Musculo-Dermato Flashcards
Microtubule inhibitor of Gout
Colchicine
SOAP BRAIN MD
SLE presentation
Serositis
Oral ulcer
Arthritis
Photosensitivity
Blood changes
Renal insufficiency ( Nephrotic s )
ANA
Immunological changes
Neurological sign(seizure / psychosis)
Malar rash
Discoid rash
Enzyme defect syndrome causing Gout
Lesb Nyhan Syndrome
Klumpke Palsy
Birth delivery trauma to shoulder
(C8-T1 nerve root ) damage
Motor- Ulnar /Medial root ( thenar /hypothecated)wasting
Sensory deficit-palmar /dorsal
Claw hand ,
Canβt extend little / ring finger
Distal Ulnar
Trouble making a fist
Little /ring finger canβt flex /close
Proximal ulnar
Hand of Benediction
Canβt flex thumb/index/middle
Canβt make a fist
Proximal median n.
Canβt open hand
Thumb/index/middle flex
Distal medial n.
Funny triad
ACL
Lateral Maniscus
MCL
Ern palsy ( waiterβs tip)
Neck traction (falling on neck or during delivery pulling from neck )
C5-C6 nerve roots ( Axillary/musculocutaneous / suprascapular)
Canβt abduct shoulder /external rotation /elbow flexion
Flexion ( arm extended )
Feels like Scapula floating after surgery
C5-C7
Long thoracic n lesion
Serratus anterior
Brachial plexus roots
Upper (C5-6)> lateral > musculocutaneous
Middle(C7) > posterior > Axillary/Radial >Medial flexor
Lower (C8-T1)> medial > ulnar
Muscle involved in Rotator cuff tear
Supraspinatous - 15 * abduction
Infraspinatous(subscapular n) - external rotation
Subscapularis - medial rotation
Teres minor - (Axillary n.) external rotation /adduct
Anticentromere antibody responsible for
CREST Syndrome ( limited scerloderma)
Anti DNA topoisomerase Antibody (anti Scl) for
Systemic sclerosis
Most concerning manifestation of systemic sclerosis
Malignant hypertension
(Rx with Bosantan and prostacyclin analog)
Anti smith (anti-sm) Antibody for
SLE
Most specific test
ANA antibody for
SLE
Most sensitive Ab
Rotator cuff tendinitis features
Pain without weakness of shoulder
Localized pain to upper back
Audible popping sound with shrugging shoulder
Subscapular bursitis
Drainage of thoracic duct
Into the vein Between int jugular veins and subclavian vein
Tachypneic
Hypoxia
Decreased/absent BS
One Chest tube
Dx?
Pneumothorax
If pneumohemothorax( 2 separate drainage tubes)
What is the most concerning risk of osteoporosis in elderly ?
Fracture
Usually of vertebral ( leading to spinal deformity and short stature )
Hip / distal radius fracture
Role of estrogen on bone ?
Prevent osteoclast activity by decreasing RANK expression on osteoblast
Rx- Denosumab ( block RANK-RANK L)
DMARDs?
Methotrexate
Hydrocychloroquine
Sulfasalazine
Anti -CCP antibody
RA
Collagen types and locations ?
I- bone ,skin , tendon
II-cartilage
III- reticular tissue , arterial wall,uterus
IV- basement membrane
Blue sclera
Cardiac insufficiency
Multiple fractures
Osteogenesis Imperfecta
Berry Aneurysm
Collagen defect
Ehlar danlos Syndrome
Hyperextensible joint
Fibrillin defects
Marfan Syndrome
Bilateral acoustic neuroma ( tumors)
NF- 2
Cafe au lait spot ( Brown pigmentation )
Axillary freckles
Iris nodules /optic glioma
Bony lesion
NF- 1
Which band in sacromere stay constant after muscle contraction
A band
Child
Muscle weakness /delayed motor skills
Waddling gait
Usually die during second decade of life
Fam Hx
Duchenne muscular dystrophy
Stage of bone healing ?
