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MSK Flashcards

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USMLE® Step 1 flashcards
1
Q

cant extend wrist … triceps reflex diminshed …. touch sensation decresed on deltoid and later post arm

A

posterior cord

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2
Q

pelvic fracture can damage which nerve

A

femoral

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3
Q

common peroneal nerve function (L4 S2)

A

PED
Peroneal Everts and Dorsiflexes
damage —- dropped foot

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4
Q

tibial nerve (L4 S3)

A

TIP

tibial Inverts and plantar flextion

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5
Q

15 year old basketball player…. 6 months of knee pain … better with rest ,,,swelling erythema tenderness of anterior leg ….

A

osgood sclatter

pain at knee extension … condition devlps where the patellar tendon inserts at tibial tubercle of proximal tibia

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6
Q

characterized by tenderness at the attachment site of the quadriceps tendon which is the inferior patellar pole.

A

patellar tendonitis

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7
Q

39 yr old … facial rash on cheeks ,,,pustules papules seen on forehead that get worse with sun exposure
erythemia with telengectasia
tx>

A

Rosascea

topical metronidazole

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8
Q

which zoonotic inf can be treated with amox clav

A

pastreulla by cat dog bites

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9
Q

cat scratch disease agent and TXT

A

bartonella henslae….

azithromycin

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10
Q

trip to Great lakes … verrucous skin lesions and bone lytic lesions

A

blastomycosis

broad base budding

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11
Q

diminution of chondrocytes and thickening of synovium

A

RA

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12
Q

Clusters of neutrophils with needle-shaped crystals

A

gouty arthritis

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13
Q

islodged pieces of cartilage and subchondral bone

A

osteoperosis

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14
Q

levels of calcium alkaline phosphate magnesiums and phosphorus is osteoperosis

A

ALL NORMAL

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15
Q

elevated alkaline phosphatase (ALP) level in the setting of normal micronutrient levels

A

paget disease

increased activity of osteoclasts…

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16
Q

Elevated calcium and alkaline phosphatase levels may indicate

A

bone metastasis

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17
Q

primary hyper PTH

A

calcium is high
phosphorus is low
alp is high too

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18
Q

erbs palsy which nerve roots damaged and which muscle is still OK

A

c5 c6

triceps ok

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19
Q

infraspinatus function

A

lateral arm rotation

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20
Q

polymyositis

A

no rash involved

endomysial infiltration of CD8 t cells

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21
Q

dermatomyositis

A

PERIMYSIAL infiltraition CD4 tcells

thinl perimysium is closer to skin

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22
Q

antiU1RNP antibodies

A

MCTD

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23
Q

pt has a known allergy to seafood and he consumes it what type of reaction is this

A

, type 1 hypersensitivity reaction

e to mast cell degranulation of the superficial dermi

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24
Q

impact of prevalence on PPV AND NPV

A

, as the prevalence of disease increases, the positive predictive value (PPV), the probability that a positive test result is truly positive, increases and the negative predictive value (NPV), the probability that a negative test is truly negative, decreases

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25
Q

femoral head fracture which artery affected

A

medial circumflex artery

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26
Q

Negatively birefringent crystals in joint fluid

A

GOUT

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27
Q

Weakly positively birefringent crystals in joint fluid

A

pseudogout

normal 50+ pt

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28
Q

evelops into the central nervous system, encompassing the brain, spinal cord, and retina.

A

neuroectoderm

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29
Q

melanocytes, the peripheral nervous system (dorsal root ganglia, etc), and Schwann cells

A

neural crest cells

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30
Q

Endoderm

A

gut tube epithelium from the esophagus all the way to the anal canal above the pectinate line.
lungs liver gall bladder

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31
Q

outer portion of our bodies, including skin and sweat glands

A

ectoderm

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32
Q

seronegative spondyloarthropathies

A 
PAIR
psoriasis
Ankylosing spondy
Inflmmtry bowel d
Reative arthritis
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33
Q

Damage to gap junctions occurs in

A

chagas

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34
Q

Pemphigus vulg

A

desmosin

desmoglein

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35
Q

nerve block agent

A

upivacaine binds to the intracellular portion of voltage-gated sodium channels, blocking the sodium influx into nerve cells, which prevents depolarization of the nerve.

bupivacaine

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36
Q

NMDA receptor antagonist.

