MSK/CT Flashcards
short limbs, big head?
achondroplasia
FGFR3 activation –> chondrocyte proliferation inhibited
85% sporadic; AD inheritance
**failure of endochondral ossification only
bone changes in osteoporosis?
trabecular (spongy) bone loses mass and interconnections
NORMAL bone mineralizations and lab values
dense bones prone to fracture, CN impingement/palsies?
osteopetrosis
mutation –> defective OCs (e.g. carbonic anhydrase II) - can’t generate acid for resorption
- pancytopenia, extramedullary hematopoiesis
- BM txp potentially curative
increased hat size, hearing loss, high-output heart failure?
Paget’s dz
long bone chalk-stick fx
mosaic pattern of woven and lamellar bone
increased AV shunting –> HF
** increased risk of osteogenic sarcoma
stages of Paget dz?
lytic: OCs
mixed: OBs and OCs
sclerotic: OBs
quiescent: minimal activity
causes of avascular necrosis?
alcohol sickle steroids pancreatitis trauma Legg-Calves-Perthes the bends
lab values in osteoporosis?
NORMAL except for DEXA
lab values in osteopetrosis?
normal or low Ca in very severe/malignant dz
lab values in Paget dz?
elevated ALP
otherwise normal
lab values in osteomalacia/Rickets?
Ca and Ph decreased
ALP and PTH increased
lab values in hypervitaminosis D?
Ca and Ph increased
PTH decreased
normal ALP
lab values in 1ary hyperparathyroidism?
increased Ca, decreased Ph
increased ALP and PTH
lab values in 2ary hyperparathyroidism?
decreased Ca, increased Ph
increased ALP and PTH
“brown tumors,” subperiosteal thinning?
osteitis fibrosa cystica
= bony changes 2/2 hyperparathyroidism
locally aggressive benign tumor, soap bubble appearance?
giant cell tumor = osteoclastoma
often at knee
epiphyseal end of long bones
20-40 yo
mature bone with cartilaginous cap?
osteochondroma
MC benign tumor
males < 25 yo
Codman triangle or sunburst pattern on XR?
osteosarcoma
metaphysis of long bones, esp knee
bimodal ages: 10-20, >65
tx: surgical en bloc resection and chemotherapy
** predisposing factors: Paget, bone infarct, radiation, retinoblastoma, Li-Fraumeni
anaplastic small blue cell tumor, onion skinning?
Ewing sarcoma
diaphysis of long bones, pelvis, scapula, ribs
boys < 15yo
** t(11;22) translocation
complications of Sjogrens?
dental caries
MALT lymphoma
why do gout attacks happen after alcohol consumption?
alcohol metabolites compete for same excretion sites as uric acid
rhomboid, weakly birefringent crystals?
pseudogout = calcium pyrophosphate crystals
assoc with hemochromatosis, hyperparathyroidism, OA
tx: NSAIDs, steroids, colchicine (ppx)
dactylitis, pencil-in-cup deformity?
psoriatic arthritis
infections assoc with Reiter?
GI: Shigella, Salmonella, Yersinia, Campylobacter
Chlamydia
common causes of death in SLE?
CV disease
infections
renal disease
lab findings in anti phospholipid syndrome?
lupus anticoagulant
anticardiolipin
anti-beta2 glycoprotein
** LAC and anticardiolipin –> false pos VDRL and prolonged PTT
elevated serum ACE and CD4/CD8 ratio?
sarcoidosis
B/L adenopathy, coarse reticular opacity, hilar/mediastinal adenopathy
widespread NONcaseating granulomas
** hypercalcemia 2/2 increased 1alphahydroxylase –> vit D activation in MACROPHAGES)
tx of fibromyalgia?
regular exercise
TCAs/SNRIs
anticonvulsants
endomysial inflammation with CD8 cells?
polymyositis
perimysial inflammation with CD4 cells?
dermatomyositis
** increased risk of occult malignancy
heterotopic ossification following injury?
myositis ossificans
metaplasia of skeletal mm –> bone after trauma
usually UE/LE
MCC of death in scleroderma?
pulmonary sclerosis
