankles

A

N gonorrhoeae

tx: ceftriaxone

37
Q

most common cause of nongonococcal septic arthritis

A

Staph aureus

tx: nafcilin & 3rd gen cephalosporin

38
Q

bone of the hand that is prone to avascular necrosis due to its retrograde blood supply

A

scaphoid

39
Q

compression of ulnar nerve at wrist or hand

seen in cyclists

A

Guyon canal syndrome

40
Q

compression of lower trunk of brachial plexus and subclavian vessels

A

thoracic outlet syndrome

results in claw hand (? like Klumpke palsy from grabbing tree branch when falling)

41
Q

nerve affected by anterior dislocation of humerus

A

axillary

see flat deltoid

42
Q

nerve damaged by midshaft humoral fracture, crutches or sleeping with arm over chair

A

radial

43
Q

nerve affected by fracture of medial condyle of the humerus or hook of the hammate

A

ulnar

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