Musculo-Dermato Flashcards by Mishkha Myat

Microtubule inhibitor of Gout

Colchicine

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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

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Enzyme defect syndrome causing Gout

Lesb Nyhan Syndrome

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Klumpke Palsy

Birth delivery trauma to shoulder
(C8-T1 nerve root ) damage
Motor- Ulnar /Medial root ( thenar /hypothecated)wasting
Sensory deficit-palmar /dorsal

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Claw hand ,
Can’t extend little / ring finger

Distal Ulnar

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Trouble making a fist
Little /ring finger can’t flex /close

Proximal ulnar

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Hand of Benediction
Can’t flex thumb/index/middle
Can’t make a fist

Proximal median n.

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Can’t open hand
Thumb/index/middle flex

Distal medial n.

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Funny triad

ACL
Lateral Maniscus
MCL

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Ern palsy ( waiter’s tip)

Neck traction (falling on neck or during delivery pulling from neck )
C5-C6 nerve roots ( Axillary/musculocutaneous / suprascapular)
Can’t abduct shoulder /external rotation /elbow flexion
Flexion ( arm extended )

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Feels like Scapula floating after surgery

C5-C7
Long thoracic n lesion
Serratus anterior

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Brachial plexus roots

Upper (C5-6)> lateral > musculocutaneous
Middle(C7) > posterior > Axillary/Radial >Medial flexor
Lower (C8-T1)> medial > ulnar

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Muscle involved in Rotator cuff tear

Supraspinatous - 15 * abduction
Infraspinatous(subscapular n) - external rotation
Subscapularis - medial rotation
Teres minor - (Axillary n.) external rotation /adduct

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Anticentromere antibody responsible for

CREST Syndrome ( limited scerloderma)

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Anti DNA topoisomerase Antibody (anti Scl) for

Systemic sclerosis

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Most concerning manifestation of systemic sclerosis

Malignant hypertension
(Rx with Bosantan and prostacyclin analog)

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Anti smith (anti-sm) Antibody for

SLE
Most specific test

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ANA antibody for

SLE
Most sensitive Ab

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Rotator cuff tendinitis features

Pain without weakness of shoulder

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Localized pain to upper back
Audible popping sound with shrugging shoulder

Subscapular bursitis

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Drainage of thoracic duct

Into the vein Between int jugular veins and subclavian vein

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Tachypneic
Hypoxia
Decreased/absent BS
One Chest tube
Dx?

Pneumothorax
If pneumohemothorax( 2 separate drainage tubes)

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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

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Role of estrogen on bone ?

Prevent osteoclast activity by decreasing RANK expression on osteoblast
Rx- Denosumab ( block RANK-RANK L)

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DMARDs?

Methotrexate Hydrocychloroquine Sulfasalazine

Anti -CCP antibody

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 ?

1. Inflammatory -hematoma , resorption of bone at edges 2. Reparative - callous /osteoprogenitor cells proliferation 3.Remodelling -callous ossified >> structural model

What’s 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