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Step 1 Review > MSK Path High Yield > Flashcards

MSK Path High Yield Flashcards

1
Q

“failure of longitudinal bone growth (endochondrial ossification) leading to short limbs”

A

Achondroplasia

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2
Q

What is the mutation in achondroplasia?

A

a constitutive activation of fibroblast growth that inhibits chondrocyte proliferation

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3
Q

“trabecular (spongy) bone loses mass and interconnections despote normal bone mineralization”

A

Primary osteoporosis

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4
Q

Which 4 drugs classes cause osteoporosis?

A

1- antconvulsants
2- steroids
3- anticoagulants
4- Thyroid replacement therapy

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5
Q

Which type of osteoporosis is associated with increased osteoclast activity?

A

Type I post menopausal

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6
Q

Which type of osteoporosis is associated with decreased osteoblast activity?

A

Type II (senile)

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7
Q

“failure of normal bone resportion due to defective osteoclasts–> thickened dense bone”

A

osteopetrosis

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8
Q

What are associated findings with osteopetrosis?

A

Visual and

Pancytopenia and estramedullary hematopoiesis

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9
Q

What is the mutation in osteopetrosis?

A

Carbonic anhydrase II

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10
Q

“defective bone mineralization/ calficification of osteoid–> soft bones that bow out”

A

Osteomalacia/ rickets

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11
Q

What is the PTH level in osteomalacia/ rickets? The ALP level?

A

Increased!!!

ALP is increased because of the osteoblasts

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12
Q

“increase in both osteoblastic and osteoclastic activity leading to a mosaic bone pattern of woven and lamellar bone”

A

Paget disease of bone

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13
Q

What are the 4 stages of paget disease?

A

1- Lytic (osteoclasts)
2- Mixed (both)
3- Sclerotc (osteoblasts)
4- Quiescent (minimal activity)

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14
Q

What cancer is there an increased risk of with pagent disease of bone?

A

osteogenic sarcoma

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15
Q

What is a common cause of death in paget disease?

A

High Output cardiac failure

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16
Q

What is the most common site of osteonecrosis? What is the causative artery?

A

Femoral head

Medial circumflex femoral artery

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17
Q

What is Leff- Calve Perthes disease?

A

Idiopathic osteonecrosis

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18
Q

What are the abnormal lab values in osteoporosis?

A

None

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19
Q

What is the abnormal lab value in paget disease?

A

Increased ALP

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20
Q

What are the abnormal lab values in osteomalacia?

A

Decreased Ca
Decreased PO4
Increased ALP
Increased PTH

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21
Q

What are the abnormal lab values in Primary hyperparathyroidism?

A

Increased Ca
Decreased PO4
Increased PTH
Increased ALP

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22
Q

What are the abnormal lab values in secondary hyperparathyroidism?

A

Decreased Ca
Increased PO4
Increased ALP
Increased PTH

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23
Q

“brown tumor due to fibrous replacement of bone and subperiosteal thinning”

A

Osteitis fibrosa cystica

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24
Q

What are the 3 actions of vit D?

A

Intestine: Increased absortion of Ca and PO4

Kidney: increased reab of Ca and PO4

Bone: increased reab of calcium and phosphate

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25
Q

Location of osteoma?

A

facial bones

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26
Q

What is condition is osteoma associated with?

A

Gardner syndrome

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27
Q

“benign tumor of osteoblasts surrounded by a rim of reactive bone”

A

Osteoid osteoma

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28
Q

Bone tumor associated with nighttime pain that improves with aspirin

A

Osteoid osteoma

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29
Q

Where are osteoid osteomas typically located?

A

Diaphysis

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30
Q

Where is osteoblastoma usually located?

A

Vertebrae

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31
Q

What is the major difference between osteoblastoma and osteoid osteoma?

A

Pain does not resolve with aspirin in osteoblastoma

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32
Q

Where are osteochondromas usually found?

A

metaphysis (lateral projection)

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33
Q

“Tumor of bone with overlying cartilage cap”

A

Osteochondroma

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34
Q

“malignant proliferation of osteoblasts”

A

Osteosarcoma

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35
Q

Where are Osteosarcomas usually located?

A

Metaphysis

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36
Q

What is the X ray appearance of osteosarcoma on Xray?

A

Codman triange or sunburst pattern

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37
Q

“bone tumor composed of multinucleated giant cells and stromal cells”

A

giant cell tumor

38
Q

Where are giant cell tumors usually located?

A

Epiphysis of long bones

39
Q

What is the appearance of giant cell tumors on xray?

A

soap bubble appearance

40
Q

“malignant proliferation of poorly differentiated cells derived from neuroectoderm”

A

Ewing sarcoma

41
Q

Where are ewing sarcomas usually located?

A

diaphysis

42
Q

Joint pain that improved with use?

A

Rheumatoid arthritis

43
Q

Joint pain that worsens with use?

A

Osteoarthrtis

44
Q

What type of hypersensitivity is RA?

A

Type III and Type IV

45
Q

Which joints are spared in osteoarthritis?

A

MCP

46
Q

What joints are spared in RA?

A

DIP

47
Q

“inflammatory granulation tissue formation in joints seen in RA”

A

Pannus

48
Q

What type of necrosis do rheumatoid nodules exhibit?

