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First Aid Diseases > MSK > Flashcards

MSK Flashcards

1
Q

Osteogenesis imperfecta

A

AD, no type I collagen (bone matrix formation impaired)

- fx at birth, blue sclera, deafness, sm teeth

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2
Q

Achondroplasia

- sx

A

AD, constitutively act’d FGFR3 gene (mutations incr w/ dad’s age) -> inhib’s chondrocyte prolif, bad cartilage at growth plates
- short arms/legs but nl head/axial sk (bc are membranous ossification not endochondral)

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3
Q

Osteopetrosis

  • mutation?
  • sx
A

AR (severe) or AD (less severe), bad osteocl’s -> incr’d bone formation (see persistence of 1* unmineralized spongiosa in medullary canals)

  • CA II mutation so no acidic envt for osteoclasts to work
  • fx, visual/hearing loss (CN compression)
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4
Q

Osteomyelitis usu at? usu due to?

  • In Sickle cell due to?
  • Draining sinuses at higher risk of?
A

Metaphysis (tibia, fibula) in kids and epiphysis (from open wound) in adults
S. aureus
Salmonella paratyphi
SCC

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5
Q 
Osteoporosis
= 
2* causes
Trtmt
Type I =
Type II =
A

loss of mineralized bone & organic bone matrix (osteoid)
- incr’d cortisol, heparin, hypogonadism, malnut’n, space travel
- bisphosphonates (inhib resorption)
I = postmenopausal (decr’d estrogen)
II = senile type

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6
Q

Osteochondrosis

A

aseptic necrosis of ossification center in kids

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7
Q

Legg-Calve-Perthes dz

A

osteochondrosis; aseptic necrosis of femoral head ossification center in boys 3-10yo

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8
Q

Osteochondritis dissecans
usu due to?
most common site
late comp?

A

Osteochondrosis limited to articular epiphysis

  • trauma, or ischemia
  • distal femur
  • OA
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9
Q

Osgood-Schlatter dz

A

painful swelling of tibial tuberosity in boys (at insertion of patellar tendon) -> knobby-appearing knees

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10
Q

Paget’s dz of bone

- See incr’d?

A

Osteoclastic phase -> osteoblastic phase, so have thick weak bone (mosaic, woven, bone)
- Alk phos

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11
Q

Fibrous dysplasia

A

defect in osteoblastic differentiation and maturation -> medullary bone replaced by fibrous tissue w/ cyst formation, usu in ribs or femur

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12
Q

McCune-Albright’s synd

A

unilat polyosteotic bone involvement (fibrous dysplasia, cysts in bones bc no osteobl’s), cafe au lait spots, precocious puberty

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13
Q

1* malignant tumors of bone in decr’ing order of freq?

A

MM > osteogenic sarcoma > chondrosarcoma > Ewing’s sarcoma

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14
Q

Osteomalacia/Rickets

  • low serum phos from?
  • incr’d serum what?
A

VitD defic -> can’t mineralize/calcify osteoid (see osteoid matrix accum around trabeculae and widened osteoid seams)

  • low VitD -> low serum Ca -> high PTH -> low serum phos
  • alk phos from high osteobl activity
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15
Q

Giant cell tumor (osteoclastoma)

  • age, gender, location
  • XR shows
  • histo
A
  • 20-40yo, F>M, in epiphyseal end of long bones (distal femur or prox tibia)
  • double bubble or soap bubble
  • spindle-shaped cells w/ multinuc’d giant cells
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16
Q

Osteochondroma =

A

benign lat projection from growth plate, cartilagenous cap (metaphysis of distal femur)

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17
Q

Osteosarcoma

  • in who?
  • location?
  • XR shows
A
  • M>F, 10-20yo
  • metaphysis of long bone (distal femur, prox tibia)
  • Codman’s triangle (from elevation of periosteum) or sunburst pattern
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18
Q

Ewing’s sarcoma

  • who gets it?
  • location
  • derived from
  • see what on histo?
  • genetics?
A
  • boys <15yo
  • diaphysis of long bones, pelvis, scapula, ribs
  • from neuroectoderm
  • onion-skin appearance in bone (new bone growth around tumor), sm blue cell in tumor
  • t(11;22)
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19
Q

