MSK Flashcards
Carpal tunnel syndrome associated with which conditions?
- pregnancy (edema)
- RA
- hypothyroidism
- diabetes
- acromegaly
- dialysis-related amyloidosis
- repetitive use?
Innervation of the iliohypogastric n
(T12-L1)
- Sensory: suprapubic region
- Motor: internal oblique and transversus abdominis
Innervation of the genitofemoral nerve
(L1-2)
- Sensory: medial/anterior thigh, scrotum/labia majora
- Motor: cremaster
Innervation of lateral femoral cutaneous n
(L2-3)
- Sensory innerve of anterior/lateral thigh
Outline meralgia paraesthetica
Outer thigh nerve syndrome
- burning pain
- paraesthesia
- hypoesthesia
Nerves of the lumbar plexus
Iliohypogastric (T12-L1) Ilioinguinal (L1) Genitofemoral (L1-2) Lateral femoral cutaneous (L2-3) Obturator (L2-4) Femoral (L2-4)
Nerves of the sacral plexus
Superior gluteal (L4-S1) Inferior gluteal (L5-S2) Posterior femoral cutaneous (S1-3) Sciatic (L4-S3) Pudendal (S2-4)
A foot drop is result of injury to which nerve
Common peroneal nerve
MOA and indications of bisphosphonates
Phosphate group in drugs binds Ca (hydroxyapatite) in bone and also inhibits osteoclasts
- osteoporosis, hypercalcemia, osteogenesis imperfecta, Paget’s ds of bone, metastatic bone ds
Eg of bisphosphonates
Alendronate, ibandronate, risedronate, zolendronate
Side effects of bisphosphonates
Esophagitis
osteonecrosis of jaw
atypical stress fractures (femur)
X-ray findings in bone tumours
Osteosarcoma: - Codman triangle - Sunburst pattern Ewing sarcoma - Onion skin pattern Giant cell tumour - Soap bubble appearance
Predisposing factors for osteosarcoma
Prior irradiation
Paget’s ds
Familial retinoblastoma
Li-Fraumeni
Approach to bone tumours according to location
Epiphysis - Giant cell tumour
Metaphysis - Osteosarcoma, osteochondroma, simple bone cyst
Diaphysis - Osteoid osteoma, Ewing sarcoma, fibrous dysplasia, mets
Approach to bone tumours according to age
Young men: - Ewing sarcoma (<15) - Osteosarcoma (10-20) - Osteochondroma (<25) Older: - Giant cell tumour (20-40) - Osteosarcoma (bimodal - >65)
Approach to bone pain/tumours based on serum tests
Ca/PTH levels:
- normal: osteoporosis, osteopetrosis, Paget, bone tumours
- low Ca/high PTH: Vit D deficiency, renal failure
- high Ca/high PTH: primary hyperparathyroidism
Hand joint involvements in OA and RA
OA: DIP, PIP (Herberden’s and Bouchard’s), 1st CMC, not MCP!
RA: MCP, PIP, not DIP or 1st CMC
Describe Caplan’s syndrome
RA nodules with pneumoconiosis
Triad of gonococcal arthritis
Polyarthralgia
Tenosynovitis
Dermatitis
3 main indications for colchicine
Side effects
Gout
Pericarditis
Familial mediterranean fever
S/E’s: Diarrhea, N&V, abdo pain
Conditions associated with CPPD
HyperPTH
Joint trauma
Haemachromatosis
The “-itis” of spondyloarthritides
- Sacroiliitis/spondylitis/peripheral arthritis
- Enthesitis
- Dactylitis
- Uveitis
- Aortitis –> AR (in ank spondy)
Bugs associated with reactive arthritis
“ShY ChiCS”
- Shigella
- Yersinia
- Chlamydia
- Campylobacter
- Salmonella
Pathologies associated with myasthenia gravis and Lambert-Eaton myasthenic syndrome
MG: thymoma, thymic hyperplasia –> do CT/MRI of mediastinum
LEMS: small cell lung CA
What is the Leser-Trelat sign
Sudden appearance of multiple seborrheic keratoses - indicating underlying malignancy (GI, lymphoid)
6 P’s of lichen planus
Pruritic, purple, polygonal planar papules and plaques
Melanoma:
- tumour marker
- Mutation in what gene?
S-100
BRAF kinase
BRAF V600E may benefit from vemurafenib (BRAF kinase inhibitor)
ABCDEs of melanoma
Asymmetry Border irregularity Colour variation Diameter >6mm Evolution with time
Side effects of methotrexate
- Myelosuppresion (reversible with leucovorin)
- Hepatotoxicity
- Mucositis
- Pulmonary fibrosis
4 types of melanomas
Superficial spreading - good prognosis
Lentigo maligna melanoma - good
Nodular - poor
Acral lentiginous - palms and soles
Describe the drug Riluzole
Glutamate inhibitor for treating ALS
Which artery supplies the ACL?
Middle geniculate artery
