MSK Flashcards
Superior trunk lesion?
Erb Duchenne - waiters tip
Lesion of inferior trunk?
Thoracic outlet syn
Klumpkes palsy
Achondroplasia mut
AD mut in FGFR3 on chr 4
GAIN OF FXN
Worst type of osteogenesis imperfecta?
Type 2 - AR
-fx, blue sclera, teeth, loss hearing
2 dzs that cause erlenmyer flask widening of bone?
Osteopetrosis
Gauchers
Osteopetrosis and 3 diff types
Inherited defect in osteoclast –> no remodeling
AR - early onset
AD - adult - lots of fx
Def of carbonic anhydrase II - need CA to break down bone – get renal tubular acidosis and cerebral calcification
Another name for Paget dz?
Osteitis deformans
Paget dz
Think of Bethoven - skull deformity hearing loss, lion facies, hat didn’t fit
D/t hypervascularity - bone can feel warm
Paget dz marker?
Increased alk phos
Urine: hyroxyproline
If hat doesn’t fit, think of?
Paget
If hat, shoes and gloves don’t fit, think of?
Acromegaly
Alendronate
Bisphosphonate - tx for osteoporosis
Osteomalacia labs:
Decreased: Ca2+ and phosphate
Inc: alk phos
MC osteomyleitis:
S. aureus
MC osteomyleitis sex active:
N. gonorrhea
MC osteomyleitis sickle cell:
Salmonella
MC osteomyleitis missing complement:
Neiserria
MC osteomyleitis IV drug user or DM:
Pseudomonas
Tuberculosis osteomyelitis
Caseating granulomas of bone
Pott dz - vertebrae
Complication: psoas abscess
Osteoma assoc with what sun?
Gardner
+ colon polyps, skin cysts
Acetaminophen overdose depletes?
Glutathione so body can’t get rid of it
Acetaminophen OD antidote?
N-acetylcysteine
6 yo painless limp?
Avascular necrosis
AKA Legg calve perthes dz
Myositis ossificans
Runner with previous injury can get reactive calcification in soft tissue
O’Donohue triad?
AKA Unhappy triad - lateral side of knee Injuries to: ACL MCL M meniscus
Fx proximal shaft of radius, before casting?
Supinate - protect pronator teres
Hangmans fracture?
Fx of pedicles of C2 d/t hyperext
ie. MVA
Sever disease
Young athlete - traction apophysistis of calcaneus at attachment of Achilles
Tx: RICE
Spondylolithesis
Ant displacement - listing forward
SpondylolOlysis
Parts interarticularis - stress fx
Whiplash damages?
Ant long lig
Notorious cause of fever unknown origin?
Still dz - variant of juvenile RA
Coccygodynia
Proctalgia fugax - sudden rectal pain at noc
Incontinence, assoc birth
Fancy fucking name for club foot?
Talipes equinovarus
Severe supination sprain of ankle, pt tender at prix head of 5th metatarsal. Most likely?
Avulsion fx - tendon pulled away - MC tendon? Peroneus brevis
what mediates Ca2+ activation of contraction in skeletal and cardiac m?
Troponin
What mediates Ca2+ activation in smooth m?
Calmodulin
Supracondylar fx of humerus damages?
Median n. = ulnar deviation of hand on flexion of wrist
Ulnar lesion
Claw of 4th and 5th
Wasting hypothenar
Pudendal n block use?
Ischial spine as guide
Median n lesion
Loss sensation thumb, 1st 2 digits
atrophy thenar
CTS
Innervates 1st lumbrical
MS HLA?
DR2
Tx for MS?
IFN-Beta
Cubital fossa
TAN
Tendon biceps brachii
A - brachial a - medial to tendon
N - median n
Anti-microsomial Ab assoc?
Hypothyroid
Anti-ribonucleoprotein Ab assoc?
Mixed CT disease
Anti-mitochondrial Ab assoc?
Primary biliary cirrhosis
Anti-centromere Ab assoc?
CREST syn
Under rib neurovascular bundle order?
VAN - damage n if do decompression below rib
Femoral hernia
Exits through the femoral ring
NAVel - venous nearest the penis
Ant dislocated humerus?
Axillary n
loss sensation over upper lateral arm
Why no trach on RA pt?
Atlantoaxial joint subluxation
can = acute compression of SC or vertebral a
Triceps reflex?
C7
Charcot Marie Tooth dz
Stork like legs - lower limb m wasted
Pes cavus
What infection can cause Paget dz of bone?
Paramyxovirus inf of osteoclasts + genetic susceptibility
If radio labeled ATP injected during m contraction?
Attaches to sarcomere and myosin head detaches
MG caused by Abs against?
Post syn nicotinic ACh R
= dec motor end plate pot
Tx MG?
Pyridostigmine - AChE inhibitor
Lambert Eaton MG Abs against?
Voltage gated Ca2+ channel for ACh release
50% have malignancy - ie. small cell lung CA
Chondrosarcoma
40-60s - hip palp lump in soft tissue just lateral to PSIS
XR: Soft tissue mass w erosion R iliac cortex
Ewings Sarcoma
Teen - diaphysis - onion skin from layers of calcified periosteum
t(11:22)
Assoc. CD99
Duchenne MD
XLR - lack of dystrophin
Tx chronic gout
Probenecid
Colchicine
Acute gout - inhibits tubulin polymerization - disrupts the cytoskeleton
DOC if high levels of uric acid in urine?
Allopurinol
HCTZ
Thiazide diuretic
Inhibits reabsorption of Na Cl and inhibits the excretion of uric acid = hyperuricemia and gout
Friedrich Ataxia
Mut: frataxin gene
Neuro, cardiomyopathy, DM, loss proprio, DTR
Gout synovium:
Needle, neg birefringent
Cloudy yellow fluid with few RBCs and normal glucose
RA synovium:
Decreased glucose
Septic arthritis synovium:
Grey, huge amt of neuts, i.e. 92%
decreased glucose
+ direct Coombs
Autoimmune hemolysis
SLE specific test?
