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
fracture of the distal radius
Colles fracture
26
most common adult sarcoma | typically on thigh or retroperitoneum
liposarcoma | lipoblasts identified with fat stains
27
benign heart tumor associated with tuberous sclerosis
rhabdomyoma
28
pain, numbness, paresthesias of thumb, index finger, 2nd or 3rd finger thenar atrophy produces "ape hand"
carpal tunnel syndrome Tinel sign Phalen maneuver
29
atrophy of type I fibers inability to relax muscles (sustained grip) see: sagging face, frontal balding, testicular atrophy
myotonic dystrophy | muscle wasting and cardiac dysfunction cause death
30
type of hypersensivity reaction associated with myasthenia gravis
Type II | antibodies inhibit or destroy ACh receptors
31
gram + anaerobe that produces alpha-toxin (lecithinase) damages cells membranes & can cause hemolysis gas gangrene
Clostridium perfringens tx: PCN G + clindamycin hyperbaric oxygen
32
fibromatous tumor of the anterior abdominal wall in women | associated with previous trauma, FAP & Gardner syndrome
desmoid tumor
33
fibromatosis involving palmar fascia causes contracture of single or mult fingers -> hooklike deformity assoc with alcoholism, DM, epilepsy
Dupuytren contractures
34
dystrophic calcification which is visible on xray | larvae encyst in striated muscle
``` trichinella spiralis undercooked pork, bear & seal periorbital edema splinter hemorrhages in nails tx: albendazole ```
35
neurotoxin binds to spinal afferent fibers and inhibits release of glycine and GABA in spinal cord sustained motor stimulation of voluntary muscles
clostridium tetany begins with stiffness in the jaw that is painful vaccine: tetanus toxoid
36
septic arthritis after UG infection | affects wrists and ankles
N gonorrhoeae | tx: ceftriaxone
37
most common cause of nongonococcal septic arthritis
Staph aureus | tx: nafcilin & 3rd gen cephalosporin
38
bone of the hand that is prone to avascular necrosis due to its retrograde blood supply
scaphoid
39
compression of ulnar nerve at wrist or hand | seen in cyclists
Guyon canal syndrome
40
compression of lower trunk of brachial plexus and subclavian vessels
thoracic outlet syndrome | results in claw hand (? like Klumpke palsy from grabbing tree branch when falling)
41
nerve affected by anterior dislocation of humerus
axillary | see flat deltoid
42
nerve damaged by midshaft humoral fracture, crutches or sleeping with arm over chair
radial
43
nerve affected by fracture of medial condyle of the humerus or hook of the hammate
ulnar