A

Ketamine

systemic medication

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37
Q

Increasing GABA channel closing time and potentiating sodium channels

A

propafol

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38
Q

sjigern syndrome HLA and increase risk of>

A

HLA DR3

risk of lymphoma

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39
Q

first line treatment burn patient

pseudomonas

A

piperacilin taazobactam

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40
Q

graves disease asooc with HLA

A

DR3

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41
Q

RA assoc with HLA

A

DR4

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42
Q

Multiple sclerosis HLA

A

DR2

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43
Q

Infliximab

A

Crohn disease, ulcerative colitis, and severe cases of this patient’s condition
monoclonal antibody

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44
Q

njectable drug used for rheumatoid arthritis that works by blocking TNF-alpha binding.

A

etanercept

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45
Q

two rows of upper and lower teeth, facial features that are “leathery” in appearance, and several small abscesses on his upper and lower extremities without surrounding erythema

A

of Job syndrome is the FATED mnemonic: Facies that are coarse, Abscesses that are cold, retained primary Teeth, increased IgE, Dermatologic problems.
failure to make IL 17

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46
Q

failure to synthesize major histocompatibility complex II

A

SCID

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47
Q

Microtubule dysfunction

A

chediak higashi

albinism, megakaryocytes, peripheral neuropahty

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48
Q

Progressive destruction of B and T cells

A

Wiskott-Aldrich syndrome due to a lack of cytoskeletal proteins
thrombocytopenia eczema recurrent pyogenic

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49
Q

denosumab

A

monoclonal AB against RANKL

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50
Q

alendronate side effect

A

esophagitis

pt can have bleeding ulcer for ex

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51
Q

trendelenburg gait

A

superior gluteal nerve
pt LEANS TOWARDS the affected side
the tilt is contralateral to the affected side

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52
Q

femoral nerve injury

A

inability to straighten knee

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53
Q

cross-links major histocompatibility complex II (MHC II) molecules on antigen-presenting cells to T-cell receptors on T cells independent of antigen

A

Tsst 1

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54
Q

nonspecific T-cell activation by exotoxin A

A

strept pyogenes can mediate a toxic shock like sydnormw

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55
Q

winged scapula nerve injury

A

long thoracic C567

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56
Q

c7 c8 injury pt presents with

A

decrease hand grip

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57
Q

IV muscle relaxant is guven to pts … muscles twitch

wha twas the agent

A

succniylcholine
mimics ACh and acts as an agonist at the nicotinic acetylcholine (nACh) receptor, depolarizing the muscle at the motor endplate. For this reason, patients often initially develop fasciculations soon after administration

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58
Q

nondepolarizing neuromuscular blocking agent. It is an acetylcholine receptor antagonist

A

veroconium

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59
Q

prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle by binding the ryanodine receptor.

A

dantrolene

Neuroleptic malignant syndrome

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60
Q

78 woman
blurring of vision initiallty at night now during day
wakes up with stiff neck and shoulders

A

giant temporal arteritis

txt with steroids

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61
Q

embolus composed of fibrin surrounding clear clefts

A

cholestrol embolus

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62
Q

deep femoral artery supplies what part of the thigh

A

posterior part

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63
Q

mandibular pain after a dental procedure and draining pus that reveals sulfur (“yellowish”) granules

A

actinomyces

penicillin

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64
Q

Muscle spindles are small sensory organs enclosed in a capsule … what are they imp for

A

proprioception

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65
Q

supracondylar fracture of the humerus is a fracture that occurs just above the elbow of the distal humerus

A

median nrve

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66
Q

r malignancies with bone metastasis:

A 
PB KTTL
prostate
Breast
kidney 
thyroid
testes
lung
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67
Q

nucleotide excision repair, which impairs a cell’s ability to repair damage induced by ultraviolet radiation.

