Musc/Skin Flashcards
Prevent paracellular movement of solutes btwn epithelial cells?
Tight junctions= Composed of Claudins & occludins
Forms a belt connecting Actin cytoskeleton of adjacent cells? Loss of this promotes Metastasis?
Adheren junctions. Cadherins (Ca dependent ahderins)
**Loss of E-cadherin= Mets
Structural support via Keratin interactions?
Desmosome= Macula adherine
Membrane proteins that maintain integrity of Basement membrane by binding to Lamina in BM?
Integrins= maintain INTEGRITY to BM
Unhappy triad?
ACL
MCL
medial meniscus
Slow twitch, high Mitochondria/ Myoglobin, Increased Ox-phos?
Type 1
Osteoclast defect causing bone in bone appearing defects leading to pancytopenia, deafness, visual issues. What is the mutation?
Osteopetrosis== Carbonic anhydrase II **Rx= BM transplant since Osteoclasts are derived from Monocytes
Pigeon breast, frontal bossing, ribs with bumps?
Rickets = Vit D def
Man complains of increased hat size, hearing loss. Bone biopsy shows mosaic formation. What is he at risk for?
Pagets dz== Lytic phase–> Blastic phase
High output cardiac failure
Osteogenic sarcoma
Labs values for: Osteoporosis? Osteopetrosis? Osteitis fibrosa cystica? Pagets dz?
porosis=> ALL normal
petrosis=> dec Ca, inc ALP
osteitis=> inc Ca/ALP/PTH, low Phosphate
Pagets=> High ALP
Pt with early puberty, multiple bone lesions, and skin spots?
McCune-Albright syndrome
- Polyostotic fibrous dysplasia
- Precocious puberty
- Cafe-au-lait
20 yo with bone pain. X-ray shows growth off metaphysis with cartilaginous cap?
Osteochondroma
What are the Risk factors for developing osteosarcoma?
Pagets
Retinoblastoma
Bone infarcts (osteomyelitis)
X-ray shows Codman’s triangle + sunburst appearance?
Osteosarcoma
12 yo with pelvic pain. Biopsy shows small blue cells in “onion skin appearing bone?”
Ewing’s sarcoma= t(11;22)
*<15yo + Neuroectodermal
pt with hx of colonic polyps develops a benign growth of the facial bone?
Gardner’s syndrome
- FAP
- Osteomas
- Multiple fibromas
16 yo boy with bone pain relieved by Aspirin. X-ray shows radiolucent focus surrounded by sclerotic bone?
Osteoid Osteoma
What kind of HS is RA?
T3HS == IgM against IgG -> activates C5a-> PMNs come
What antibodies are associated with RA?
Anti-IgG - Rheumatoid factor
Anti-citrullinated peptide
HLA-DR4
Pannus vs Osteophyte?
Pannus= RA osteophyte= Osteoarthritis
Pt with chronic RA can develop?
Sjogrens
Rheumatoid nodules = Fibrinoid necrosis
2nd Amyloidosis= SAA
What is the Rx for Sjogrens symptoms?
Cholinergic agonist== Cevimelin
What things are associated with increased risk for GOUT?
HGPRT def = Lesch nyhan PRPP excess Thiazide diuretics = Low Uric acid excretion Leukemia/Lymphomas Von Gierke's Dz= Lactic acidosis ETOH
Needle shaped, negatively (yellow) birefringent crystals are?
MSU= Gout **Chronic= Tophus
Rhomboid + Positively (blue) birefringent crystals are?
Calcium Pyrophosphate = Pseudogout
What are the seronegative (-RF) HLA-B27 associated spondlyoarthropathies?
Psoriatic = "pencil in a cup" Ankylosing = Bamboo spin, Uveitis, Aortic Regurg, Restrictive lung dz IBD = accompany Ankylosing spondylitis Reiters= Conjunctivitis, Uveitis, arthritis (post Chlamydia)
Osteomyelitis in children vs Adults?
Children= metaphysis (high BF) adults = Epiphysis
Bone biopsy of Osteomyelitis shows?
Sequestra = necrotic bone Involucrum = New bone
Rx for AA female with erythema nodosum, restrictive lung dz, high ACE levels, and biopsy shows Asteroid bodies?
Sarcoidosis –> STEROIDS
Muscle weakness + Endomesial CD8 inflammation?
Polymyositis
- *Inc CK
- *Rx= Steroids
Signs and symptoms of Dermatomyositis?
Malar rash Gottron's papules heliotrope rash= Under the eyes Perimysial CD4 inflammation **inc CK + Anti-Jo1 antibodies Rx= Steroids
Pt with recent trauma to arm has an x-ray showing a suspicious mass @ site of injury?
Myositis ossifcans == Muscle–> Bone METAPLASIA
Anti-centromere vs anti-topoI antibodies?
Anti-Scl-70 (topoI)= Scleroderma
Anti-Centromere= CREST syndrome
When is epidermal hyperplasia of the Spinosum layer seen?
Acanthosis nigricans
Pregnant women complains of getting hyperpigmentation of the the face?
Melasma= normal
**also seen with OCP (estrogen related)
Condyloma accuminatum vs Condyloma lata?
accuminatum= HPV Lata = 2nd syphilis
Person randomly develops a bunch of “stuck on” lesions?
Seborrheic keratosis= associated with GI malignancy
Erythemas: ? Chronicum migrans= Marginatum= Multiforme= nodosum?
migrans= Lymes dz (think head= bells palsy) Marginatum= Rheumatic fever Multiforme= Infections/drugs (sulfa/mycoplasma) Nodosum= inflammation of subq Fat (infections)
pruritic plaque with fine white lines on surface. Polyglonal shaped lesion is biopsied and showes Sawtooth lymphocytic infiltrates @ dermal-epidermal junction?
Lichen Planus= Lots of Ps
Pt comes in with a patch on the neck that a week later followed by a patches climbing up his back?
Pityraisis rosea= SELF limiting
UVA vs UVB?
A= aging + drug photosensitivity B= burn
Anagen vs Telogen phases of hair growth?
Telogen= Resting Anagen = Growing
Pt with well circumscribed area of hair loss?
Alopecia Areata
Telogen affluvium?
Post partum self-limiting hair loss
Hyper/hypopigmentation of skin caused by a “spaghetti & meatball” looking organism under KOH?
Tinea vesicolor= Malasthenia furfur
Pt with a S-100+ cancer that also has a BRAF kinase mutation?
Melanoma
Rx= vemurafenib (TKi)
