Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK-Derm by Minnie > MSK SAS/Review > Flashcards

MSK SAS/Review Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

A herniation of the L5-S1 space primarily affects the S1 nerve root, a primary component of the sciatic nerve, but would not affect the femoral or obturator nerve (L2-4). What muscle group of the lower limb would be least affected by this herniation?

A. Lateral compartment of the leg

B. Anterior compartment of the leg

C. Medial compartment of the thigh

D. Posterior compartment of the thigh

E. Deep posterior compartment of the leg

A

C. Medial compartment of the thigh (obturator nerve)

All other listed compartments are innervated by the sciatic nerve or the tibial or fibular branches of it

  • Lateral leg = superficial fibular nerve
  • Anterior leg = deep fibular nerve
  • Posterior thigh = sciatic nerve
  • Deep posterior compartment of the leg = tibial nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Citrullinated peptide (ACPA or CCP) is associated wtih which autoimmune disorder?

A

Rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

You are following a patient with psoriatic arthritis. Which of the following is NOT a feature consistent with this diagnosis?

A. Dactylitis

B. Nail pitting

C. MCP erosions

D. Pencil in cup deformity

E. Sacroiliitis

F. Enthesitis

A

C. MCP erosions

  • MCP involvement more often seen in rheumatoid arthritis
  • MCP usually spared in psoriatic
  • Psoriatic usually involves DIP and/or PIP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rickets is the inability to calcify which zone in the developing growth plate?

Identify the zone

A

B - Zone of hypertrophy

  • A = zone of ossification
  • B = zone of hypertrophy
  • C = zone of proliferation
  • D = resere cartilage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which of the following histological sections shows elastic cartilage?

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is atopic dermatitis most likely to present in toddlers?

A

Extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following opioid medications is most likely to cause side effects of itching and palpitations?

Why?

A. Fentanyl

B. Tramadol

C. Morphine

D. Hydrocodone

A

C. Morphine

  • Morphine is the most likely opioid to cause histamine release
  • This could lead to hypotension, tachycardia, urticaria, and pruitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Between which layers in the hand is the midpalmar space located?

A

Between the flexor tendons and metacarpal bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which drugs are associated with drug-induced eczema?

A

Calcium chanel blockers

Consider in adults with new-onset eczema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following is a major driver of scleroderma pathogenesis?

  1. Microangiopathy with associated ischemic tissue injury
  2. Increased production of IL-1 from the inflammasome
  3. Oxidative stress of the endoplasmic reticulum
  4. Genetic defects in collagen cross-linking
  5. “Garbage disposal”. Hypothesis of accumulation of autoantibodies and subsequent complement activation through Interferon Gamma
A

a. Microangiopathy with associated ischemic tissue injury

Damage of the endothelium causes microangiopathy. As a part of healing, fibroblasts never fully shut off and continue to produce collagen and scar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A cervical herniation at C5-6 will affect the musculocutaneous nerve. During physical examination, what difficulty would you expect to see in a such a patient?

A

Flexing the arm at the shoulder, flexing the elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most appropriate treatment for acute gout?

A

Colchicine

  • Depolymerized microtubules to prevent leukocyte migration

Note: Long-term management with probenecid to prevent an acute attack, but it will not treat an acute attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of the following is a side effect of methotrexate?

A. Hypertension

B. Osteoporosis

C. Transaminitis

D. Progressive Multifocal leukoencephalopathy

E. Avascular Necrosis

A

C. Transaminitis (elevation of liver enzymes)

  • Make sure you monitor in patients on methotrexate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A 35 year comes to your office with right foot weakness since her hospital stay 1 month ago. She says her right foot slaps when she walks quickly. On exam, she has weakness at the right ankle and loss of sensation at the first web space of the foot.

Which nerve is most likely affected?

A

Deep fibualr nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What substance lines the articular surfaces of bones in a synovial joint?

A

Hyaline cartilage

Note - there is no perichondrium on articular cartilage

(Perichondrium is the connective tissue that envelops cartilage when it is not at a joint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which blood test should you check before starting treatment with infiximab or adalimumab?

Why?

A. Hepatitis C

B. Quantiferon gold

C. JC virus

D. TPMT enzyme levels

A

B. Quantiferon gold

Check for latent TB infection

Both infliximab and adalimumab are anti-TNF-alpha agents. TNF-alpha plays an important role insequestering bacteria inside of granulomas to prevent systemic infection.

