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MSK: 4/6-4/8 > MSK- FA > Flashcards

MSK- FA Flashcards

1
Q

Acute gout: Is allopurinol an option?

A

NO.
allopurinol is used as a prevention (for chronic gout)

For ACUTE gout attack, first line is NSAIDs and
other anti-inflammatory drugs (glucorcorticoid, colchicinine) are also options for acute gout)

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2
Q

medial epicondyle vs. lateral epicondyle: injury due to what kind of repetitive arm motion?

A

medial: golfer, forehand shots- flexion
lateral: tennis, backhand shots- extension
* golf swings medially, tennis swings backhand

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3
Q

Which hand bone can be palpated in snuff box? what is special about this bone?

A

scaphoid

  • scaphoid is the most common injury site for avascular necrosis due to retrograde blood supply
    (this is UWORLD question)
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4
Q

Myositis ossificans

  • what is it?
  • cause and location
  • x-ray finding
A
  • growth of bone in muscle (heterotrophic ossification)
  • trauma, located in traumataized muscle
  • bony ossification in muscle
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5
Q

Polymyalgia rheumatica: lab findings

  • ESR
  • CRP
  • CK
A
  • ESR: elevated
  • CRP: elevated
  • CK: normal (vs. polymyositis/dermatomyositis)
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6
Q

Compare etiologies: femoral nerve damage vs. obturator nerve damage

A
  • femoral n: pelvic fracture
  • obturator n: pelvic surgery
  • makes sense: femoral n. runs lateral, kinda all over across pelvic bone, while obturator nerve runs medial, and inside of pelvic area (inside=deep= surgery related)
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7
Q

Lumbricals

  • innervated what nerve? nerve root?
  • motion of MCP
  • motion of DIP/PIP
A
  • ulnar (C8-T1)
  • MCP flexion
  • DIP/PIP extension

*think about clawed hand (lower root, ulnar damage)
: hands can’t flex MCP, and can’t extent DIP/PIP

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8
Q

Compare fracture etiologies: median nerve damage vs. radial nerve damage

A

median n: supracondylar fracture

radial n: midshaft humerus fracture

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9
Q

MOA of N-acetylcysteine as a antidote for acetoaminophen overdose

A

regeneration of glutathione

GS-SG -> 2GH

*acetoaminophen causes centrilobular necrosis of liver by generating free radicals

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10
Q

Dislocation of what bone may cause carpal tunnel syndrome

A

lunate

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11
Q

Amount and usage for each dose of aspirin

  • low
  • intermediate
  • high
A
  • low: <300mg, anti-platelet aggregation
  • intermediate: < 300, <2400: antipyretic, analgestic
  • high:<2400, <400: anti-inflammatory
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12
Q

Acanthosis nigrans: hyperplasia of what dermal layer

A

acanthosis: hyperplasia of stratum spinosum

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13
Q

What wrist bone damage is associated with ulnar nerve injury?

A

hammate

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14
Q

Most common cause of death in osteitis deformans?

A

osteitis deformans= pagets

hight output HF

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15
Q

Smoker has weak muscle strength, dry mouth and impotence. What’s up?

A

Lambert-Eaton syndrome (associated with small cell lung cancer)

autonomic symptoms of Lambert-Eaton: dry mouth and impotence

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16
Q

Patient taking probenecid for chronic gout. How penicillin dose needs to be modified? why?

A

Dose needs to be lowered.

probenecid also limits penicillin secretion, increasing interstitial nephritis

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17
Q

Carpal tunnel syndrome: how is sensation of thenar eminence affected? why?

A

thenar eminence sensation is intact

recurrent branch of median nerve (which innervates thenar eminence) does not go through carpal tunnel

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18
Q

Sarcoidosis: facial manifestation?

A

facial palsy

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19
Q

UV- which type mediates sunburn? which type mediates tanning? which type mediates skin aging?

A
  • UVA- Aging
  • UVB- sun Burn

A-aging B-burn

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20
Q

cardiac manifestation of anklyosing spondylitis

A

aortic regurgitation

  • aortitis (inflammation) -> dilation of aortic root -> AR
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21
Q

Which autoanitbody in SLE tells about prognosis? which organ is usually involved in the presence of this antibodiy?

A

anti-dsDNA

renal is usually involved with positive anti-dsDNA

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22
Q

woman with breast cancer had mastetomy. what skin cancer should I worry about?

A

angiosarcoma

  • this is UWORLD question
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23
Q

List 4 drugs that can cause lupus. What autoantibody is specific for drug induced lupus?

A

proclainamide, INH, phenytoin, and HYDRALYZINE

anti-histone

*pt wit heart condition showing lupus symptoms, think drug induced lupus

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24
Q

Which cell’s activity is impaired in osteopetrosis? which enzyme?