- Inflammatory -hematoma , resorption of bone at edges
- Reparative - callous /osteoprogenitor cells proliferation
3.Remodelling -callous ossified»_space; structural model
Whatβs hip joint made of ?
Femur head + articulating acetabulum
Complication of femoral head fracture ?
A vascular necrosis of femoral head
Diaphysis tumor/damage
Ewing sarcoma
Osteoid osteoma
Fibrous
Epiphysis tumor
Giant cell tumor ( osteoclast )
-benign
Branch of celiac trunk
Splenic artery
Left gastric artery
common hepatic artery
SAD PUCKER
Abdominal retriperitoneal viscera
Malignant proliferation of epidermal keratinocytes
Discoloration of skin
Scaly erythematous patch
SCC
Risk : Sun exposure
Most common skin cancer
BCC
Most common ligament injury of ankle sprain
Anterior talofibular ligament ( low ankle sprain )
Overinversion /supination
Nerve (stretch)injury during childbirth causing urinary incontinence ,loss of sensation in perineum
Pudendal ( S2-4)
Trendenlenberg gait lead to which nerve injury ? Due to iatrogenic injury during intramuscular injection In
Superior gluteal n (L4-S1)
Foot drop
Loss of sensation dorsum of the foot
Common fibular peroneal (L4-S2)
Nerve injury leading to loss of ability to curl toes and loss of sensation of sole of foot
Tibial ( L4-S3)
Hip extension exacerbate lower abdominal pain
Flank pain
Fever
Inguinal mass
Psoas abscess
Baker cyst
Popliteal cyst ( in gastronimius semimembranous bursa)
Housemaid knee
Prepatellar bursitis
Boxer hand injury
Metacarpal neck fracture
Mother, often lifting a baby
Pain developed at radial styloid while stretching thumb
De quervain tenosynovitis
Abductor pollicis longus and extensor pollicis brevis tendon inflammation
Fibroblastic proliferation and thickening of superficial palmar fascia
Little and ring fingers
Dupuytren contracture
Osteoclast activity regulated by
RANK -L & M-CSF on osteoblast ( increase clast)
OPG on blast- decrease clast
Function of osteocytes
Regulation of bone minerals
Ca2+
PO4+
Increase Ca2*
Increase PTH
Parathyroid Adenoma
Primary Hyper PTH
osteitis Fibrosa Cystica ( decrease PO4)
Decrease Ca2+ ( hypocalcemia)
Increase PTH
FB mechanisms
Malabsorption
Rickets / osteomalacia
Pancreatitis
IBD (chrons /UC)
Normal Ca2* / PTH
Pain/ fracture
Osteoporosis
Osteopetrosis
Pagets
Bone tumor
Bone tumor
Osteosarcoma
Osteochondroma
Osteoblastoma
Osteoid osteoma
Ewing sarcoma
Giant cell tumor ( osteoclast)
Benign bone tumor
Respond to aspirin Rx
Blast tumor
<2cm
Osteoid osteoma
Benign bone tumor
Not responsive to aspirin
Blast >2cm
Family bc of bone and gut problems
Osteoblastoma
Gardner $ -FAP + osteoma
Li fraumani $
Abnormal p53 genes
-osteosarcoma
-FAP
-AML
-Breast Ca
Adrenal cortical tumor
Paget
Wrist drop
Radial nerve lesions
Sensory loss
Loss of extensor function
Cause of radial nerve palsy
Mid shaft humerus fracture
Alcohol Saturday night palsy - compress radial nerve
Crutches compression
Origin of radial nerve
Post cord of brachial plexus
Axillary nerve
Post cord of brachial plexus
Radial groove lesion
Normal triceps extension
Moderately affect forearms and hand extension
Thoracic outlet $ causes
Extra cervical rib above c7
Whiplash injury
Compress not only nerve but also veins /arteries
Swelling / disrupt blood flow > ischemia ( pain pallor cold) ,Low SBP
similar to Klampke palsy but worse