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Pathology 1st aid > MSK Path > Flashcards

MSK Path Flashcards

1
Q

Short Limbs
Big Head
Normal lifespan
Fertile

A

Achondroplasia

Common cause of dwarfism

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2
Q

Achondroplasia Mutation

A

FGFR3

On all the time –> inhibits chondrocyte proliferation

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3
Q

Acute back pain
kyphosis
loss of height

A

Vertebral crush fracture

osteoporosis

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4
Q

Osteoporosis

A

Trabecular (spongy( bone loses mass despite normal bone mineralization and labs

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5
Q

Type 1 osteoporosis

A

Post menopausal

increased bone resorption due to decreased estrogen

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6
Q

Type 1 osteoporosis common fxrs

A

Colles (distal radius)

Femoral neck

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7
Q

Type II osteoporosis

A

Senile

men and women > 70

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8
Q

Type II osteoporosis Prophylaxis

A

weight bearing exercise (increase mm. mass)

Ca and Vit. D intake

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9
Q

Type II osteoporosis Tx

A

Estrogen (SERMS)
Calcitonin

Severe:
Bisposphonates
Pulsatile PTH

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10
Q

Rx contraindicated in osteoporotic pts.

A

Glucocorticoids

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11
Q

Failure of bone resorption due to defective osteoclasts
Thickened/dense bones prone to fxr
pancytopenia

A

Osteopetrosis

Osteoclasts can’t get acidic env. to resorb bone

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12
Q

X-ray finding of osteopetrosis

A

Bone in bone

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13
Q

Why do you get pancytopenia with osteopetrosis?

A

Bone fills marrow space inhibiting hematopoeiesis

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14
Q

Osteopetrosis Tx

A

Bone marrow transplant

Osteoclasts come from stem cells–replace them

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15
Q

Vitamin D deficiency in kids? Adults?

A

Kids–rickets (bowing of long bones)
Adults–Osteomalacia

Hyperactivity of osteoblasts –> inc. serum Alk Phos

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16
Q 
Increased osteoblastic and osteoclastic activity
chalk stick fxr
Normal Ca, P, PTH
Increased ALP
Increased Hat size and hearing loss
A

Paget’s Disease of bone

Hearing loss due to CN impingement

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17
Q

Paget’s Disease of bone pattern

A

Mosaic woven bone pattern –> chalk stick fxr

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18
Q

How does Paget’s Disease of bone cause high output heart failure?

A

Increased blood flow to bone due to increased AV shunts

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19
Q

Cancer risk increased in Paget’s disease of bone

A

Osteogenic Sarcoma

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20
Q

Bone diseases that impinge cranial nerves.

A

Osteopetrosis
Paget’s disease of bone

Bones thicken and narrow foramina

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21
Q

Bone replaced by fibroblasts, collagen, and irregular boney trabeculae

A

Polycystic Fibrous Dysplasia

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22
Q

McCune-Albright Syndrome

A

Polyostotic fibrous dysplasia

multiple unilateral bone lesions

Endocrine abnormalities (precocious puberty)
Cafe-au-lait spots
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23
Q

Tumors common at knee (distal femur proximal tibia)

A

Giant Cell tumor

Osteosarcoma

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24
Q

Tumors at metaphysis of long bones

A

osteosarcoma

otrochondroma

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25
Q

Epiphyseal tumor

A

Giant Cell tumor

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26
Q

Men 30-60
Malignant Cartilaginous tumor
expansile glistening mass in medullary cavity

A

Chondrosarcoma

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27
Q

Boys < 15
Diaphysis of long bone
Onion skin appearance of bone
anaplastic small blue cell malignant tumor

A

Ewing’s Sarcoma

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28
Q

Ewing Sarcoma mutation

A

t(11:22) translocation

33–Ewing’s jersey

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29
Q

10-20 y/o male
Malignant bone tumor
sunburst pattern on x-ray
metaphysis of long bone–knee

A

Osteosarcoma

30
Q

Codman’s Triangle

A

elecation of periosteum seen in osteosarcoma

31
Q

Male < 25
#1 benign bone tumor
mature bone with cartilage cap

A

osteochondroma (exostosis)

32
Q

Giant cell tumor of bone AKA

A

osteoclastoma

33
Q

Giant cell tumor x-ray buzz

A

double bubble

soap bubble

34
Q

Spindle shaped cells
multinucleated giant cells
20-40 y/o
Tumor at knee

A

Giant cell tumor

AKA osteoclastoma

35
Q

Infectious Arthritis bugs

A

S. aureus
Streptococcus
N. gonorrhoeae

36
Q

Sexually active

asymmetrical migratory arthritis

A

N. gonorrhoeae

37
Q

Infarction of bone and marrow

pain with activity

A

Osteonecrosis (avascular necrosis)