A

ostetoclast

defective carbonic anhydrase

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25
Q

What type of fracture is common in osteoporosis?

A

vertebral compression/ fracture

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26
Q

What two insults cause axillary nerve damage?

A
  • anterior transolocation of humeral head

- humeral neck fracture

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27
Q

What two insults cause radial nerve damage?

A
  • midshaft fracture of humerus

- axillary compression (crutch)

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28
Q

What two insults cause median nerve damage?

one in arm, one in wrist

A
  • suprcondylar fracture

- lunate fracture

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29
Q

What two insults cause ulnar nerve damage?

one in arm. one in wrist

A
  • lateral epicondyle fracture

- hammate fracture

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30
Q

Two dermatologic processes in psoriasis?

A
  • hyperkaratosis

- parakaratosis (retained nuclei in startum corenum)

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31
Q

Achondroplasia

  • what gene, what is function of this gene
  • what mutation
  • inheritance pattern
  • most sporadic? or inherited?
  • phenotype of homozygosity?
A
  • FGFR3, inhibition of chondrocyte
  • constitutive activation -> inhibition of chondrocyte
  • autosomal dominant
  • most cases are sporadic
  • homozygote lethal
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32
Q

Which nerve innervates each rotator cuff muscle?

A
  • supra/infrasipnatous: suprascapular nerve
  • teres minor: axillary
  • subscapularis: subscapular nerve
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33
Q

function of dorsal interossei? palmar interossei? what is pneumonic for it? (there is pneumonic for this)

A

PAD DAB

Palmar interossei- finger adduction
Dorsal interossei - fingeer abduction

abduction- kinda like stretch - backside (dorsal)
adduction- kinda like flexion - frontside (palmar)

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34
Q

What is melasma?

A

hyperpigmentation in preganants

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35
Q

Describe pathologic findings (2) in osteitis fibrosa cystica

A
  • cystic lesions in bone

- brown fibrous tissue

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36
Q

Three side effects of NSAIDs

A
  • anti-inflammtory
  • anti-pyretic
  • analgestic
37
Q

neurologic manifestation in osteopetrosis? why?

A

cranial impingement due to narrowing of foramina

38
Q

Thenar vs. Hypothenar eminence: innervated by what nerve in each?

A
  • thenar eminence: recurrent branch of median

- hypothenar eminence: ulnar

39
Q

Which disc level herniation is responsible for

  • femoral n. compression
  • peroneal n. compression
  • tibial n. compression
A
  • L4 (L3-L4)
  • L5 (L4-L5)
  • S1 (L5-S1)
40
Q

nerve root for

  • femoral n.
  • obturator n.
  • peroneal n.
  • tibial n.
A
  • femoral and obturator: L2-L4 (3)
  • peroneal: L4-S2 (4)
  • tibial: L4-S3 (5)
41
Q

How does estrogen works for bone?

A

estrogen -> OPG -> decoy receptor for RANKL

-> inhibition of osteoclast activity

42
Q

Which nerve and artery have increased risk for damage in humeral neck fracture?

A

posteior circumflex

43
Q

What is common theme of drugs for acute gout management? List their names (3)

A

anti-inflammatory

  • NSAID
  • colchinine
  • glucorcorticoid
44
Q

Sarcoidosis: skin manifestation?

A

erythema nodosum

45
Q

Which muscle of rotator cuff is commonly injured in pitcher? what about nerve?

A

infraspinatous

musculocutaneous nerve is also frequently damaged in pitcher

46
Q

Name 3 diseases that predispose development of osteosarcoma

A
  • retinoblastoma
  • Li-Furafani
  • pagets
47
Q

Rosacea: describe dermatologic finding

A

erythematous papules, skin flushing after external stimuli (alcohol)

48
Q

Sciatic nerve splits into what two nerves

A

peroneal and tibial

49
Q

What is bony land mark for injection for knocking down pudendal nerve?

A

ischial spine

  • this is UWORLD question
50
Q

nerve root for pudendal nerve

A

S2-S4

51
Q

prognosis of Ewing sarcoma? treatment option?

A
  • bad prognosis, aggresive

- well respond to chemotherapy

52
Q

What does TXA2 do to vasculature?

A
  • vasoconstriction

* this is different to other COX cytokines (prostacycline, prostaglandin)

53
Q

What mutation on what gene is associated with melanoma?

A

BRAF V600E

54
Q

Erysipelas and Cellulitis are skin manifestations (also impetigo) of GAS infection. What is main difference between two?

A
  • Erysipeals: superficial epidermis

- Cellulitis: deep including dermis

55
Q

SLE manifestation in oral / pharyngeal area?

A

oralpharyngeal ulcer

56
Q

What infection is associated with hairy leukoplakia? how is it different from thrush?