Loss of TNF-alpha can lead to reactivation of TB. Need to test before starting treatment to clear latent TB first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anti SCL-70 (Anti Topoisomerase I) antibody is associated with which autoimmune disease?

Describe its presentation

A

Scleroderma

  • Taut/thickened skin
  • Stiffness and tightness in fingers; limited motion
  • Raynaud phenomenon
  • Difficulty swallowing
  • Cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is atopic dermatitis most likely to present in older children and adults?

A

Flexural distribution

(insides of joints)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which cytokines are involved in the pathogenesis of systemic juvenile idiopathic arthritis?

A

IL-1, IL-6, and IL-18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Are these crystals characteristic of gout or pseudogout?

A

Gout

  • Negatively birefringent
    • Yellow when parallel to the polarizer
    • Needle shaped
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

HLA B27 is associated with which condition?

A

Seronegative arthropathis (aka spondyloarthropatheis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What kind of tissue is this?

A

Loose connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the following is a major driver of the pathogenesis of systemic lupus erythematosis?

  1. Microangiopathy with associated ischemic tissue injury
  2. Increased production of IL-1 from the inflammasome
  3. Oxidative stress of the endoplasmic reticulum
  4. Genetic defects in collagen cross-linking
  5. “Garbage disposal”. Hypothesis of accumulation of autoantibodies and subsequent complement activation through Interferon Gamma
A

e. “Garbage disposal”. Hypothesis of accumulation of autoantibodies and subsequent complement activation through Interferon Gamma

This continues to drive the immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

74 y/o comes in with unilateral calf pain with walking more than 3 blocks. Symptoms have been present for six months. Denies knee pain, numbness or tingling, or pain at rest. You decide to check an ankle-brachial index, which is abnormal.

Which of the following conditions is the most likely diagnosis?

A. Ruptured Baker’s (popliteal) cyst

B. Popliteal artery entrapment

C. Peripheral artery disease

D. Deep venous thrombosis

A

C. Peripheral artery disease

No symptoms at rest, symptoms with exertion = characteristic of PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which cytokine is inhibited by Tocilizumab?

Which condition does it treat?

A

IL-6

Rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A cervical herniation at C5-6 will affect the musculocutaneous nerve. What muscle group will be affected by impingement of this nerve?

A

Anterior arm (biceps brachii, brachialis, coracobrachialis))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which of the following histological sections could be from the annulus fibrosis?

A

B

This image shows fibrocartilage, which is what the annulus fibrosis is made from

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which artery serves the anterior compartment of the leg?

A

Anterior tibeal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which gene is mutated in Ehlers Danlos Syndrome?

What is the effect on the corresponding protein?

A

COL5A1 or COL5A2 - Type 5 Collagen

Results in haploinsufficiency -> stretchy, fragile skin, joint hypermobility, dislocations, mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which artery supplies the gastrocnemius muscle?

A

Popliteal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Back pain that is “unaffected by sitting and bending over, but feels worse with ‘cobra’ streching” most likely originates from which anatomic structure?

A. Intervertebral disc

B. Zygapophysial (facet) joint

C. Interspinous ligament

D. Quadratus lumborum muscles

A

B. Zygapophysial (facet) joint

  • Disc pain would be worse with sitting and bending over
  • Interspinous ligament doesn’t usually cuase low back pain
  • Quadratus lumborum pain is likely less severe and unilateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Usain Bolt can run 100m in under 10 seconds.
During such a sprint, what substrate would his gastrocnemius muscle likely use to produce ATP to generate muscle contractions?

A. Glycogen via aerobic pathways

B. Creatine phosphate (CP)

C. Glycogen via anaerobic pathways

D. Fat via aerobic pathways

A

B. Creatine phosphate (CP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which biologic agent prevents the activation of CD20 on B cells?

A

Rituximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the mechanism of action of infliximab?

A

Monoclonal antibody against TNF-alpha; prevents TNF-alpha from binding to its receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

13y/o with 3 months of left anterior knee pain. Minimal pain with walking but more pain with sports play. There is tenderness to palpation and mild swelling at the left tibial tuberosity.

What is the most likely diagnosis?

A. Osgood-Schlatter

B. Sinding-Larsen-Johansson

C. Patellar tendinopathy

D. Patellar fracture

A

A. Osgood-Schlatter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where is atopic dermatitis most likely to present in infants?

A

Face and scalp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where is atopic dermatitis most likely to present in adults?

