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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
RA = - Fusion of jts from? - Hand sx - Assoc'n w/ HLA? - Abs to?
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
Sjogren's synd - sx - incr'd risk of? - dx by?
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
JRA - RF? - Still's dz for 20% = ?
- usu neg | - F, rash, polyarthritis
28
Infec arthritis - sx? - caused by?
STD: Synovitis (knee), Tenosynovitis (hand), Dematitis (pustules) - S. aureus, Strep, Neisseria gonorrhoeae
29
``` Reactive arthritis (Reiter's synd) = - dx'ic sign? ```
post-GI or chlamydia infec's - can't see (conjunctivitis), can't pee (urethritis), can't climb a tree (arthritis) - Achilles tendon periostitis
30
If you have AS, you can also have?
Aortitis, uveitits w/ potential for blindness
31
SLE sx
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
Drug induced lupus - drugs? - Ab?
- Procainamide, hydralazine, isoniazid | - antihistone Abs
33
Septic arthritis: 4 causes?
S. aureus, NG, Lyme dz, Pasteurella multocida
34
DMD Becker's type? at birth have incr'd?
XR, no dystrophin - have dystrophin but is deficient - CK, decr's as m's degenerate
35
Myotonic dystrophy | - sx
CTG trint repeat d/o, AD, atrophy of type I fibers | - sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement
36
Myasthenia gravis - sx - trtmt
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
Fibromatosis - sx - assoc'd w/?
non-neoplastic, prolif ct d/o - Dupuytren's contracture (of palmar fascia) - Gardner's polyposis synd
38
Lambert-Eaton myasthenic synd | - sx
autoAbs to presyn Ca ch -> decr'd ACh release | - prox m. wkns that improves w/ m. use
39
Myositis ossificans
metaplasia of SkM to bone post-trauma, see mass in bone on XR
40
Molluscum contagiosum | - trtmt?
poxvirus; bowl-shaped lesions w/ central depression filled w/ keratin and viral particles - spont remission in 6-9mo if imm competent
41
Polymyositis | - sx
endomysial inflamm w/ CD8 T cells | - symm prox m. wkns
42
Dermatomyositis - sx - incr'd risk of? - Labs?
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
CREST synd =
``` Calcinosis and centromere Ab Raynaud's Eso dysmotility Sclerodactyly Telangiectasia ```
44
Hyperkeratosis = | seen in
incr'd thickness of stratum corneum | - Psoriasis
45
Parakeratosis = | seen in
hyperkeratosis w/ retention of nuc in stratum corneum | - Psoriasis
46
Acantholysis = | seen in
separation of epi cells | Pemphigus vulgaris
47
Acanthosis = | seen in
``` epi hyperplasia (incr'd spinosum layer) Acanthosis nigricans ```
48
Dermatitis = | seen in
inflamm of skin | atopic dermatitis
49
Melasma (chloasma) =
hyperpigmentation assoc'd w/ preg or OCP use
50
Seborrheic keratosis =
flat, greasy, pigmented sq epi prolif w/ keratin-filled cysts (horn cysts), looks "stuck on"; most common benign tumor in older ppl
51
Leser-Trelat sign =
sudden appearance of multiple seborrheic keratoses -> underlying malig (GI like stomach adenoca, lymphoid)
52
Dermatitis herpetiformia = | - assoc'd w/? thus, trtmt is?
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
Actinic (solar) keratosis =
premalig lesions caused by sun exposure; sm rough erythematous or brownish papules/plaques; risk of SCC (pearly grey-white)
54
Lichen Planus = - assoc'd w/? - histo shows?
6Ps: pruritic, purple, polygonal planar papules and plaques - HepC - sawtooth infiltrate of lymph's at dermal/epidermal jxn
55
Keratoacanthoma
variant of SCC that grows quick and regresses quickly too (benign crateriform tumor w/ central keratin plug)
56
Solar lentigo have incr'd # of?
melanocytes (liver spots in elderly)
57
Superficial spreading melanoma is? Lentigo maligna melanoma is? Nodular melanoma has?
- most common type of malig melanoma - in elderly, least likely to have vertical phase - no radial phase, only vertical phase (BAD)
58
Psoriasis - 2 other signs besides erythematous plaques w/ silver scales?
Munro microabscesses in stratum corneum and Auspitz sign
59
Innervation of rotator cuff m's
C5-6
60
Melanoma often driven by mutation in? | - sp trtmt?
BRAF kinase | - Vemurafenib = BRAF kinase inhib

First Aid Diseases (16 decks)

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