A
  • EBV

- not scrapable

57
Q

Gaucher disease: bone manifestation?

A

avascular necrosis

58
Q

Two most common bacteria for septic arthritis?

A
  • S. auerus

- N. gonorrhoeae

59
Q

Three antibodies for anti-phospholipid syndrome?

A
  • cardiolipin
  • lupus anticoagulant
  • beta 2 glycoprotein
60
Q

midshaft of humerus fracture- what nerve and artery are getting damaged

A
  • raidal n.

- deep brachial artery

61
Q

Describe histology of basal cell carcinoma. what about gross appearance?

A

purlent (shiny)
palisading nuceli

  • pathoma p.205
62
Q

median nerve runs with which artery? through what fossa?

A

brachial artery

63
Q

low dose aspirin vs. high dose aspirin: different effect on gout?

A
  • high dose: inhibit uric acid reabsorption
  • low dose: inhibit uric acid secretion
  • needs HIGH dose to be beneficial
64
Q

weakness in dorsiflexsion, difficulty with heel walking: what disc herniation?

A
  • peroneal, L4-L5
65
Q

weakness of knee extension, decreased patellar reflex: what disc herniation?

A
  • femoral, L3-L4
66
Q

weakness of plantarflexion, difficulty in toe walking: what disc herniation? what reflex will be diminished?

A
  • tibial, L5-S1

reduced archillis tendon reflex

67
Q

Base of skull: endochondral ossification? or membranous ossification?

A

endochonral ossification

  • facial bone is membranous ossification, which is not same as base of skull
68
Q

gap junction: what protein?

A

connexons

  • gap junction CONNEcts between two cells, allowing communication
69
Q

adhesion junction: what protein?

A

Cadherine

*cADHERine

70
Q

tight junction: what proteins (2)?

A
  • occludin

- claudin

71
Q

dermatologic term for pemphigus vulgaris? (positive Nilkosky sign?)

A

acantholysis

72
Q

Name three diseases/conditions that can lead to pseudogout

A
  • hemochromatosis
  • joint trauma
  • hyperparathyroidism
  • MCP deposition of calcium pyrophosphate in hemochromatosis => Don’t get confused with RA!!
73
Q

basement membrane: what protein?

A

integrin

  • integrity of basement membrane
74
Q

benign, painful, red-blue tumor under fingernails. what tumor is this?

A

glomus tumor

75
Q

Describe finding in immunmofluoresecne in pemphigus vulgaris? vs. bullous pemphigoid?

A

pemphigus vulgaris: fish net (all over epidermis)

bullous pemphigoid: linear (along basement membrane)

76
Q

which cell is in the blisters of bullous pemphigoid?

A

eosiniphils

77
Q

Which drug is used to diagnose myasthenia gravis?

A

edrophonium (tensilon)

  • edrophonium is rapid acting AchE inhibitor. positive edrophonium test means transient improvement of muscle strength after edrophonium
78
Q

What two bugs are associated with erythema multiforme?

A
  • mycoplasma bacteria

- HSV (UWORLD)

79
Q

umbilicated papule. what infection?

A

poxvirus

*umbilicated: central depression

80
Q

Which amino acid is precursor for NO synthesis?

A

L-Ariginine

81
Q

Grabbing a tree branch to break a fall: what nerve root injury?

A

This is classic case for Klumpke palsy, so lower trunk of brachial plexus

82
Q

Ulnar nerve penetrates through what structure in elbow?

A

cubital fossa

83
Q

What is PGI2? its functions (2)? From where is it released?

A
  • prostacyclin
  • inhibits platelet aggregation and vasoconstriction
  • exactly opposite to TXA2
  • endothelial cells release PGI2
84
Q

MOA of aspirin? vs. acetoaminophen?

A

aspirin: IRREVERSIBLE COX1 and 2 inhibitor via ACETYLATION
acetoaminophen: REVERSIBLE COX inhibitor, mostly in CNS => why it is not anti-inflammatory, rather analgestic and antipyretic

85
Q

During delivery, anesthetic is injected to nerve that runs between sacrospinus ligament and ischial spine. what nerve is this?

A

pudendal (S2-S4)

pudendal nerve is somatic nerve.
* also remember this nerve is associated with ejacuation in male (point, shoot, spoon)

  • keyword: delivery, ischial spine = pudendal
86
Q

Which nerve innervates biceps?

A

musculocutaneous

87
Q

nerve root of long thoracic?

A

C5-C7

  • I thought it is C5-T1, but no. JUST FIRST THREE
88
Q

paget disease: how levels get changed?

  • Ca2+
  • phosphate
  • ALP
  • PTH
A

everything is normal EXCEPT ALP (high)

MSK: 4/6-4/8 (6 decks)

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