A

More head, neck, and hand lesions

Insides of joints too (Also see this in older children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What kind of tissue is this?

A

Elastic cartilage

39
Q

A 35 year comes to your office with right foot weakness since her hospital stay 1 month ago. She says her right foot slaps when she walks quickly. On exam, she has weakness at the right ankle and loss of sensation at the first web space of the foot.

Which muscle is most likely to be weak?

A. Fibularis longus

B. Tibialis anterior

C. Flexor hallucis longus

D. Soleus

A

B. Tibialis anterior

  • Controls dorsiflexion (extension) of the foot, which is necessary to prevent the foot from slapping
  • Inervated by deep fibular nerve
40
Q

What kind of tissue is this?

Label the structures

      1. 4.
A

Hyaline cartilage

  1. Lacunar space
  2. Chondrocyte
  3. Interterritorial matrix
  4. Isogenous groups
41
Q

A fracture in which of the locations indicated in the X-ray below would result in pain and diminished function during extension of the elbow joint?

A. A

B. B

C. C

D. D

E. E

A

B

The olecranon process of the ulna

Attachment for triceps brachii

42
Q

Which of the movements of the thumb illustrated below would NOT be affected by carpal tunnel syndrome?

A

B (extension)

Extensor pollicis longus and brevis are in the posterior forearm, supplied by the radial nerve

  • Abduction - Abductor pollicis longus (anterior forearm) and brevis (thenar compartment) are controlled by the median nerve
    • Recurrent branch for brevis
43
Q

Which opioid blocks the reuptake of serotonin and norepinephrine in the CNS?

A

Tramadol

44
Q

A 54 year old woman presents to the clinic with fatigue, difficulty swallowing, cough and stiffness and tightness in her fingers. Additionally she explains her fingers occasionally become pale and painful when she forgets to wear gloves on a cold day, and she has a picture of that on her phone. On examination, her skin is taught and thickened in her fingers. Her hand skin appears contracted and fingers have limited motion.

Which serologic marker helps recognize her condition?

A

Anti SCL-70 (Anti Topoisomerase I) antibody

She has scleroderma

  • Tighness and stiffnes in fingers
  • Raynaud phenomenon
  • Taut/thickened skin
45
Q

In a patient with lupus, what is the SSA antibody associated wtih?

A
  • Neonatal lupus
  • Heart block
  • Subacute cutaneous lupus

anti-SSA antibody is not associated with renal involvement

(anti-dsDNA antibody is associated with renal involvement)

46
Q

Describe the presentation of systemic juvenile idiopathic arthritis

A
  • 16 y/o and younger
  • F = M
  • Fever daily for ≥2 weeks + arthritis for ≥6 weeks, and one or more of the following
    • Evanescent rash
    • Hepatosplenomegaly
    • Lymphadenopathy
    • Serositis
  • Anemia, leukocytosis, thrombocytosis
  • Elevated LFTs
  • Driven by IL-1, IL-6, IL-18
47
Q

Back pain in adolescent.

Which part of the vertebra is fractured?

A

Pars interarticularis (connecting facet joints)

48
Q

What bacterial typically causes erysipelas?

A

Group A strep

49
Q

Avascular necrosis is associated with which medication commonly used in musculoskeletal medicine?

A

Prednisone (oral corticosteroids)

50
Q

60 year old falls on an outstretched hand and has immediate onset of wrist pain. There is a visible deformity of the distal forearm at the wrist with surrounding swelling.

What bone is affected?

What part?

A

Radius

Metaphysis

51
Q

What is the difference between dependence on and tolerance of a drug?

A
  • Dependence
    • Physical and psychological symptoms if drug is withdrawn
    • Caused by physiological adaptations in the CNS and brain due to chronic exposure
  • Tolerance
    • Reduced reaction to a drug following its repeated use
52
Q

____% of melanomas develop within a pre-existing nevus

A

30% of melanomas develop within a pre-existing nevus

53
Q

45 year old male comes in with 4 months of pain at the right distal posterior leg. Pain occurs primarily with running but can sometimes occur with walking. On exam, he can do a single-legged heel raise but has pain when doing this on the right. He has swelling and tenderness to palpation at the Achilles tendon on the right. There is no erythema or increased warmth.

What is the most likely diagnosis?

A. Gastrocnemius muscle strain

B. Retrocalcaneal bursitis

C. Achilles tendinopathy

D. Lumbosacral radiculitis

A

C. Achilles tendinopathy

NOT an inflamatory pathogenesis

54
Q

A patient has compartment syndrome in the anterior compartment of the leg as a result of bleeding and swelling from a bone fracture.

