MSK, rheum

Question 1

Pharyngeal pouch 1

Answer 1

Epithelium of middle ear and auditory tube, TM, epithelium of external ear canal

Question 2

Pharyngeal pouch 2

Answer 2

Epithelium of palatine tonsil crypts

Question 3

Pharyngeal pouch 3

Answer 3

Thymus, inferior parathyroid glands

Question 4

Pharyngeal pouch 4

Answer 4

Superior parathyroid glands

Question 5

Hip flexion

Answer 5

Iliopsoas, rectus femoris, TFL

Question 6

Hip extension

Answer 6

Gluteus maximus, semitendinosus, semimembranosus, biceps femoris

Question 7

Hip abduction

Answer 7

gluteus medius, minimus

Question 8

Hip adduction

Answer 8

Adductor brevis, longus, magnus

Question 9

Sitting up from supine requires which muscles?

Answer 9

External abdominal oblique, rectus abdominis, hip flexors

Question 10

Prepatellar bursitis

Answer 10

pw inability to kneel on affected side; chronic trauma from repeated kneeling “housemaid’s knee”

Question 11

Anserine bursitis

Answer 11

Pain, tenderness along medial aspect of knee; overuse in athletes or fat people

Question 12

Common peroneal nerve

Answer 12

Fibular neck fractures or compression; cause weakness of dorsiflexion (deep peroneal), eversion (superficial peroneal nerve), loss of sensation over foot dorsum; “foot drop”

Question 13

Rickets: histology, clinical presentation

Answer 13

Unmineralized osteoid matrix and widened osteoid seams; bowed legs, “rosery chest,” lower rib indentations (harrison’s sulci), softening of skull (craniotabes), and growth retardation

Question 14

Obdurator nerve traverses through what and innervates?

Answer 14

Obturator foramen, supplies the muscles of the medial compartment of the thigh

Question 15

Avascular necrosis of the femoral head 2/2 injury to what artery

Answer 15

Medial femoral circumflex artery

Question 16

Caudal regression syndrome: etiology, presentation

Answer 16

Poorly controlled maternal diabetes; sacral agenesis with LE paralysis and urinary incontinence

Question 17

Osteoporosis rf

Answer 17

Smoking, menopause, steroids, inactivity, white, low body weight, ETOH use

Question 18

Tetracycline (e.g. doxy): contraindications and presentations of se

Answer 18

Avoid in pregnancy/young children; pw total bone growth retardation and staining of teeth

Question 19

Biggest determinant of bone density differences

Answer 19

Genetics

Question 20

Methotrexate se

Answer 20

Stomatitis (prevent with FA supplement), hepatotoxity

Question 21

Hydroxychloroquine se

Answer 21

permanent retinal damage

Question 22

Mitochondral encephalomyopathy presentation, example of what genetic principle

Answer 22

Lactic acidosis, ragged red SK fibers, CNS infarcts; heteroplasmy (different orgenellar genomes in 1 cell)

Question 23

Hypercalcemia in HL, sarcoid moa

Answer 23

T cells secrete interferon-gamma, activate macrophage, increase 1-alpha-hydroxylase activity, increase extrarenal formation of 1,25 hydroxy calciferol

Question 24

Eternacept moa, have to check what?

Answer 24

Fusion protein of TNF-alpha receptor and IG, act as decoy receptor to inhibit TNF-alpha activity in RA; check TB before

Question 25

Shaken baby syndrome pw

Answer 25

Subdural hematoma, b/l retinal hemorrhage

Question 26

Raloxifene moa

Answer 26

Prevent osteoporosis, protect against ER-positive BC

Question 27

Medroxyprogesterone

Answer 27

Prevent endometrial hyperplasia, carcinoma in women on estrogen therapy, prolonged use leads to osteoporosis

Question 28

Paget disease of bone moa, pw

Answer 28

Extensive osteoclastic activity (very large, up to 100 nuclei); bone pain with elevated alk phos

Question 29

Achondroplasia moa, pw

Answer 29

Activiating mutation of FGF receptor @ epiphyseal growth plate inhibits growth; dwarfism (short long bones with normal body)

Question 30

2 types of bone; which one more susceptible to osteo?

Answer 30

Cortical/compact (shaft of leg bones, outer envelope of all bones), cancellous bone (vertebral column, distal radius, hip, neck of femur); cancellous

Question 31

Primary osteoporosis: lab findings

Answer 31

Normal Ca, phosphorus, PTH

Question 32

Myasthenia gravis rx, se, and rx for se

Answer 32

AChase inhibitor (pyridostigme); can experience GI upsetness; scopolamine (selective muscarinic Ach receptor antagonist)

Question 33

Accomodation moa

Answer 33

Ciliary muscle contract, zonular fibers relax, and lens assume more convex shape

Question 34

Biphosphonate moa, indications, intake pecularities

Answer 34

Structural analog of pyrophosphynate; makes hydroxyapatite more insolub,e interferes with ostecloast function; osteoporosis, PDB, malignancy-induced hypercalcemia; fasting state with lots of water, stay upright to prevent reflux esophigitis

Question 35

Lambert Eaton presentation; check for?

Answer 35

proximal muscle weakness, CN/ANS involvement, hyporeflexia, incremental improvement to repeated movement; 1/2 have maligancy (small cell lung cancer)

Question 36

Steroid-induced osteo: moa

Answer 36

decreased bone matrix synthesis, inhibition of vita D activity at GI, increase PTH activity

Question 37

Musculocutaneous nerve

Answer 37

C5-C7; Motor: flexor muscles of upper arm; Sensory: lateral forearm

Question 38

Duchenne inheritence pattern, moa, pw, histo

Answer 38

XLR; absence of dystrophine causes myonecrosis; Gower sign, kyphoscoliosis; early: true hypertrophy of distal muscle, late: pseudohypertrophy in that fat and connective tissue replace muscle in distal muscle

Question 39

Succinylcholine SE

Answer 39

Severe hyperkalemia in burn/crush patients, malignant hyperthermia, arrythmia

Question 40

Muscle relaxants (dantrolene, baclofen) and moa

Answer 40

Dantroline: Acts on ryanodine receptors in SR, prevents Ca release; Baclofen: Affects GABA receptors at spine;