A

xeroderma P

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68
Q

carpal tunnel syndrome which muscles are most commonly weaknd

A

oponens pollicis
flexor pollicis brevis
abductor pollicis brevis
supplied by median nerve … thenar brach which is compressed

69
Q

cachexia

A

TNF alpha … macrophages

70
Q

bcl2 function

A

inhibit actions of pro apoptotic proteins

71
Q

Duchene mutation mechanism

A

frameshift deletion

72
Q

a point mutation in the fibroblast growth factor receptor (FGFR-3) gene

A

achondroplasia

inhibition of chondrocyte prolif

73
Q

which signs can show mandibular nerve is intact

A

he lack of jaw deviation and intact general sensation

74
Q

drooping of the side of the mouth

A

cranial nerve 7

exits stylomastoid foramen

75
Q

treatment for tinea corporis

mechanism and name

A

Griseofulvin

interferes with microtubule formation … alpha beta tubulin dimers

76
Q

Antimicrosomal antibodies are associated with

A

hashimoto

77
Q

Anti-Jo-1 antibodies

A

are directed against histidyl–tRNA synthetase.

dermatomyositis

78
Q

ailure of the resorption and remodeling of bone
lack of meduillary canal
remnants of primary spongiosa

A

osteopetrosis cant resorb bone

79
Q

hyper igE

A

jobs

th17 stat3 mutation — impaired recruitment of neutrophils

80
Q

define the mnemonic FATED

A 
Facies coarse
Abscess
Teeth 2 rows
E hyper igE
Dermatitis
81
Q

which arachidonic acid product increases in aspirin txt

A

leukotrienes
LT CDE are bronchoconstrictors
LTb4 neutrophil chemotaxis

82
Q

strept pyogene infcts a childs throat … appropriate antibiotic can save which complication

A

theumatid heart dsease

affects the mitral valve

83
Q

Tumor necrosis factor antagonists

which test to do before giving these

A

infliximab adalimumab
PPD
can reactivate TB

84
Q

which tongue muscle is innervated by cranial nerve 10

A

palatoglossus

elevates posterior tongue

85
Q

after squats or other weight-bearing exercise of the lower extremity, causing difficulty in adducting the thigh.

A

obturator nerve

86
Q

quotidian fevers, arthritis, and a classic salmon pink rash

A

Juvenile idiopathic arthritis (JIA)

87
Q

ntellectual disability, self-mutilation behaviors, gout, and disordered movement

A

lesch nyhan
HPGRT deficiency
Since guanine and hypoxanthine are being lost as uric acid, the de novo synthesis pathway for purines must compensate; this compensation pathway utilizes folate and vitamin B12.

88
Q

sensation over the medial 1½ digits and hypothenar eminence and has a deep motor branch that supplies most of the intrinsic muscles of the hand

A

ulnar

89
Q

acute gout drugs

A

NSAIDS
glucocorticoids
colchicine

90
Q

e most commonly affected ligament in ankle sprains and will always be the first ligament to become injured

A

anterior talofibular ligament

91
Q

X-linked disorder is characterized by nephritis with hematuria, sensorineural deafness, and ocular disorders

A

alport

92
Q

UNHAPPY TRIAD

A

ACL MCL and Medial lemniscus

93
Q

g staphylococcal toxic shock syndrome (TSS)

A

excessive t cell activation

IL1 IL2 IL6 TNF IFNgmma

94
Q

mechanism of sarcoidosis

A

t is a cell-mediated immune response to an antigen

Th1 CD4+ cells that are activated by foreign antigens will secrete IFN gamma, which activates macrophages. These macrophages secrete TNF-alpha which furthers macrophage maturation and induces granuloma formation.

95
Q

Overgrowth of granulation tissue due to excess collagen p

A

keloid

96
Q

failure of the maxillary, medial nasal to fuse

A

cleft lip[

97
Q

atient with arthritis, conjunctivitis, and urethritis after treatment for chlamydial infection (obligate intracellular organism) is presenting with
what copuld be another assoc with this diagnosis

A

reactive arthritis

sacroillitis

98
Q

seronegative spondylopathies what is a common smptom

A

sacroiliitis HLA B27

99
Q

endochondral bone formation due to a mutation in the fibroblast growth factor receptor-3 (FGF-3 gene)
endochondral ossification

A

achondroplasia

100
Q

MEMBRANOUS ossification problem

A

will have an effect on bone formation not just the extremities like in achondroplasia