What nerve is in danger of being compromised due to lack of blood flow?

A

Deep fibular nerve

Innervates the anterior compartment of the leg

55
Q

Which of these tests is most specific for a diagnosis of lupus?

A. ANA

B. dsDNA

C. SSA

D. Low C4

E. Lupus anticoagulant

A

B. dsDNA

  • ANA is more sensitive, but not specific
    • Used to screen patients with a high pre-test probability of having lupus
    • Should not be used in the general population; many people with no symptoms or disease will have a positive ANA
  • dsDNA is associated with renal involvement in lupus
56
Q

A malignant bone tumor is identified on the femoral diaphysis of a 12 yo boy. The physician suspects….

A. Ewing’s sarcoma

B. Osteosarcoma

C. Osteochondroma

D. Fibrous dysplasia

E. Giant cell tumor

A

A. Ewing’s sarcoma

Any tumor in the femor in a boy <15 years old is most likely Ewing sarcoma

57
Q

Progressive multifocal leukoencephalopathy is a potential side effect of which drug used in musculoskeletal medicine?

A

Rituximab

A monoclonal antibody against CD20 on B cells; When rituximab binds to its target, it triggers cell death; used to treat some autoimmune conditions

58
Q

What muscles attach to the Achilles tendon?

A

Gastrocnemius, soleus, plantaris

59
Q

Name the structures indicated in this x-ray.

Which structures attach here?

A
  • A - Lateral epicondyle of the humerus
    • Extensors of the wrist (superficial posterior forearm)
  • B - Olecranon of the ulna
    • Triceps brachii
  • C - Medial epicondyle of the humerus
    • Flexors of the wrist (anterior forearm)
  • D - Radial tuberosity
    • Biceps brachii
  • E - Ulnar tuberosity
    • Brachialis
60
Q

A 45 year-old man presents to your office with a several year history of ulcerating skin nodules and abdominal pain after eating heavy meals. In addition, you find that left foot plantarflexion is weak, as well as right hand grip (the patient is right-handed). Examination shows no giant cells or granulomas. ANCA-negative.

You suspect:

A. Takayasu Arteritis

B. Polyarteritis Nodosa

C. Kawasaki Disease

D. Granulomatosis with Polyangiitis

E. Microscopic Polyangiitis

A

B. Polyarteritis Nodosa

  • Cutaneous manifestantion
  • Renal disease (not glomerular)
  • Neuropathy
  • Myalgia/weakness
  • Mesenteric ischemia
  • Orchitis
61
Q

A herniation of the L2-L3 space would affects the femoral nerve. Where on the lower limb is the dermatome of the femoral nerve?

A. Posterior thigh & leg

B. Dorsum of foot

C. Little toe

D. Anterior thigh

A

D. Anterior thigh

Also medial leg - basically the yellow spaces

62
Q

What nerve innervates the gastrocnemius?

A

Tibial nerve

63
Q

Which bacteria typically causes bullous impetigo?

A

S. aureus

64
Q

What clinical clues would increase your suspicion for Achondroplasia?

A
  • Shortened proximal limbs
  • Recessed midface/microcephaly
  • Trident hand
  • Short stature
65
Q

Which gene is mutated in Marfan Syndrome?

What is the effect on the corresponding protein?

A

FBN1 - Fibrillin 1

Mutated protein cannot form connective tissue microfibrils in the inter-cellular matrix

  • No scaffold for elastin
  • Excess TGF-beta signaling
66
Q

A patient has weakness in their power grip from swelling in the compartment containing flexor pollicis longus. What artery is compressed?

A. Ulnar (main branch)

B. Posterior interosseous

C. Deep palmar arch

D. Anterior interosseous

E. Deep brachial

A

D. Anterior interosseous

Flexor policis longus is in the deep anterior compartment of the forearm, supplied by the anterior interosseus artery

Anterior interosseus is a branch of the ulnar artery

67
Q

Which gene is mutated in achondroplasia?

What is the effect on the corresponding protein?

A

FGFR3 - fibroblast growth factor 3

Normally, when FGF binds to its site on FGFR3, chondrocyte proliferation is inhibited. In Achondroplasia, FGFR3 is constituitively on, resulting in the constituitive inhibition of chondrocyte proliferation. This results in inhibited bone growth

68
Q

These crystals are characteristic of which crystaline joint disease?