38
Q

Osteonecrosis causes

A

trauma
high dose corticosteroids
EtOH
Sickle Cell Anemia

39
Q

Most common site for osteonecrosis

A

femoral head

40
Q

HLA-B27+
Arthritis without Rheumatoid Factor
Male

A

Seronegative spondyloarthropathies

41
Q 
Skin rash
joint pain
Dactylitis
Pencil in cup finding on xray
HLA-B27+
A

Poriatic Arthritis

1/3 of psoriasis pts.

sausage fingers

42
Q

stiff spine due to fusion of joints–bamboo spine
HLA-B27
uveitis
Aortic regurgitation

A

Ankylosing Spondylitis

43
Q

Crohn’s and UC associated with what joint diseases?

A

Ankylosing Spondylitis

peripheral arthritis

44
Q 
Conjunctivitis
Urethritis
Arthritis
Post GI or chlamydia infxn
HLA-B27+
A

Reactive Arthritis (Reiter’s Syndrome)

“I can’t see, pee, climb trees”

45
Q

Marker specific for Rx induced lupus

A

Antihistone Ab

46
Q

Why is there a false + on Syphilis RPR/VDRL with SLE pts?

A

Antiphospholipid Abs cross react with cardiolipin used in tests

47
Q

Kidney syndromes associated with SLE

A
  1. Diffuse proliferative GN (nephritic)

2. Membranous GN (nephrotic)

48
Q

Markers for SLE

A

ANA–sensitive but not specific

dsDNA–specific, poor prognosis

Anti-Smith (anti-Sm)–very specific, not prognostic

49
Q

Sx of SLE

A 
Fever
fatigue
weight loss
Liebman-Sacks endocarditis
hiar adenopathy
Raynaud's
Malar rash (butterfly)
arthritis
Neurologic Sx
photosensitivity
50
Q

Liebman-Sacks Endocarditis

A

verrusous sterile vegetations on both side of heart valve

associated with SLE

51
Q 
Immune mediated widespread noncaseating granulomas
elevated ACE
Hypercalcemia
bilateral hilar denopathy on chest xray
Black female
Enlarged lymph nodes
A

Sarcoidosis

52
Q

Sarcoidosis associated with

A

restrictive lung disease
erythema nodosum
uveitis
hypercalcemia

53
Q

Mechanism of hypercalcemia with sarcoidosis

A

elevated 1-alpha Hydroxylase mediated vit. D activation in epithelioid macrophages

54
Q

Sarcoidosis Tx

A

Steroids

55
Q

Microscopic findings of sarcoid (buzz words)

A

Schaumann bodies

Asteroid Bodies

56
Q 
Pain/Stiffness in shoulder and hips
fever
malaise 
weight loss
femal > 50
Increased ESR, normal CK
NO MM. WEAKNESS
A

Polymyalgia rheumatica

57
Q

Polymyalgia rheumatica associated with

A

Giant Cell Temporal Arteritis

58
Q

Tx Polymyalgia rheumatica

A

Low dose steroids

59
Q 
Woman 20-50 
chronic widespread MSK pain
Stiffness parasthesia
poor sleep
fatigue
A

Fibromyalgia

60
Q

Progressive symmetrical proximal mm. weakness (shoulders most common)

endomysial inflammation

CD8+ mediated

A

Polymyositis

61
Q

Progressive symmetrical proximal mm. weakness

malar rash
Grottron’s papules
heliotrope rash
CD4+ cells

A

Dermatomyositis

62
Q

What do you need to worry about with dermatomyositis pts.

A

Occult malignancy

63
Q

Cells involved in Polymyositis and dermatomyositis

A

Poly–CD8+

Derm–CD4+
D is 4th letter of alphabet

64
Q

Poly/Dermatomyositis Labs

A

Increased CK
ANA+
anti-Jo-1 Ab’s

65
Q

Poly/Dermatomyositis Tx

A

Steroids

66
Q

1 NMJ disease

A

Myasthenia Gravis

67
Q

Proximal mm. weakness that improves with use

A

Lambert Eaton

68
Q

Lambert Eaton Pathophys

A

auto-Ab against presynaptic Ca channel –> decreased ACh released

69
Q

Myasthenia Gravis pathophys

A

Ab against post synaptic ACh receptors

70
Q

MG associated with

A

Thymoma

Thymic Hyperplasia

71
Q

Lambert Eaton Associated with

A

Small Cell CA of lung

72
Q

Metaplasia of Skeletal mm. to bone following trauma

UE and LE most commonly

A

Myositis Ossification

Pathology 1st aid (11 decks)

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