MSK Flashcards
cant extend wrist … triceps reflex diminshed …. touch sensation decresed on deltoid and later post arm
posterior cord
pelvic fracture can damage which nerve
femoral
common peroneal nerve function (L4 S2)
PED
Peroneal Everts and Dorsiflexes
damage —- dropped foot
tibial nerve (L4 S3)
TIP
tibial Inverts and plantar flextion
15 year old basketball player…. 6 months of knee pain … better with rest ,,,swelling erythema tenderness of anterior leg ….
osgood sclatter
pain at knee extension … condition devlps where the patellar tendon inserts at tibial tubercle of proximal tibia
characterized by tenderness at the attachment site of the quadriceps tendon which is the inferior patellar pole.
patellar tendonitis
39 yr old … facial rash on cheeks ,,,pustules papules seen on forehead that get worse with sun exposure
erythemia with telengectasia
tx>
Rosascea
topical metronidazole
which zoonotic inf can be treated with amox clav
pastreulla by cat dog bites
cat scratch disease agent and TXT
bartonella henslae….
azithromycin
trip to Great lakes … verrucous skin lesions and bone lytic lesions
blastomycosis
broad base budding
diminution of chondrocytes and thickening of synovium
RA
Clusters of neutrophils with needle-shaped crystals
gouty arthritis
islodged pieces of cartilage and subchondral bone
osteoperosis
levels of calcium alkaline phosphate magnesiums and phosphorus is osteoperosis
ALL NORMAL
elevated alkaline phosphatase (ALP) level in the setting of normal micronutrient levels
paget disease
increased activity of osteoclasts…
Elevated calcium and alkaline phosphatase levels may indicate
bone metastasis
primary hyper PTH
calcium is high
phosphorus is low
alp is high too
erbs palsy which nerve roots damaged and which muscle is still OK
c5 c6
triceps ok
infraspinatus function
lateral arm rotation
polymyositis
no rash involved
endomysial infiltration of CD8 t cells
dermatomyositis
PERIMYSIAL infiltraition CD4 tcells
thinl perimysium is closer to skin
antiU1RNP antibodies
MCTD
pt has a known allergy to seafood and he consumes it what type of reaction is this
, type 1 hypersensitivity reaction
e to mast cell degranulation of the superficial dermi
impact of prevalence on PPV AND NPV
, 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
femoral head fracture which artery affected
medial circumflex artery
Negatively birefringent crystals in joint fluid
GOUT
Weakly positively birefringent crystals in joint fluid
pseudogout
normal 50+ pt
evelops into the central nervous system, encompassing the brain, spinal cord, and retina.
neuroectoderm
melanocytes, the peripheral nervous system (dorsal root ganglia, etc), and Schwann cells
neural crest cells
Endoderm
gut tube epithelium from the esophagus all the way to the anal canal above the pectinate line.
lungs liver gall bladder
outer portion of our bodies, including skin and sweat glands
ectoderm
seronegative spondyloarthropathies
PAIR psoriasis Ankylosing spondy Inflmmtry bowel d Reative arthritis
Damage to gap junctions occurs in
chagas
Pemphigus vulg
desmosin
desmoglein
nerve block agent
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
NMDA receptor antagonist.
Ketamine
systemic medication
Increasing GABA channel closing time and potentiating sodium channels
propafol
sjigern syndrome HLA and increase risk of>
HLA DR3
risk of lymphoma
first line treatment burn patient
pseudomonas
piperacilin taazobactam
graves disease asooc with HLA
DR3
RA assoc with HLA
DR4
Multiple sclerosis HLA
DR2
Infliximab
Crohn disease, ulcerative colitis, and severe cases of this patient’s condition
monoclonal antibody
njectable drug used for rheumatoid arthritis that works by blocking TNF-alpha binding.
etanercept
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
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
failure to synthesize major histocompatibility complex II
SCID
Microtubule dysfunction
chediak higashi
albinism, megakaryocytes, peripheral neuropahty
Progressive destruction of B and T cells
Wiskott-Aldrich syndrome due to a lack of cytoskeletal proteins
thrombocytopenia eczema recurrent pyogenic
denosumab
monoclonal AB against RANKL
alendronate side effect
esophagitis
pt can have bleeding ulcer for ex
trendelenburg gait
superior gluteal nerve
pt LEANS TOWARDS the affected side
the tilt is contralateral to the affected side
femoral nerve injury
inability to straighten knee
cross-links major histocompatibility complex II (MHC II) molecules on antigen-presenting cells to T-cell receptors on T cells independent of antigen
Tsst 1
nonspecific T-cell activation by exotoxin A
strept pyogenes can mediate a toxic shock like sydnormw
winged scapula nerve injury
long thoracic C567
c7 c8 injury pt presents with
decrease hand grip
IV muscle relaxant is guven to pts … muscles twitch
wha twas the agent
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
nondepolarizing neuromuscular blocking agent. It is an acetylcholine receptor antagonist
veroconium
prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle by binding the ryanodine receptor.