A

BCP arthropathy

(Basic calcium phosphate)

  • 1st MTP in young women
  • Milwaukee shoulder syndrome
  • Tendons (shoulder, mostly supraspinatus)
69
Q

An otherwise healthy boy was born by difficult vaginal delivery during which his neck was stretched damaging the upper trunk of the brachial plexus (C5-6) which contributes primarily to the axillary and musculocutaneous nerves. He has an abnormal appearance of right upper limb. His arm hangs by his side, pronated and medially rotated.

Which of the following muscles is still functioning in this patient?

A. Biceps brachii

B. Deltoid

C. Teres Minor

D. Flexor carpi ulnaris

A

D. Flexor carpi ulnaris

  • Injury to C5, 6 will affect the musculoscutaneous and axillary nerves. This results in loss/reduced function in:
    • Deltoid
    • Teres minor
    • Anterior arm (biceps brachi)
  • Injury to C7, 8 will affect the radial nerve, ulnar nerve, and median nerv
    • Deficits in wrist and hand function
70
Q

NSAIDs decrease pain by which of the following mechanisms?

  1. Increasing release of prostaglandin in the central nervous system
  2. Decreasing release of cyclooxygenase in the central nervous system
  3. Inhibiting the action of cyclooxygenase in the peripheral nervous system
  4. Decreasing the release of arachidonic acid
A

c. Inhibiting the action of cyclooxygenase in the peripheral nervous system

71
Q

What clinical clues would increase your suspicion for Ehlers Danlos Syndrome?

A
  • Stretchy skin
  • Abnormal scarring and bruising
  • Flat feet

Associated wtih defect in Type 5 Collagen (COL5A1)

72
Q

What material is attacked/destroyed in osteoarthritis?

A

A - hyaline cartilage

  • B is elastic cartilage
  • C is lamellar bone
  • D is skeletal muscle
73
Q

The 16th President of The United States was quite tall (6’ 4”), with relatively long limbs and long fingers and toes. He had pectus carinatum. Photographs form the time show his crossed leg blurred, inferred as a wide pulse pressure. His most likely heart murmur would have been caused by:

A. Aortic insufficiency

B. Mitral stenosis

C. Chest wall deformity

D. Anemia

A

A. Aortic insufficiency

Associated with Marfan Syndrome

74
Q

Which is NOT true of scintigraphy?

A. Useful to detect metastasis to bone

B. Sensitive

C. Specific

D. Time intensive

A

C. Specific

Will indicate areas of increasd bone turnover, but not what is causing it. Can be due to:

  • Infection
  • Healing fracture
  • Tumor
75
Q

What kind of tissue is this?

How do you know?

A

Dense regular connective tissue

Compressed fibroblasts (slivers)

76
Q

A 76 year old man presents with headache. On further questioning he also notes diplopia, difficulty combing his hair, getting out of a chair, and with chewing.

Laboratory testing demonstrates elevated ESR & CRP.

Which of the following is most appropriate diagnostic step?

A. Test for Hepatitis A

B. ANCA test

C. Electromyography

D. Temporal Artery Biopsy

A

D. Temporal Artery Biopsy

Suspect Giant Cell Arteritis - start high dose steroids immediately

  • Pts >50 y/o
  • Extracranial arteres
  • Fever, anemia, high ESR, headaches
  • Involvement of the opthalmic artery can lead to blindness
77
Q

Open fractures are managed with irrigation and debridement to reduce the chance of ….

A

Osteomyelitis

(#1 culprit is staph. aureus)

78
Q

13 y/o girl presents with several weeks of bilateral elbow and knee pain, fevers for two weeks, and shortness of breath. On exam she has a rash, tenderness and swelling around her elbows and knees, and a temp of 102. Exam of eyes is normal. Upon checking labs, she has several abnormalities including anemia, leukocytosis, and thrombocytosis

Which of the following is thought to be involved in the pathogenesis of this disease?

A. IgA vasculitis

B. Myopathy with vasculopathy

C. Inflammation driven by IL-1, IL-6, and IL-18

D. Systemic necrotizing vasculitis

A

C. Inflammation driven by IL-1, IL-6, and IL-18

This is systemic juvenile idiopathic arthritis

79
Q

What kind of tissue is this?

How do you know?

What structures are made from this?

A

Fibrocartilage

Herringbone pattern

Annulus fibrosis of the vertebral disk, meniscus of the knee

80
Q

This crystal is characteristic of which crystaline joint diseae?

