MSK/rheum Flashcards
Elderly pt with bullae. Histopathology with linear immunofluorescence at the dermal-epidermal junction
Bullous pemphigoid (BP) Autoimmune attack against hemidesmosomes
Pathophysiology of Guillain-Barre (even if it follows gastroenteritis)
Autoimmune disorder against peripheral nerves and Schwann cells.
Histology = perivenular and endoneurial infiltration with lymphocytes, Macrophages, and plasma cells
Symmetrical ascension
Pt unable to raise left arm. Leaves arm hanging at his side with forearm pronated
Erb palsy “waiters tip”
Upper trunk lesion
Affected muscles: abductors (deltoid, supraspinatus), lateral rotators (infraspinatus), and biceps
Pt with dysphagia, claw like hand due to tightened skin, small flat red skin marks, Subq nodules, with significant cold sensitivity in her hands
CREST Syndrome, varient of scleroderma Calcinosis (skin nodules) Raynaud phenomenon Esophageal dysfunction Sclerodactyly (skin thickening) Telangiectasis (small red marks from dilated vessels Anticentromere antibodies
Pt falling on outstretched hand, anterior shoulder dislocation likely
Axillary n. injury, inn deltoid. thus unable to abduct the shoulder
Pt that can’t lift arm the first 15 degrees of abduction
Supraspinatus injury
Pt may comment that they can lift arm after passing the 15 degree point
infant with lethargy, FTT, fever, increased head circumference, prominent hepatosplenomegaly with profound anemia and leukopenia. Autopsy shows infiltration of the medullary canal space by bony spongiose tissue
osteopetrosis
failure in bone remodeling due to osteoclast malfunction. medullary canal is replaced by bony matrix (loss of hemopoeitic material) and pts rely on extramedullary hematopoeisis. bone becomes brittle. AD version is more benign
function of isoniazid
prophylactic TB med following +PPD but - CXR. decreases synthesis of mycolic acids.
can cause drug induced SLE (anti histone Ab)
HLA type associated with RA and DM
HLA-DR4
HLA associated with akylosing spondylitis, post gonococcal arthritis, acute anterior uveitis
HLA-B27
HLA associated with Graves dz
HLA-B8
HLA associated with kawasaki dz
HLA-BW22
HLA associated with chronic active hepatitis, sjogren syndrom and T1DM
HLA-DR3
appearance of gout aspirate
negatively birefringent crystals
ca, phosphate, and alk phos in a pt with paget bone dz
nl ca, phos
high alk phos
which muscle opens the jaw?
lateral pterygoid. inn by V3
in a region of high prevalence what happens to PPV and NPV
PPV increases
NPV decreases
pt with fatigue, headache, and blurry vision. can also have fever and jaw pain
temporal (giant cell) arthritis
tx with corticosteroids
40-60yo pt with flaccid blisters that rupture leaving painful raw spots.
pemphigus vulgaris
autoimmune against desmoglein 3 in the desmosome and macula adherins (attaches epithelial cells together)
can be lethal
tx - corticosteroids
if a kid punches a wall and fractures his hand he probably broke which bone?
metacarpals “boxers fracture”
Mechanism of action of Tacrolimus
post transplant immunosuppresant
Inhibits calcineurin - inhibits T lymphocyte signaline
Test used to dx myasthenia gravis? Potential complication?
Test - ACh receptor Ab
Complication - thymomas (widened mediastinum)
tx - AChEI (pyridostigmine)
In long bone ossification
endochondral ossification = osteoblasts secrete osteoid over a hyaline cartilage model (woven bone)
Pt with fractures with a CBC showing:
elevated Calcium
Low Phosphate
High Alk phos
osteitis fibrosa cystica, a complication of untreated hyperPTH (too much reasorption, brown tumor in bone)