MSK

Question 1

first line treatment for acute gout

Answer 1

NSAIDs
second line: cochicine.
do not use allopurinol because it can make it worse

Question 2

Injury causing axillary nerve damage

Answer 2

dislocation of humerus (anterior is most common)

Question 3

positive HLA B27

Answer 3

ankylosing spondylitis

Question 4

what do you need to routinely check in ankylosing spondylitis?

Answer 4

chest expansion

pain can lead to decreased chest wall expansion and hypoventilation

Question 5

cause of vitiligo

Answer 5

loss epidermal melanocytes

Question 6

explain myopia improving with age

Answer 6

lens elasticity decreases with age–> cannot focus on near objects (prebyopia)
but if you have myopia, this results in retaining near vision and some improvement in myopia.

Question 7

what causes wrinkles?

Answer 7

decreases synthesis of dermal collagen and elastin

Question 8

female with persistent back pain, fatigue, poor sleep. pain worsens with exercise

Answer 8

fibromyalgia

Question 9

obturator nerve damage
injury
motor deficit
sensory deficit

Answer 9

injury: anterior hip dislocation
motor: thigh adduction
sensory: medial thigh

Question 10

femoral nerve damage
injury
motor deficit
sensory deficit

Answer 10

injury: pelvic fracture
motor: thigh flexion and leg extension
sensory: anterior thigh and medial leg

Question 11

greatest factor in determining peak bone mass

Answer 11

genetic factors

Question 12

course of median nerve through the arm

Answer 12

between biceps brachii and brachialis
between humeral and ulnar heads of pronator teres
between flexor digitorum superficialis and flexor digitorum profundus muscles
enters wrist

Question 13

function of small nuclear ribonucleoprotein (snRNP)

Answer 13

splices introns out of mRNA. works in spliceosomes

Question 14

RNA fragment with dihydrouracil, thymidine, and acetylcytosine residues

Answer 14

tRNA (has weird nucleosides)

ends in CAA before where amino acid attaches to OH

Question 15

Etanercept mechanism

Answer 15

TNF decoy receptor that binds TNF alpha

Question 16

actinic keratosis predisposes to

Answer 16

squamous cell carcinoma

Question 17

side effects of colchicine

Answer 17

GI distress (especially when given orally)

Question 18

mechanism of colchicine

Answer 18

binds intracellular tublin preventing polymerization into microtubules–> impairs leukocyte migration and phagocytosis (decreasing inflammation)

effect on GI cells causes side effects of GI upset

Question 19

common peroneal nerve damage
injury
motor deficit
sensory deficit

Answer 19

injury: trauma to lateral aspect of leg or fibula neck fracture
motor deficit: foot eversion and dorsiflexion, toe extension, food drop, foot slappage, steppage gait
sensory deficit: anterolateral leg and dorsal aspect of foot

Question 20

tibial nerve damage

Answer 20

injury: knee trauma
motor deficit: foot inversion and plantar flexion, toe flexion
sensory deficit: sole of foot

Question 21

superior gluteal nerve damage
injury
motor deficit

Answer 21

injury: posterior hip dislocation or polio

motor deficit: thigh abduction (positive trendelenburg)

Question 22

inferior gluteal
injury
motor deficit

Answer 22

injury: posterior hip dislocation

motor deficit: can’t jump clib stairs, rise fro seated position, cannot push downward (inferiorly)

Question 23

chronic lymphedema increases risk for?

Answer 23

angiosarcoma

Question 24

baby with flaccid lower extremities, absent lower extremity reflexes and poorly developed lumbar and sacral spine

Answer 24

caudal regression syndrome
may also have urinary incontinence and anal atresia

associated with poorly controlled maternal diabetes

Question 25

muscles used for sitting up (flexion)

Answer 25

external abdominal obliques rectus abdominis iliopsoas

Question 26

what kind of glands does smelly sweat come from?