101
Q

why does rigor mortis occus

A

dead cells cant generate ATP which is neede to realease actin from myosin

102
Q

features calcium pyrophosphate deposition,

A

pseudogout

103
Q

HLA DR2

A

multiple sclerosis, hay fever, systemic lupus erythematosus, and Goodpasture syndrome

104
Q

HLA DR4

A

Addison DM 1 RA

105
Q

HLA DQ8

A

celiac disease

106
Q

is a folic acid analog that inhibits dihydrofolate reductase and acts as antimetabolite

A

MTX

107
Q

deltoid, supraspinatus, infraspinatus, and biceps brachii are affected in whch type of injuery

A

erbs palsy

C5 C6

108
Q

defect in N-acetylglucosaminyl-1-phosphotransferase,

A

I cell disease

in Golgi

109
Q

lipid synthesis and detoxification

A

smooth ER

110
Q

bullous impetigo is always caused by

A

staph aureus

111
Q

stiffness, fatigue, poor sleep, cognitive disturbance, and symptoms of depression or anxiety

A

signs of fibromyalgia

mostly in young females

112
Q

cremasteric muscle is made from

A

internal obliquw

113
Q

anemia of chrnoc disease

A

normochromic normocyic

114
Q

osteonecrosis of the jaw presents with exposure of the mandibular or maxillary bones in the mouth, along with pain and inflammation surrounding the exposed bone.

A

bisphosphonates

115
Q

drug for crohns disease and gout if taken together can cause hemolytic anemia

A

azathioprine and allopurinol

blocking xanthine oxidase increases levels of 6MP …. toxic for pt

116
Q

10-year-old boy presents with progressive neurologic and dermatologic symptoms
he has thick, dry, and scaly skin
difficulty with sense of smell and sensori neural hearing loss
low action potential propagation

A

Peroxisomes contain enzymes involved in very-long-chain fatty acid metabolism.

Refsum disease

117
Q

an accumulation of uric acid and is associated with self-mutilation behaviors, intellectual disability, gout, and movement disorders.

A

HGPRT def

118
Q

homeless man presenting with hemoptysis, worsening back pain, fever, and night sweats….. tender back

A

POTTS disease

119
Q

high specificity for RA.

A

anti-CCP—an autoantibody against citrullinated protein—has high specificity for RA.

120
Q

highly specific for limited scleroderma (CREST syndrome)

A

Antibodies against centromeres or small nuclear ribonucleotide proteins (snRNPs)

121
Q

HIV-positive patient’s severe upper back pain and low CD4 count, together with a finding of caseating granulomas (necrotic inflammatory infiltrate and giant cells) on a bone biopsy specimen, suggest that

A

potts

txt with antimycobacterial therapy, often consisting of isoniazid, rifampin, and pyrazinamide.

122
Q

fever followed by an erythematous rash that begins on the face and spreads to the trunk and extremities
rash described as pink, coalescing macules that spread down to the trunk

A

rubelaa

123
Q

roseola infantum characterized

A

HHV6

rash starts at trunk then spreads to face

124
Q

relapsing spiking fevers
transient macular, salmon-pink rash hemophagocytic syndrome, in which macrophages begin digesting RBCs (which is the cause of this patient’s low hematocrit)
polyarticular joint pain, swelling

A

juvenile idiopathic arthritis (JIA).

125
Q

herniated bowel (which has passed through the internal inguinal ring and external inguinal ring to reach the scrotum) is covered by all three layers of spermatic fascia.

A

Indirect

lateral to inferior epigastric and superior to inguinal ligamnt

126
Q

triggered by a recent genitourinary or gastrointestinal infection with Shigella, Yersinia, Chlamydia, Campylobacter, or Salmonella

A

ShY ChiCS

reative arthritis

127
Q

best test for measuring the anti-CCP antibodies in this patient.

A

ELISA immunologic test used to detect a specific antibody or antigen in a patient’s blood sample.

128
Q

four muscles of mastication

A 
Lateral Lowers jaw (lateral pterygoid)
Medial munch (masseter,l medial pterygoid and temporalis)
129
Q

arthus reaction

A

An Arthus reaction is a type III hypersensitivity reaction in which immune complexes are deposited into the walls of blood vessels, causing painful swelling and erythema

130
Q

s difficulty rising from a seated position and requires assistance when ascending stairs. It is also noted that he has difficulty abducting his thigh.