Chondrosarcoma =

  • who gets it
  • mets to?
A

malig cartilaginous tumor in medullary cavity of diaphysis

  • M 30-60yo
  • lungs
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20
Q

Osteoma

  • location
  • assoc’d w/?
A
  • facial bones

- Gardner’s polyposis synd

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21
Q

Osteoid osteoma =

  • location (on XR?)
  • pain?
A

benign tumor of osteobl’s surrounded by rim of rctive bone (osteoma)

  • long bone cortex in diaphysis (on XR see bony mass w/ lucent core)
  • resolves w/ ASA
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22
Q

Osteoblastoma =

A

like osteoid osteoma but in vertebra and no pain response to ASA

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23
Q

OA =

  • Other findings
  • Sx
  • On fingers see?
A

noninflamm jt dz, from wear and tear, progressive degen of articular cartilage

  • osteophytes at jt margins; clefts, subchondral cysts; no fusion of bone
  • Jt stiffness after inactivity
  • Heberden’s (DIP) nodes and Bouchard’s (PIP) nodes
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24
Q

Ochronosis (alkaptonuria) =

- causes?

A

AR, defic of homogentisic acid oxidase -> accum of homogentisic acid (urine turns blk when ox’d) -> deposits in intervertebral discs -> OA and other systemic findings

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25
Q

RA =

  • Fusion of jts from?
  • Hand sx
  • Assoc’n w/ HLA?
  • Abs to?
A

RF from B cells (IgM against Fc of IgG) combos w/ IgG -> imm complex -> C’ -> chronic synovitis and pannus formation (granulation tissue)

  • Pannus formation -> cytokines that destroy articular cartilage -> fusion of jt by scar tissue
  • MCP and PIP jts, symmetric, ulnar dev and morning stiffness, swan neck deform and Boutonniere deform
  • HLA-D4
  • RF, but anti-cyclic citrullinated peptide Ab is more sp
26
Q

Sjogren’s synd

  • sx
  • incr’d risk of?
  • dx by?
A

autoimm destruc of minor salivary gl’s and lacrimal ducts

  • RA, dry eyes, dry mouth, dental carries
  • B cell lymphomas
  • (+) ANA, RF, anti-SS-A/-B; confirm by lip bx
27
Q

JRA

  • RF?
  • Still’s dz for 20% = ?
A
  • usu neg

- F, rash, polyarthritis

28
Q

Infec arthritis

  • sx?
  • caused by?
A

STD: Synovitis (knee), Tenosynovitis (hand), Dematitis (pustules)
- S. aureus, Strep, Neisseria gonorrhoeae

29
Q 
Reactive arthritis (Reiter's synd) = 
- dx'ic sign?
A

post-GI or chlamydia infec’s

  • can’t see (conjunctivitis), can’t pee (urethritis), can’t climb a tree (arthritis)
  • Achilles tendon periostitis
30
Q

If you have AS, you can also have?

A

Aortitis, uveitits w/ potential for blindness

31
Q

SLE sx

A

I’M DAMN SHARP:

  • Igg’s (anti-dsDNA, anti-Sm, antiphospholipid)
  • Malar rash
  • Discoid rash
  • ANA
  • Mucositis (oropharyngeal ulcers)
  • Neuro d/o’s
  • Serositis (pleuritis, pericarditis) (interstitial fibrosis of lung)
  • Heme d/o’s (Abs to cells)
  • Arthritis
  • Renal d/o’s
  • Photosensitivity
32
Q

Drug induced lupus

  • drugs?
  • Ab?
A
  • Procainamide, hydralazine, isoniazid

- antihistone Abs

33
Q

Septic arthritis: 4 causes?

A

S. aureus, NG, Lyme dz, Pasteurella multocida

34
Q

DMD
Becker’s type?
at birth have incr’d?