Answer 26

apocrine glands

Question 27

alkaptonuria

Answer 27

lack of homogentisic oxidase blocking metabolism of phenylalanine and tyrosine build up of homogentistic oxidase tyrosine cannot be converted to fumerate

Question 28

amino acid sequence of collagen

Answer 28

Gly-X-Y XY may be proline or lysine

Question 29

mechanism of Osteogenesis imperfecta

Answer 29

defective synthesis of collagen type1 | problem with bone matrix formation

Question 30

histology of contact dermititis

Answer 30

spongiosis

Question 31

Raloxifene

Answer 31

SERM estrogen agonist in bone (for osteoporosis) antagonist in breast an uterus (for risk of breast cancer)

Question 32

empty can test

Answer 32

tests supraspinatus

Question 33

crystals in pseudogout

Answer 33

calcium pyrophospate | monosodium urate in gout

Question 34

capitation

Answer 34

physician is paid fixed fee per enrollee

Question 35

histo of skin s/p chronic topical steroid use?

Answer 35

``` dermal atrophy/thinning loss of dermal collagen drying, cracking of skin tightening of skin telangiectasias ecchymoses ```

Question 36

muscle weakness and cramping | with HCTZ use

Answer 36

hypokalemia

Question 37

which diuretic causes hypercalcemia?

Answer 37

HCTZ

Question 38

floppy baby, poor feeding, bid tongue, umbilical hernia

Answer 38

cretinism (hypothyroid)

Question 39

golgi tendon organ

Answer 39

sensor in muscle innervated by group 1b | sensitive to force and muscle tension

Question 40

muscle spindle system

Answer 40

monitors and maintains muscle length

Question 41

function of matrix metalloprotease

Answer 41

degradation of collagen and extracellular matrix proteins involved in wound contracture

Question 42

what step of vitamin D metabolism requires sunlight

Answer 42

7-dehydrocholesterol to Cholecalciferol

Question 43

What is the function of T tubules in the muscle fiber?

Answer 43

invaginations in the cell membrane and transmit depolarization signals--> uniform contraction of myofibrils

Question 44

mechanism of topical vitamin D for psoriasis

Answer 44

binds vitamin D receptor and inhibits keratinocyte proliferation and stimulates keratinocyte differentiation

Question 45

niacin deficiency symptoms

Answer 45

photosensitivty | skin rashes, ataxia

Question 46

Hartnup disease

Answer 46

excess loss of tryptophan--> niacin deficiency symptoms

Question 47

dark spots on sclera, dark urine, dark helix of ears

Answer 47

alkaptouria | deficient in homogentistic acid oxidase

Question 48

what is damaged when the tibia can be anteriorly displaced from femur

Answer 48

ACL

Question 49

what activates glycogen breakdown in muscle with contraction?

Answer 49

contraction increases Ca in cytosol--> activates phosphorylase kinase--> activates muscle phosphorylase

Question 50

mechanism of osteoporosis

Answer 50

porous bones: trabecular thinning

Question 51

what structures are damaged in radial head subluxation

Answer 51

annular ligament is torn and displaced

Question 52

effect of hypoestrogen on bone

Answer 52

increased bone resorption from increased osteoclast formation--> lower bone mass

Question 53

muscle affected by injury to long thoracic nerve

Answer 53

serratus anterior

Question 54

what artery runs with the radial nerve at the midshaft of the humerus?

Answer 54

deep brachial artery

Question 55

pellegra

Answer 55

niacin vitamin B3 deficiency (synthesized from tryptophan) | diarrhea, dermatitis, dementia

Question 56

changes in the post synaptic muscle cell with mysethenia gravis

Answer 56

reduced motor endplate potential

Question 57

specific marker for rheumatoid arthritis

Answer 57

anti CCP (cyclic citrullinated peptide)

Question 58

side effects of methotrexate

Answer 58

oral ulcers and hepatotoxicity

Question 59

Cidofovir

Answer 59

nucleotide monophospate | antiviral that does not need activation (like acyclovir, or gancyclovir)

Question 60

mechanism of terbinafine

Answer 60

inhibits synthesis of ergosterol by inhibiting squalene epoxide

Question 61

dystonia

Answer 61

sustained, involuntary muscle contractions forcing body parts into abnormal movements or postures

Question 62

mechanism of elevated Ca in sarcoidosis

Answer 62

activated T lymphocytes release IFN gamma - -> increases activity of 1 alpha hydroxylase activity in macrophages - -> extra renal conversion of 25-hydroxy Vit D- to 1, 25 dyhydroxy vit D

Question 63

where does Vit C mediated step of college formation take place in the cell

Answer 63

R endoplasmic reticulum