Anti-ds DNA Abs
SLE sensitive test?
ANA
3 MC Drug induced SLE
H - hydralazine
I - isoniazid
P - procainamide
FOOSH assoc with
Colles fx - extraarticular fx of distal radius
Scaphoid fx
Overexpression of RANK?
(Receptor activator of nuclear factor kappa B)
Inc bone resorption - inc osteoclast activity
Which m band is only thick myosin?
H band
Where is actin bound to structural proteins?
Z line
Thin myofilament?
Actin
Sarcomere goes from?
Z to Z
What is rheumatoid factor?
IgM Ab specific for Fc component of self IgG
-binds and deposits in synovium and cartilage
Rickets d/t?
Excess of unmineralized matrix
McCune Albright syn?
GNAS gene = activating mut in CAMP pathway
Cafe au lait spots, endocrine abnl, fibrous dysplasia of hip or pelvis
Median n passes through?
2 heads of pronator teres m
Innervates - pronator teres and opponenes pollicis
MC form of skin CA?
Basal cell
Basal cell carcinoma
Common on face - pearly papules, central ulceration and telangiectasias
H: palisading nuclei
Blood to femoral head?
Medial femoral circumflex a
Cleft lip failure of?
L max prominence to unite w L medial nasal prominence
Cleft palate failure of?
Palantine shelves (max prominences) to fuse
Common MS lesion affecting vision?
MLF - internuclear ophthalmoplegia
Ie. R eye doesn’t move past midline when attempting L gaze
Rotator cuff m
S - supraspinatus
I - infraspinatus
t - teres minor
S - subscapularis
Medial epicondylitis
Golfer from flexion
Lateral epicondylitis
Tennis from extension
Fx to surgical neck of humerus
Axillary n
Loss abd shoulder, sensation to deltoid
Fx midshaft of humerus
Sat night palsy
Radial n - wrist drop
Upper trunk compression damages?
Musculocutaneous n (C5-7) Loss forearm flex and supination
Apehand
Supracondylar fx of proximal humerus
Damages: median n
Popes hand damages?
Median n
Fx medial epicondyle of humerus or fx hook o’ hamate
Ulnar claw
Atrophy of hypothenar
Osteoid osteoma
teen, tender, teen, tibia
ASA = get better
XR: center lucency, sclerotic rim
RA HLA assoc?
DR4
4 seronegative arthropathies
RAPE - HLA-B27 R - reactive arthritis A - ankylosing spondylilitis P - psoriatic arthritis E - enteropathic arthritis
Lesch Nyhan Syn
XL
Lef HPRT - hypoaxanthine guanine phosphoribosyl transferase
MR, spastic
self-mutilation of lips, fingers
Tophi
Chalky white deposits
Gout
Tx for gout that helps excrete uric acid
Probenicid
Pseudogout
AKA chrondrocalcinosis
Rhomboid crystals, pos birefringent
Assoc: metabolic
Lyme dz
Borrelia burgdorferi
Ixodes tick
Bulls eye, migratory arthritis, 3rd degree heart block
Ixodes tick causes what 2 things?
Borrelia burgdorferi
Babesia
Polymyositis
Chronic inflam in m fibers
B/L proximal m weak
H: endomysial lymphocytic inflam
Dermatomyositis
CT d/o involving inflame of skeletal m and skin
B/L prox m weak, rash upper eyelids, periorbital edema
H: perimysial and vascular lymphocytic inflam
Inclusion body myositis
Asymmetric distal m weakness
Cytoplasmic vacuoles w basophilic granules and amyloid
Duchenne Lab
Inc serum creatine kinase
Bx: m fibers various size, necrosis, degeneration
Guillian Barre Syn
AI destruction of Schwann cells
Viral illness - ascending paralysis and loss DTR
2 SE of opiates that don’t develop tolerance
Miosis
Constipation
Mydriasis
D in it = dilation
Loperamide
Dec in mortality in inflam BD
Crohns and UC
Diphenoxylate
Control D
Baclofen
GABAb R agonist
PGA2
Thromboxane
plt aggregation, vasoconstiction
Epidural hematoma lucid interval?
PGA2 and serotonin = vasoconstriction
PGI2
Prostacyclin
PGF2
LatanaPROST
CarboPROST
PROST drugs
Latana and Carbo
LatanaPROST
Tx glaucoma, grow eyelashes, turn iris brown
CarboPROST
Induce abortion
If you Fuck (PGF2) in a car, you may need an abortion
Alprostadil
PGE1
Keeps PDA open
Misoprostil
PGE1
M-iso-prostol
Makes more mucus, give to pregnant = abortion from vasoconstriction
ASA MOA
Irreversible COX1 and COX2
81mg antiplt
ASA 1st 15 min
Acidic so body will inc resp rate = blow off more CO2 = Dec PCO2 and Increased pH
ASA 2nd 15 min
Acid dissociates and buffers so Decreased HCO3
ASA 3rd 15 min
GABA kicks in
Inc PCO2 - less CO2 off and Dec breathing rate
Dec HCO3 and pH
Indomethicin
Most potent NSAID
Closes PDA
NSAID for dysmenorrhea
Naproxen
NSAID with morphine like potency?
Ketorolac
2 steroids that induce surfactant production
Beclomethasone
Betamethasone
Dexamethasone
Best CNS penetration
Suppression test
Drug to take the place of aldosterone in CAH
Fludrocortisone
Megesterol
Inc appetite in CA
-makes Meg beg for food
Tx for endometriosis
Danazol