dantrolene
Neuroleptic malignant syndrome
78 woman
blurring of vision initiallty at night now during day
wakes up with stiff neck and shoulders
giant temporal arteritis
txt with steroids
embolus composed of fibrin surrounding clear clefts
cholestrol embolus
deep femoral artery supplies what part of the thigh
posterior part
mandibular pain after a dental procedure and draining pus that reveals sulfur (“yellowish”) granules
actinomyces
penicillin
Muscle spindles are small sensory organs enclosed in a capsule … what are they imp for
proprioception
supracondylar fracture of the humerus is a fracture that occurs just above the elbow of the distal humerus
median nrve
r malignancies with bone metastasis:
PB KTTL prostate Breast kidney thyroid testes lung
nucleotide excision repair, which impairs a cell’s ability to repair damage induced by ultraviolet radiation.
xeroderma P
carpal tunnel syndrome which muscles are most commonly weaknd
oponens pollicis
flexor pollicis brevis
abductor pollicis brevis
supplied by median nerve … thenar brach which is compressed
cachexia
TNF alpha … macrophages
bcl2 function
inhibit actions of pro apoptotic proteins
Duchene mutation mechanism
frameshift deletion
a point mutation in the fibroblast growth factor receptor (FGFR-3) gene
achondroplasia
inhibition of chondrocyte prolif
which signs can show mandibular nerve is intact
he lack of jaw deviation and intact general sensation
drooping of the side of the mouth
cranial nerve 7
exits stylomastoid foramen
treatment for tinea corporis
mechanism and name
Griseofulvin
interferes with microtubule formation … alpha beta tubulin dimers
Antimicrosomal antibodies are associated with
hashimoto
Anti-Jo-1 antibodies
are directed against histidyl–tRNA synthetase.
dermatomyositis
ailure of the resorption and remodeling of bone
lack of meduillary canal
remnants of primary spongiosa
osteopetrosis cant resorb bone
hyper igE
jobs
th17 stat3 mutation — impaired recruitment of neutrophils
define the mnemonic FATED
Facies coarse Abscess Teeth 2 rows E hyper igE Dermatitis
which arachidonic acid product increases in aspirin txt
leukotrienes
LT CDE are bronchoconstrictors
LTb4 neutrophil chemotaxis
strept pyogene infcts a childs throat … appropriate antibiotic can save which complication
theumatid heart dsease
affects the mitral valve
Tumor necrosis factor antagonists
which test to do before giving these
infliximab adalimumab
PPD
can reactivate TB
which tongue muscle is innervated by cranial nerve 10
palatoglossus
elevates posterior tongue
after squats or other weight-bearing exercise of the lower extremity, causing difficulty in adducting the thigh.
obturator nerve
quotidian fevers, arthritis, and a classic salmon pink rash
Juvenile idiopathic arthritis (JIA)
ntellectual disability, self-mutilation behaviors, gout, and disordered movement
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.
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
ulnar
acute gout drugs
NSAIDS
glucocorticoids
colchicine
e most commonly affected ligament in ankle sprains and will always be the first ligament to become injured
anterior talofibular ligament
X-linked disorder is characterized by nephritis with hematuria, sensorineural deafness, and ocular disorders
alport
UNHAPPY TRIAD
ACL MCL and Medial lemniscus
g staphylococcal toxic shock syndrome (TSS)
excessive t cell activation
IL1 IL2 IL6 TNF IFNgmma
mechanism of sarcoidosis
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.
Overgrowth of granulation tissue due to excess collagen p
keloid
failure of the maxillary, medial nasal to fuse
cleft lip[
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
reactive arthritis
sacroillitis
seronegative spondylopathies what is a common smptom
sacroiliitis HLA B27
endochondral bone formation due to a mutation in the fibroblast growth factor receptor-3 (FGF-3 gene)
endochondral ossification
achondroplasia
MEMBRANOUS ossification problem
will have an effect on bone formation not just the extremities like in achondroplasia
why does rigor mortis occus
dead cells cant generate ATP which is neede to realease actin from myosin
features calcium pyrophosphate deposition,
pseudogout
HLA DR2
multiple sclerosis, hay fever, systemic lupus erythematosus, and Goodpasture syndrome
HLA DR4
Addison DM 1 RA
HLA DQ8
celiac disease
is a folic acid analog that inhibits dihydrofolate reductase and acts as antimetabolite
MTX
deltoid, supraspinatus, infraspinatus, and biceps brachii are affected in whch type of injuery
erbs palsy
C5 C6
defect in N-acetylglucosaminyl-1-phosphotransferase,
I cell disease
in Golgi
lipid synthesis and detoxification
smooth ER
bullous impetigo is always caused by
staph aureus
stiffness, fatigue, poor sleep, cognitive disturbance, and symptoms of depression or anxiety
signs of fibromyalgia
mostly in young females
cremasteric muscle is made from
internal obliquw
anemia of chrnoc disease
normochromic normocyic
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.
bisphosphonates
drug for crohns disease and gout if taken together can cause hemolytic anemia
azathioprine and allopurinol
blocking xanthine oxidase increases levels of 6MP …. toxic for pt
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
Peroxisomes contain enzymes involved in very-long-chain fatty acid metabolism.