A

Pseudogout

CPPD crystal

  • Postive birefringence
    • Blue when parallel to the polarizer
  • Rhomboide shaped
81
Q

What kind of tissue is this?

How do you know?

A

Hyaline cartilage

Round spaces are lacunae, where the chondrocytes live. They are surrounded by pink stuff

82
Q

Which gene is mutated in osteogenesis imperfecta?

What is the effect on the corresponding protein?

A

COL1A1 - Type I collagen

Different phenotypes; most severe = dominant negative effect, less severe = loss of function

83
Q

Which of the following medications does not affect platelets?

A. Ibuprofen

B. Diclofenac

C. Celecoxib

D. Naprosyn

A

C. Celecoxib

  • Selective COX2 inhibitor; does not affect coagulation/platelets
  • > decreased risk of GI ulcer/bleed
  • Can still cause renal problems, elevate BP, and increase risk of MI
84
Q

What is the cell of origin in:

  • Basal cell carcinoma:
  • Squamous cell carcinoma:
  • Melanoma:
A
  • Basal cell carcinoma: Keratinocytes (basal keratinocytes)
  • Squamous cell carcinoma: Keratinocyte
  • Melanoma: Melanocyte
85
Q

What clinical clues would increase your suspicion for Marfan Syndrome?

A
  • Tall, long limbs
  • Flat feet
  • Thumb sign - thumb sticks out when tucked under the fingers in a fist
  • Wrist sign - can wrap thumb and pinky finger around opposite wrist

Caused by a defect in fibrillin

86
Q

Modulation of ____ cell activation is an effective treatment for rheumatoid arthritis

A

Modulation of T cell activation is an effective treatment for rheumatoid arthritis

87
Q

Back pain that is “worse with sitting and bending over and better with standing, walking, and ‘cobra’ streching” most likely originates from which anatomic structure?

A. Intervertebral disc

B. Zygapophysial (facet) joint

C. Interspinous ligament

D. Quadratus lumborum muscles

A

A. Intervertebral disc

  • Disc pressures are higher with sitting and bending over vs. standing and walking
  • Z joint pain is usually worse with extension, not worse with sitting or flexion
  • Interspinous ligament doesn’t usually cuase low back pain
  • Quadratus lumborum pain is likely less severe and unilateral
88
Q

60 y/o male presents with one year of difficulty gripping using his nondominant hand. He also notes some difficulty with walking but says he tends to drive everywhere and does not exercise. On exam, you note mild weakness in the affected hand only but no other neurologic findings. His CK is mildly elevated.

Which of the following is the most likely diagnosis?

A. Polymyositis

B. Inclusion body myositis

C. Dermatomyositis

D. Polymyalgia rheumatica

A

B. Inclusion body myositis

  • Keys:
    • Distal weakness
    • Difficulty walking
    • Male >50
    • Asymmetric
    • Mildly elevated CK
89
Q

A 34 year old woman presents to you with joint pain and morning stiffness for the past nine months. The joint pain is present in both hands and feet bilaterally and has caused both deformity and weakness. On examination these joints are tender to palpation, warm and swollen. There is ulnar deviation of the fingers bilaterally

Which of the following are a genetic risk factor for this condition?

A. HLA B27

B. HLA DR loci

C. E4 allele of the apolipoprotein E (APOE)

D. HLA-A*3303

E. HLA-B51

A

B. HLA DR loci

  • This is a classic presentation of rheumatoid arthritis
  • DRB*01 and DRB*04 are associated with RA
90
Q

What clinical clues would increase your suspicion for Osteogenesis Imperfecta?

A
  • Multiple broken bones
  • Blue sclera
  • Wormian bones

Caused by a defect in Collagen Type I (COL1A1 or COL1A2)

91
Q

What is the definition of addiction?

A

Continued use of a drug despite the occurence of negative consequences with its continued use

92
Q

What medications are known to cause psoriasis flares?

A

Lithium

Beta-blockers

Steroid taper

Hydroxychloroquine

93
Q

Which cytokines can be targeted to treat psoriasis?

A

TNF-alpha

IL-17

IL-23

Note: Cytokine expression is driven by Th1 and Th17 helper T cells

94
Q

Which image shows lamellar bone?

A

C

  • A is hyaline cartilage
  • B is elastic cartilage
  • D is skeletal muscle

MSK-Derm by Minnie (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions