MSK Flashcards
achondroplasia - gene mutation, pathophys
- most common inherited form of dwarfism
- mutation in FGF-3 (fibroblast growth factor 3)
- results in premature endochondral ossification leading to proximal limb shortening, frontal bossing, etc
ankylosing spondylitis (genetic factors, associated complications)
- HLA-B27
- uveitis and aortic regurg
osteogenesis imperfecta (type of collagen and affected tissues, genetics)
- defect in formation of type I collagen, due to AD mutation
- collagen I important in tensile strength, affected tissues: bone, skin, tendons, ears, teeth (blue sclera)
- defect in translation of mRNA
radial nerve innervation
- anterior compartment of the forearm except flexor carpi ulnaris and ulnar portion of flexor digitorum profundi
- thenar muscles and first and second lumbricals in the hand
ulnar n. innervation
- flexor carpi ulnaris and ulnar portion of the flexor digitorum profundi
- all of the muscles of the hand except thenar and lumbricals
median n. innervation
-entire posterior compartment of the forearm
heberden’s nodes
-enlargement of DIPs
RA vs OA
-OA: heberden’s nodes, weight bearing joints, degenerative disease, progressive, better after rest
giant cell arteritis
- common cause of unilateral or bilateral blindness
- associated with HA, fatigue, and polymyalgia rheumatologica (PMR)
- tx: high dose corticosteroids
gout (diagnosis (crystals), extraarticular manifestations and tx, both acute and chronic)
- negatively birefringant
- gout nephropathy and tophi are most common
- acute tx: indomethacin (or other NSAID) to treat inflammation and pain, colchicine
- chronic tx: allopurinol (decrease uric acid formaiton) and/or probenecid (increase excretion in urine)
4 muscles of jaw movement
- M’s munch and lateral lowers
- masseter, medial pterygoid and teMporalis
- lateral pterygoid
- all innervated by V3
ehlers-danlos (genetics, collagen type, sequelae)
- defect in collagen cross-linking
- collagen type III
- sequelae: scoliosis, vascular disorders, spontaneous ruptures of vessels and organs, retinal detachment
prostate cancer (associated lesion?)
-osteoblastic lesion
guillen-barre
- autoimmune, destruction of schwann cells
- starts distally, ascends symmetrically
- often follows camp. jejuni infection
cremaster muscle
- derived from internal oblique
sero-negative spondyloarthropathy
- reactive arthritis
- extra-articiular manifestations: conjunctivitis, arthritis
lyme disease (signs and symptoms) FAKE
-FAKE
facial nerve palsy, oligoarthritis, kardiac block, erythema migricans
ANCA vasculitides (what does ANCA mean, 3 vasculitides and p-ANCA vs c-ANCA)
- antineutrophil cytoplasmic antibody
- allergic granulomatosis and angiitis (churg-strauss)… eos, allergies/asthma… p-ANCA
- microscopic polyangiitis… p-ANCA
- granulomatosis and polyangiitis (wegners)… c-ANCA
rocky mountain spotted fever (common symptoms, causative agent, tx)
- rash starting on palms of hands and soles of feet, fever
- caused by rickettsia rickettsii, obligate intracellular parasite bacterium
- tx: tetracycline antibiotics ASAP
polyarteritis nodosum
- affects small to medium arteries, especially renal, GI and cardiac
- up to 20% of pts have Hx of HBV
- tx: with immunosuppression: glucocorticoids and/or cylcophosphamide
beurger’s vasculitis
- affects arteries of the extremities: claudication and raynauds
- often heavy smokers–> tx: quit smoking
takayasu’s vasculitis
- fibrotic thickening of the aortic arch (sometimes pulmonary arteries and rest of aorta)
- weaker pulses in upper extremities than lower
- tx: with steroids are CABG in non-responsive pts.
kawasaki’s
- oral erythema, conjunctivitis, edema and erythema of soles and palms, fever and enlarged nodes
- often self limited
- tx: with IV IG
toxic shock syndrome
- tsst-1, superantigen produced by staph infection
- creates non-specific activation of t-lymphocytes
- gram positive cocci on culture
most commonly injured ligament in ankle sprain
-anterior talofibular ligament
radial nerve innervates…
BEST
- brachioradialis
- extensors of wrist and fingers
- supinator
- triceps
most common cause of osteomyelitis in kids
-staph aureus
winging scapula
- injury to serratus anterior or long thoracic n.
- C5,6 and 7
anti-jo-1 antibodies
- polymyositis and dermatomyositis
- other signs/symptoms: symmetric proximal muscle weakness, heliotrope rash, elevated muscle enzymes
sjøgrens
- typically women, 35-45
- dry eyes, dry mouth and some other autoimmune or connective tissue disease
- HLA DR-3
polymyositis vs dermatomyositis
- both: symmetric progressive proximal muscle weakness
- poly: shawl rash, CD-8 T cells
- dermato: shawl and malar rash, CD-4 T cells, increase risk of malignancy, mechanics hands, gottron papules
osteomyelitis (common causes)
-IV drug users–> pseudomonas
3rd branchial arch
-stylopharyngeus, innervated by CN IX
injuries of superior and inferior gluteal n. (common associations and affected movements)
- superior: unable to stabilize hip when walking, swing straight leg circumferentially, associated with polio
- inferior: difficulty standing or jumping, defect with innervation to gluteus maximus, associated with hip dislocation
common type of fracture in child abuse
-spiral (twisting arm)
ewing’s sarcoma
- boys under 15, aggressive, but responsive to chemo
- small blue cells
- 11-22 translocation (patrick ewing’s number was 33)
osteosarcoma
- young men, 10-20 years old, often at metaphysis of long bones
- most common malignant tumor of the bone
waiters tip palsy
- stretching of C5-C6 nerve roots during birth, affects superior trunk
- arm is adducted, flexed and medially rotated
association with giant cell arteritis
-polymyalgia rheumatica
JIA (juvenile idiopathic arthritis)
- spiking and remitting fever that coincides with salmon-pink rash, also joint pain
- no Rh factor typically
- tx: NSAID, corticosteroids, IVIG etc
osteopetrosis
- failure of osteoclasts, bone marrow is replaced by bony matrix–> hematopoeisis fails, starts producing extramedullary
- brittle bones
- AD: less malignant, can be found incidentally
- AR: more malignant, usually fatal in utero or perinatal period
RRF (ragged red fibers)
- mitochondrial inheritance myopathy
- all kinds of bad symptoms
rhuematic fever
- group a beta-hemolytic strep (strep pyogenes)
- 2 of 5: migratory polyarthritis, carditis, subQ nodules, spreading circular erythema, chorea
most common hernia and anatomical predisposition
-indirect, due to failure of processes vaginalis to close
formation of long bones vs facial bones and skull bones (type of ossification)
- long bones: endochondral ossification, osteoblasts deposit minerals over hyaline cartilage mold
- facial/skull bones: membranous ossification, osteoblasts weave bone de novo
Tom, Dick And Very Nervous Harry
-Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, Vein, Nerve and flexor Hallucis
