Musc Skel

Question 1

Paget’s appearance on XR

Answer 1

cotton ball appearance

widened bone with coarse trabecular marking

Question 2

Incr risk of ____ with Paget’s

Answer 2

osteosarcoma

Question 3

Name each condition
A) brittle bone disease, genetic
B) softening of bones, Vit D or Ca deficiency
C) rare inherited, bones become more dense
D) infection of bone or bone marrow

Answer 3

A) osteogenesis imperfecta
B) Rickets (in adults, osteomalacia)
C) osteopetrosis
D) osteomyelitis

Question 4

Paget's T or F
A) aka osteitis deformans
B) decreased osteoclast / blast activity
C) elevated alk phos
D) narrow trabeculae of osteoid

Answer 4

A) T
B) F accelerated activity, incr bone turnover
C) T
D) F mosaic pattern of lamellar bone

Question 5

In Paget’s a fracture is characterized by

Answer 5

breaking straight across

Question 6

MC organism assoc with osteomyelitis

Answer 6

Staph aureus

Question 7

With osteomyelitis, children are mostly affected in the ____ bones while adults are mostly affected in the ____ bones

Answer 7

children = long bones
adults = vertebrae and pelvis

Question 8

Bone cysts: solitary or aneurysmal?
A) honey-combed appearance
B) occur in metaphysis of long bns, vertebrae
C) occur in distal ends long bones
D) symmetrical

Answer 8

A) aneurysmal
B) aneurysmal.
C) solitary
D) solitary

Question 9

Condition assoc w deficiency of Type 1 collagen

Answer 9

osteogenesis imperfecta

Question 10

avascular osteonecrosis of the epiphysis of the femoral head

Answer 10

legg-calve-perthes

Question 11

Osteoporosis: primary or secondary?
A) advanced age
B) immobilization
C) hyperparathyroidism
D) menopause

Answer 11

A) primary
B) secondary
C) secondary
D) primary

Question 12

Bone cysts: solitary or aneurysmal?
A) occurs in young men
B) occurs in females in 20s, 30s
C) recurrence common
D) cavity filled w clear/bloody fluid

Answer 12

A) solitary
B) aneurysmal
C) aneurysmal
D) solitary

Question 13

MC type of joint disease

Answer 13

osteoarthritis

Question 14

Histo of osteroarthritis

Answer 14

fibrous lined cysts in subchondral bone, osteophytes

Question 15

The breakdown of articular cartilage is triggered by the release of ____ by chondrocytes

Answer 15

cytokines such as IL-1 IL-6 and TNF-alpha

Question 16

Nodules on DIPS?

Nodules on PIPS?

Answer 16

Heberden’s nodes

Bouchard’s nodes

Question 17

Changes within the joint in ostearthritis

Answer 17

joint space narrowing, bone spurs, subchondral bone cysts

Question 18

Bilateral, symmetrical fusiform swelling and redness of PIPs, MCT, MTP

Answer 18

RA

Question 19

JIA or RA?
A) subcutaneous nodules infrequent
B) more joint pain
C) 80% of cases assoc w RF
D) more frequent high fever, rash, LAD

Answer 19

A) JIA
B) RA
C) RA (vs 10-20% in JIA)
D) JIA

Question 20

MC GU infx that precedes reactive arthritis

Answer 20

Chlamydia

Question 21

Name for clinical triad of RA, including splenomegaly and manifestations of hypersplenism

Answer 21

Felty’s syndrome

Question 22

Genetic mutation for most seronegative spondyloarthropathies?

Answer 22

HLA-B27

Question 23

RA, AS, PA, Reactive or Septic?
A) Axial skeleton is affected
B) Affects DIPs
C) proliferative exudative synovitis 
D) dactylitis

Answer 23

A) AS
B) PA
C) RA
D) reactive, PA

Question 24

Calcium pyrophosphate dehydrate crystals (bifringent) deposit in knees/ankles

Answer 24

Pseudogout

Question 25

Pathognomonic lesion of gout

Answer 25

tophus, MTP 1

Question 26

Viral causes of arthritis

Answer 26

Parvo B19, rubella, Hep C, HIV

Question 27

Crystal that causes gout

Answer 27

uric acid

Question 28

``` Causes septic arthritis (organism) A) elderly, immunocomp B) MC older children/adults C) 2nd MC cause D) Sickle cell pts ```

Answer 28

A) E coli B) Staph aureus C) Strep spp D) Salmonella

Question 29

T or F | Reactive arthritis is caused by pathogens infecting the joints

Answer 29

F, arthritis is caused by antibody response to LPS in cell wall of organism. The organisms themselves do not infect joints.

Question 30

Reactive arthritis triad

Answer 30

non-gonococcal urethritis or cervicitis, conjunctivitis, and arthritis

Question 31

``` RA, AS, PA, Reactive or Septic? A) pitting of nails B) HLA-DR4 C) follows GU and GI infx D) hyperplastic synoviocytes ```

Answer 31

A) PA B) RA C) reactive D) RA

Question 32

MC form of muscular dystrophy

Answer 32

Duchenne's

Question 33

Poly, dermatomyositis, or Inclusion body? A) no skin involvement B) T8 lymphocyte infiltration C) periorbital heliotrope rash and Gottran's sign D) 50% of cases dt paraneoplastic syndrome

Answer 33

A) poly B) poly C) dermato D) dermato

Question 34

X-linked inability to produce dystrophin, resulting in excess Ca++ causing oxidative stress (death of cell)

Answer 34

Duchenne's

Question 35

MG or Lambert-Eaton? A) Ab block Ach receptors post synapse B) Assoc w small cell lung CA C) Abs target presynaptic Ca++ channels, inhibiting Ach release

Answer 35

A) MG B) LE C) LE

Question 36

People with MG also tend to have abnormalities of the _____. What form of abnormality in males? females?

Answer 36

thymus thymoma in males thymic hyperplasia in females

Question 37

MG or Lambert-Eaton? A) lymphocytes; pale/atrophic muscle fibers B) better w initial exertion, then worse C) worse activity / better rest

Answer 37

A) MG B) LE C) MG

Question 38

Poly, dermatomyositis or Inclusion body? A) adults; rare/nonexistent in persons younger than 20 B) slowly progressive weakness and wasting of distal and proximal muscles C) mixed B and T cell inflamm infiltrate D) dysphagia is a poor prognostic sign

Answer 38

A) poly B) inclusion C) dermato D) poly

Question 39

focal areas of white blood cells and other inflammatory cells, the appearance of vacuoles in the muscle, deposits of amyloid-related proteins within the muscle cells

Answer 39

inclusion body myositis

Question 40

Muscles fibers appear | pale & enlarged, invasion by macrophages

Answer 40

polymyositis

Question 41

Inflammatory cells invading muscle Necrotic muscle fibers under inflammatory cells Regenerating muscle fibers.

Answer 41

dermatomyositis

Question 42

Arthritis assoc with IBD, IgG associated

Answer 42

enteropathic arthritis