Refsum disease
an accumulation of uric acid and is associated with self-mutilation behaviors, intellectual disability, gout, and movement disorders.
HGPRT def
homeless man presenting with hemoptysis, worsening back pain, fever, and night sweats….. tender back
POTTS disease
high specificity for RA.
anti-CCP—an autoantibody against citrullinated protein—has high specificity for RA.
highly specific for limited scleroderma (CREST syndrome)
Antibodies against centromeres or small nuclear ribonucleotide proteins (snRNPs)
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
potts
txt with antimycobacterial therapy, often consisting of isoniazid, rifampin, and pyrazinamide.
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
rubelaa
roseola infantum characterized
HHV6
rash starts at trunk then spreads to face
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
juvenile idiopathic arthritis (JIA).
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.
Indirect
lateral to inferior epigastric and superior to inguinal ligamnt
triggered by a recent genitourinary or gastrointestinal infection with Shigella, Yersinia, Chlamydia, Campylobacter, or Salmonella
ShY ChiCS
reative arthritis
best test for measuring the anti-CCP antibodies in this patient.
ELISA immunologic test used to detect a specific antibody or antigen in a patient’s blood sample.
four muscles of mastication
Lateral Lowers jaw (lateral pterygoid) Medial munch (masseter,l medial pterygoid and temporalis)
arthus reaction
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
s difficulty rising from a seated position and requires assistance when ascending stairs. It is also noted that he has difficulty abducting his thigh.
gluteal maximus
inferior gluteal nerve L5 S2
HLA assovc with RA
HLA DR4
HLA B8
graves
HLA BW22
kawasaki
areas of increased unmineralized osteoid adjacent to normal trabeculae.
osteomalacia
Lack of a medullary canal and decreased numbers of osteoclasts
osteopetrosis
lack of calcium and phosphorus causes osteocytes to produce less mineralized bone surrounding the cells
Pronation of the forearm
median nerve
ronic mucocutaneous candidiasis are thought to have a rare
t cell def
non bulous impetigo by staph wat would diff staph aur from strept
coagulase positive
coagulase break fibrinogen to fibrin
characterized by a well-demarcated skin lesion with a black base, along with systemic symptoms
francisella tularenisis
coxsackie virus
SS +ve Rna
paramyxovirus
SS-ve RNA enveloped
Rubella
SS +ve enveloped RNA
general sensory info of e cornea, sclera, upper eyelid & conjunctiva.
V1
gents are commonly used against intracellular organisms.
Tetracyclines act by binding to 30s and prevent attachment of aminoacyl-tRNA.
Blockade of translocation at 50s
clindamycin
cover gram-negative organisms exclusively.
aminoglycoside
Irreversible binding of the 30S subunit
aminoglycoside
what is the problem in achondroplasisa
endochondrial ossification
problem with hyaline cartilage model on which the osteoblasts work by laying out bone
what makes the diagnosis of Carpal tunnel more likely
tapping the nerve elicits a tingling response like pins n needles
trophied hypothenar eminence is assoc with which nerve pathology
ulnar nerve
treatment for M gravis
pyridostigmine which is acetylcholinesterase inhibitor
edrochonium is used for
ONLY DIAGNOSIS of MG
gram-negative bacteria that cause a positive Weil-Felix reaction
rickettsia species`
prosthetic joint and infection main pathogenB
staph aur
main muscles to laterally rotate arm are ….
and which one more common in injury
infraspinatus and tere minor
infraspinatus f=injury more common
enetic mutations of the Rb gene are associated withwhich bone tumor
osteosarcoma
distal femur
abnormal cellular trafficking, which results in failure of phagolysosome formation
albinism, pyogenic infections, peripheral neuropathy, and bleeding tendencies.
chediak higashi
microtubule dysf LYST
pt with history of typ2 diab and iv drug induced endocarditis comes with back pain
thoracic vertebrae — tender warm erythema
what do us suspect
osteomyelitis
DO MRI
fall on outsretched hand … which fracture most common
scaphoid
takes abt 2 weeks to be detevcted as a hyperdense xray
radial artery injury but hand still warm what contributes to the blood supply
superficial arch (ulnar continuation) and deep arch(radial)
atopic dermatitis has a defected …. protein
filaggrin protein….. disrupts tight juntion so allergen can enter dermis
what happens in pagets disease
increase in osteoclastic and osteoblastic activity
ONLY ALP is high
multiple fractures from a minor accident, in the setting of high serum calcium and low phosphate,
osteitis fibrosa cystica
osteomalacia define
due to low vit D
low calcium
untreated paget disease can lead to?
osteosarcoma
lyme disease pt under 8 years txt
amoxicillin
osteomyelitis in a homeless person … blood culture shows gram negative oxidase +ve rod
pseudomonas
IV drug
treatment for ETEC includes
fluoro and macrolides