A

XR, no dystrophin

  • have dystrophin but is deficient
  • CK, decr’s as m’s degenerate
35
Q

Myotonic dystrophy

- sx

A

CTG trint repeat d/o, AD, atrophy of type I fibers

- sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement

36
Q

Myasthenia gravis

  • sx
  • trtmt
A

autoAbs to ACh Rs

  • m. wkns worse w/ exercise and better w/ rest; ptosis, diplopia
  • Tensilon/Edrophonium (ACHE inhib) to test, pyridostigmine to trt
37
Q

Fibromatosis

  • sx
  • assoc’d w/?
A

non-neoplastic, prolif ct d/o

  • Dupuytren’s contracture (of palmar fascia)
  • Gardner’s polyposis synd
38
Q

Lambert-Eaton myasthenic synd

- sx

A

autoAbs to presyn Ca ch -> decr’d ACh release

- prox m. wkns that improves w/ m. use

39
Q

Myositis ossificans

A

metaplasia of SkM to bone post-trauma, see mass in bone on XR

40
Q

Molluscum contagiosum

- trtmt?

A

poxvirus; bowl-shaped lesions w/ central depression filled w/ keratin and viral particles
- spont remission in 6-9mo if imm competent

41
Q

Polymyositis

- sx

A

endomysial inflamm w/ CD8 T cells

- symm prox m. wkns

42
Q

Dermatomyositis

  • sx
  • incr’d risk of?
  • Labs?
A

perimysial (edge of m.) inflamm and atrophy w/ CD4 T cells (Ab damage)

  • bilat prox m. wkns w/ malar rash, Gottron’s papules and heliotrope rash
  • occult malig
  • Incr’d CK, ANA(+), (+)anti-Jo-1 Abs
43
Q

CREST synd =

A 
Calcinosis and centromere Ab
Raynaud's
Eso dysmotility
Sclerodactyly
Telangiectasia
44
Q

Hyperkeratosis =

seen in

A

incr’d thickness of stratum corneum

- Psoriasis

45
Q

Parakeratosis =

seen in

A

hyperkeratosis w/ retention of nuc in stratum corneum

- Psoriasis

46
Q

Acantholysis =

seen in

A

separation of epi cells

Pemphigus vulgaris

47
Q

Acanthosis =

seen in

A 
epi hyperplasia (incr'd spinosum layer)
Acanthosis nigricans
48
Q

Dermatitis =

seen in

A

inflamm of skin

atopic dermatitis

49
Q

Melasma (chloasma) =

A

hyperpigmentation assoc’d w/ preg or OCP use

50
Q

Seborrheic keratosis =

A

flat, greasy, pigmented sq epi prolif w/ keratin-filled cysts (horn cysts), looks “stuck on”; most common benign tumor in older ppl

51
Q

Leser-Trelat sign =

A

sudden appearance of multiple seborrheic keratoses -> underlying malig (GI like stomach adenoca, lymphoid)

52
Q

Dermatitis herpetiformia =

- assoc’d w/? thus, trtmt is?

A

pruritic papules, vesicles and bullae; deposits of IgA at tips of dermal papillae; assoc’d w/ Celiac dz so resolves w/ gluten-free diet

53
Q

Actinic (solar) keratosis =

A

premalig lesions caused by sun exposure; sm rough erythematous or brownish papules/plaques; risk of SCC (pearly grey-white)

54
Q

Lichen Planus =

  • assoc’d w/?
  • histo shows?
A

6Ps: pruritic, purple, polygonal planar papules and plaques

  • HepC
  • sawtooth infiltrate of lymph’s at dermal/epidermal jxn
55
Q

Keratoacanthoma

A

variant of SCC that grows quick and regresses quickly too (benign crateriform tumor w/ central keratin plug)

56
Q

Solar lentigo have incr’d # of?

A

melanocytes (liver spots in elderly)

57
Q

Superficial spreading melanoma is?
Lentigo maligna melanoma is?
Nodular melanoma has?

A
  • most common type of malig melanoma
  • in elderly, least likely to have vertical phase
  • no radial phase, only vertical phase (BAD)
58
Q

Psoriasis - 2 other signs besides erythematous plaques w/ silver scales?

A

Munro microabscesses in stratum corneum and Auspitz sign

59
Q

Innervation of rotator cuff m’s

A

C5-6

60
Q

Melanoma often driven by mutation in?

- sp trtmt?

A

BRAF kinase

- Vemurafenib = BRAF kinase inhib

First Aid Diseases (16 decks)

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