A

gluteal maximus

inferior gluteal nerve L5 S2

131
Q

HLA assovc with RA

A

HLA DR4

132
Q

HLA B8

A

graves

133
Q

HLA BW22

A

kawasaki

134
Q

areas of increased unmineralized osteoid adjacent to normal trabeculae.

A

osteomalacia

135
Q

Lack of a medullary canal and decreased numbers of osteoclasts

A

osteopetrosis

lack of calcium and phosphorus causes osteocytes to produce less mineralized bone surrounding the cells

136
Q

Pronation of the forearm

A

median nerve

137
Q

ronic mucocutaneous candidiasis are thought to have a rare

A

t cell def

138
Q

non bulous impetigo by staph wat would diff staph aur from strept

A

coagulase positive

coagulase break fibrinogen to fibrin

139
Q

characterized by a well-demarcated skin lesion with a black base, along with systemic symptoms

A

francisella tularenisis

140
Q

coxsackie virus

A

SS +ve Rna

141
Q

paramyxovirus

A

SS-ve RNA enveloped

142
Q

Rubella

A

SS +ve enveloped RNA

143
Q

general sensory info of e cornea, sclera, upper eyelid & conjunctiva.

A

V1

144
Q

gents are commonly used against intracellular organisms.

A

Tetracyclines act by binding to 30s and prevent attachment of aminoacyl-tRNA.

145
Q

Blockade of translocation at 50s

A

clindamycin

146
Q

cover gram-negative organisms exclusively.

A

aminoglycoside

147
Q

Irreversible binding of the 30S subunit

A

aminoglycoside

148
Q

what is the problem in achondroplasisa

A

endochondrial ossification

problem with hyaline cartilage model on which the osteoblasts work by laying out bone

149
Q

what makes the diagnosis of Carpal tunnel more likely

A

tapping the nerve elicits a tingling response like pins n needles

150
Q

trophied hypothenar eminence is assoc with which nerve pathology

A

ulnar nerve

151
Q

treatment for M gravis

A

pyridostigmine which is acetylcholinesterase inhibitor

152
Q

edrochonium is used for

A

ONLY DIAGNOSIS of MG

153
Q

gram-negative bacteria that cause a positive Weil-Felix reaction

A

rickettsia species`

154
Q

prosthetic joint and infection main pathogenB

A

staph aur

155
Q

main muscles to laterally rotate arm are ….

and which one more common in injury

A

infraspinatus and tere minor

infraspinatus f=injury more common

156
Q

enetic mutations of the Rb gene are associated withwhich bone tumor

A

osteosarcoma

distal femur

157
Q

abnormal cellular trafficking, which results in failure of phagolysosome formation
albinism, pyogenic infections, peripheral neuropathy, and bleeding tendencies.

A

chediak higashi

microtubule dysf LYST

158
Q

pt with history of typ2 diab and iv drug induced endocarditis comes with back pain
thoracic vertebrae — tender warm erythema
what do us suspect

A

osteomyelitis

DO MRI

159
Q

fall on outsretched hand … which fracture most common

A

scaphoid

takes abt 2 weeks to be detevcted as a hyperdense xray

160
Q

radial artery injury but hand still warm what contributes to the blood supply

A

superficial arch (ulnar continuation) and deep arch(radial)

161
Q

atopic dermatitis has a defected …. protein

A

filaggrin protein….. disrupts tight juntion so allergen can enter dermis

162
Q

what happens in pagets disease

A

increase in osteoclastic and osteoblastic activity

ONLY ALP is high

163
Q

multiple fractures from a minor accident, in the setting of high serum calcium and low phosphate,

A

osteitis fibrosa cystica

164
Q

osteomalacia define

A

due to low vit D

low calcium

165
Q

untreated paget disease can lead to?

A

osteosarcoma

166
Q

lyme disease pt under 8 years txt

A

amoxicillin

167
Q

osteomyelitis in a homeless person … blood culture shows gram negative oxidase +ve rod

A

pseudomonas

IV drug

168
Q

treatment for ETEC includes

A

fluoro and macrolides

usmle rx qbank (29 decks)

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