A

Fibrinoid necrosis

49
Q

What HLA type is associated with RA?

A

HLA DR4

50
Q

What are the 2 autoantibodies associated withRA?

A

Anti- IgG antibody

Anti- cyclic citrullinated peptide antibody

51
Q

“reactive bony formation seen in osteoarthritis”

A

Osteophyte

52
Q

“reactive bony formation seen in osteoarthritis”

A

Osteophyte

53
Q

Autoantibodies seen in sjogrens?

A

Anti SS-A and SS-B (ANA antibodies)

54
Q

What are 2 possible complications of Sjogrens?

A

Dental carries

MALT (parotid enlargement)

55
Q

Which genetic conditions cause an over production of uric acid?

A

Lesch- Nyhan syndrome
von Gierke disease
PRPP excess

56
Q

What color are urate crystals under parallel light? Perpendicular light?

A

Parallel–> yellow

Perpendicular–> blue

57
Q

“white chalky aggregates of uric acid crystals with fibrosis and giant cells seen in gout”

A

tophus

58
Q

:“pain and effusion in a joint caused by deposition of calcium pyrophosphate crystals within the joint space”

A

Pseudogout

59
Q

Shape of pseudogout crystals?

A

rhomboid crystals

60
Q

What are 3 possible causes of pseudogout?

A

1- hemochromatosis
2- hyperparathyroidism
3- osteoarthitis

61
Q

What color are pseudogout crystals in parallel light?

A

Blue

62
Q

Most common cause of infectious arthritis in older children and adults?

A

S. aureus

63
Q

What is the most common cause of infectious arthritis in young adults?

A

Neisseria gonorrhea

Migratory infections arthritis

64
Q

What HLA type are Psoriatic arthritis, ankylosing spondyliti, IBD and Reactive arthritis associated wth?

A

HLA- B27

65
Q

“chronic inflammatory disease of spine and sacroiliac joints”

A

Ankylosing spondylitis

66
Q

What are 2 common findings of ankylosing spondylitis?

A

bamboo spine (vertebral fusion)

aortic regurgitation

67
Q

“conjunctivitis + urethritis + arthritis”

A

Reactive arthritis

68
Q

What are 4 organisms associated with reactive arthritis?

A

Shigella

Salmonella
Yersinia
Campylobacter
Chlamydia

69
Q

What 2 renal presentations are seen in lupus?

A

Membranous glomerulonephritis—> nephrotic

DPGN–> Nephritic

70
Q

What autoantibody is MOST SPECIFIC for lupus?

A

anti- dsDNA/ anti- smith

71
Q

What are anti-smith antibodies against?

A

snRNPs

72
Q

What is antihistone antibodies associated with?

A

drug induced lupus

73
Q

What is needed for a diagnosis of antiphospholipid syndrome?

A

Hx of thrombosis

Lupus anticoagulant/ anticoardiolipin/ ant beta2 glycoprotein sntibodies

74
Q

Anticardiolipin antibodies can cause a false positive in what test?

A

VDLR

75
Q

:immune mediated, widespread noncaseating granulomas with elevated ACE levels”

A

Sarcoidosis

76
Q

What is the ratio of CD4/ CD8 in sarcoidosis?

A

Increased!

77
Q

Is sarcoidosis a restrictive or obstructive lung disease/

A

restrictive

78
Q

What causes hypercalcemia in sarcoidosis?

A

Increased 1alpha hydroxylase mediated vit D activation in macrophagges

79
Q

“pain andstiffness in soulders and hips with fever, malaise and weightloss”

A

Polymyalgia rheumatica

80
Q

What disease is polymyalgia rheumatica associated with?

A

temporal (giant cell) arteritis

81
Q

“chronic widespread musculoskeletal pain associated with stiffness, paresthesias, poor sleep and fatigue”

A

fibromyalgia

82
Q

What are the antibodies associated with polymyosiitis and dermatomyositis?

A

ANti-Jo-1
Anti SRP
Anti Mi-2

83
Q

“progressive PROXIMAL muscle weakness, characterized by endomysial inflammation with CD8+ cells”

A

Polymyositis

84
Q

“progressive PROXIMAL muscle weakness with associated malar rash, grotton papules on elbows and knees, “shawl and face” rash”

A

Dermatomyositis

85
Q

What is the cell type associated with polymyositis?

A

CD8+

86
Q

What cel type is associated with dermatomyositis?

A

CD4+

87
Q

Autoantibodies to presynaptic Ca channel leading to decreaed ACh release?

A

Lambert- Easton Syndrome

88
Q

What condition is myasthenia gravis associated with?

A

Thymoma

89
Q

“metaplasia of skeletal muscle into bone following muscular trauma”

A

Myositis ossificans

90
Q

“autoimmunity, noninflammatory vasculopathy, collagen deposition with fibrosis”

A

Scleroderma

Tightening of the skin without wrinkles

91
Q

What autoantibody is associated with diffuse scleroderma?

A

anti- Scl-70 (anti- DNA topoisomerase I antibody)

92
Q

What is seen in limited scleroderma?

A

CREST

Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telandiectasia

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