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MSK Flashcards

1
Q

first line treatment for acute gout

A

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

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2
Q

Injury causing axillary nerve damage

A

dislocation of humerus (anterior is most common)

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3
Q

positive HLA B27

A

ankylosing spondylitis

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4
Q

what do you need to routinely check in ankylosing spondylitis?

A

chest expansion

pain can lead to decreased chest wall expansion and hypoventilation

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5
Q

cause of vitiligo

A

loss epidermal melanocytes

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6
Q

explain myopia improving with age

A

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.

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7
Q

what causes wrinkles?

A

decreases synthesis of dermal collagen and elastin

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8
Q

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

A

fibromyalgia

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9
Q

obturator nerve damage
injury
motor deficit
sensory deficit

A

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

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10
Q

femoral nerve damage
injury
motor deficit
sensory deficit

A

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

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11
Q

greatest factor in determining peak bone mass

A

genetic factors

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12
Q

course of median nerve through the arm

A

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

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13
Q

function of small nuclear ribonucleoprotein (snRNP)

A

splices introns out of mRNA. works in spliceosomes

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14
Q

RNA fragment with dihydrouracil, thymidine, and acetylcytosine residues

A

tRNA (has weird nucleosides)

ends in CAA before where amino acid attaches to OH

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15
Q

Etanercept mechanism

A

TNF decoy receptor that binds TNF alpha

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16
Q

actinic keratosis predisposes to

A

squamous cell carcinoma

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17
Q

side effects of colchicine

A

GI distress (especially when given orally)

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18
Q

mechanism of colchicine

A

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

effect on GI cells causes side effects of GI upset

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19
Q

common peroneal nerve damage
injury
motor deficit
sensory deficit

A

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

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20
Q

tibial nerve damage

A

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

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21
Q

superior gluteal nerve damage
injury
motor deficit

A

injury: posterior hip dislocation or polio

motor deficit: thigh abduction (positive trendelenburg)

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22
Q

inferior gluteal
injury
motor deficit

A

injury: posterior hip dislocation

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

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23
Q

chronic lymphedema increases risk for?

A

angiosarcoma

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24
Q

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

A

caudal regression syndrome
may also have urinary incontinence and anal atresia

associated with poorly controlled maternal diabetes

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25
Q

muscles used for sitting up (flexion)

A

external abdominal obliques
rectus abdominis
iliopsoas

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26
Q

what kind of glands does smelly sweat come from?

A

apocrine glands

27
Q

alkaptonuria

A

lack of homogentisic oxidase blocking metabolism of phenylalanine and tyrosine

build up of homogentistic oxidase

tyrosine cannot be converted to fumerate

28
Q

amino acid sequence of collagen

A

Gly-X-Y

XY may be proline or lysine

29
Q

mechanism of Osteogenesis imperfecta

A

defective synthesis of collagen type1

problem with bone matrix formation

30
Q

histology of contact dermititis

A

spongiosis

31
Q

Raloxifene

A

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

32
Q

empty can test

A

tests supraspinatus

33
Q

crystals in pseudogout

A

calcium pyrophospate

monosodium urate in gout

34
Q

capitation

A

physician is paid fixed fee per enrollee

35
Q

histo of skin s/p chronic topical steroid use?

A 
dermal atrophy/thinning
loss of dermal collagen
drying, cracking of skin
tightening of skin
telangiectasias
ecchymoses
36
Q

muscle weakness and cramping

with HCTZ use

A

hypokalemia

37
Q

which diuretic causes hypercalcemia?

A

HCTZ

38
Q

floppy baby, poor feeding, bid tongue, umbilical hernia

A

cretinism (hypothyroid)

39
Q

golgi tendon organ

A

sensor in muscle innervated by group 1b

sensitive to force and muscle tension

40
Q

muscle spindle system

A

monitors and maintains muscle length

41
Q

function of matrix metalloprotease

A

degradation of collagen and extracellular matrix proteins

involved in wound contracture

42
Q

what step of vitamin D metabolism requires sunlight

A

7-dehydrocholesterol to Cholecalciferol

43
Q

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

A

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

44
Q

mechanism of topical vitamin D for psoriasis

A

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

45
Q

niacin deficiency symptoms

A

photosensitivty

skin rashes, ataxia

46
Q

Hartnup disease

A

excess loss of tryptophan–> niacin deficiency symptoms

47
Q

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

A

alkaptouria

deficient in homogentistic acid oxidase

48
Q

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

A

ACL

49
Q

what activates glycogen breakdown in muscle with contraction?

A

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

50
Q

mechanism of osteoporosis

A

porous bones: trabecular thinning

51
Q

what structures are damaged in radial head subluxation

A

annular ligament is torn and displaced

52
Q

effect of hypoestrogen on bone

A

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

53
Q

muscle affected by injury to long thoracic nerve

A

serratus anterior

54
Q

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

A

deep brachial artery

55
Q

pellegra

A

niacin vitamin B3 deficiency (synthesized from tryptophan)

diarrhea, dermatitis, dementia

56
Q

changes in the post synaptic muscle cell with mysethenia gravis

A

reduced motor endplate potential

57
Q

specific marker for rheumatoid arthritis

A

anti CCP (cyclic citrullinated peptide)

58
Q

side effects of methotrexate

A

oral ulcers and hepatotoxicity

59
Q

Cidofovir

A

nucleotide monophospate

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

60
Q

mechanism of terbinafine

A

inhibits synthesis of ergosterol by inhibiting squalene epoxide

61
Q

dystonia

A

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

62
Q

mechanism of elevated Ca in sarcoidosis

A

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
63
Q

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

A

R endoplasmic reticulum

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