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MUSCULOESKELETAL,SKIN,CONNECTIVE TISSUE Flashcards

0
Q

What’s the most common injury at the knee In contact sports?

A

Lateral meniscus injury

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1
Q

What’s the unhappy triad?

A

LATERAL FORCE CAUSE:

ACL
MCL
Medial meniscus

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2
Q

Most common bone injured in the carpal zone?

A

Scaphoid

AVASCULAR NECROSIS

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3
Q

What have if there is a dislocation of lunate bone?

A

Cause carpal tunnel syndrome

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4
Q

What nerve is impaired in lesion of hook of the hamate?

A

Ulnar nerve damage

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5
Q

What’s the guyon canal sindrome?

A

Ulnar compression in cyclisits

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6
Q

Explain sites of upper extremity injury and its nerve injury (6)

A

Axiliary C5-C6Fractured surgical neck of humerus; anterior dislocation of humerus

musculocutaneusC5-C7 Upper trunk compression

radial C5-T1 Midshaft fracture of humerus;“Saturday night palsy”

median C5-T1 Supracondylar fracture of humerus (proximal lesion); carpal tunnel syndrome and wrist laceration (distal lesion)

Ulnar C8-T1 Fracture of medial epicondyle of humerus (proximal lesion); fractured hook of hamate (distal lesion)

Recurrent branch median nerve C5-T1 Superficial laceration of palm

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7
Q

Signs of injuries in brachial plexus (9)

A
  1. Erb palsy (“waiter’s tip”) UPPER TRUNK
  2. Claw hand (Klumpke palsy) LOWER TRUNK
  3. Wrist drop POSTERIOR CORD
  4. Winged scapula ROOT long thoracic nerve
  5. Deltoid paralysis AXILLARY
  6. “Saturday night palsy” (wrist drop) RADIAL
  7. Difficulty flexing elbow, variable sensory loss MUSCULOCUTANEUS
  8. Decreased thumb function, “Pope’s blessing” MEDIAN
  9. Intrinsic muscles of hand, claw hand ULNAR
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8
Q

Explain sites of lower extremity injury and its nerve injury (6)

A

Obturador L2-L4 Pelvic surgery
Femoral L2-L4 Pelvic fracture
Common peroneal L4-S2 lateral aspect of leg, fibular neck fracture
Tibial L4-S3 Knee trauma, Baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion)
Superior Gluteal L4-S1 intramuscular injection to upper medial gluteal region
Inferior Gluteal Posterior L5-S2 hip dislocation

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9
Q

Signs of lumbosacral radiculopathy 3

A

L3-L4 Weakness of knee extension,  patellar reflex
L4-L5 Weakness of dorsiflexion, difficulty in heel-walking
L5-S1 Weakness of plantarflexion, difficulty in toe-walking,  Achilles reflex

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10
Q

What nerve is affected in L3-L4 herniation?

A

L4!!!!!!!

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11
Q

How the sarcomere is divided?

A

MHAIZ

MHA MIOSINA

IZ ACTINA

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12
Q

What bands shrink ?

A

HI

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13
Q

What engines are activated in muscle contraction and relaxation?

A

Myosin-light-chain kinase CONTRACTION

Myosin-light-chain phosphatase RELAXATION

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14
Q

PTH actions depend of levels (2)

A

LOW INTERMITENT Anabolica

HIGH CONSTAT Catabolic

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15
Q

Gene implicated in achondroplasia ?

A

Activation of FGFR inhibit Chondrocyte proliferation

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16
Q

Diagnostic and causes of primary osteoporosis (1-4)

A

DEXA< 2.5

Steroids
Anticonvulsant
Anticoagulant
Thyroid replacement

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17
Q

What’s denosumab?

A

Antibody against RANKL (active osteoclasts)

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18
Q

Cause and treatment of osteoporosis

A

Mutation of carbonic anhydrise in osteoclasts

Bone marrow transplant

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19
Q

How pager disease cause heart failure ?

A

Bone fractures cause arterio-venus shunts

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20
Q

Causes of avascular necrosis of femur head ASEPTIC

A 
Alcoholism
Sickle cell disease
Exogenous/ Endogenous corticosteroids
Pancreatitis
Trauma
Idiopathic (Legg-Calvé-Perthes disease)
Caisson
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21
Q

Difference between primary and secondary hyperparathyroidism Ca serum, PO4,ALP

A

primary ⬆️Ca serum ⬇️PO4 ⬆️ALP

secondary ⬇️Ca serum ⬆️PO4 ⬆️ALP

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22
Q

Age and principal characteristics of benign bone tumors

A

GIANT CELL 20-40 yrs
around knee. “Soap bubble”

OSTEOCHONDROMA Males < 25 years old.
Un cachito epifisis

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23
Q

Age and principal characteristics of malign bone tumors

A

OSTEOSARCOMA 10-20yrs >65
Around the knee metaphysis
Codman triangle elevation of periosteum

EWING SARCOMA
Boys<15 yrs diaphysis scapula pelvis ribs
Onion skin periosteum reaction
t11:22

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24
Q

Genetic association or rheumatoid arthritis

A

HLA-DR4

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25
Q

Antibodies in sjogren syndrome (2)

A

SS-A(anti-Ro)

SS-B (anti-La)

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26
Q

How are the crystals in gout

A

Negative birefringent

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27
Q

Articulation and microscopic difference between gout and pseudogout

A

Gout : MTP big toe yellow parallel light negative birefringent

Pseudogout: knee blue parallel light positive birefringent

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28
Q

What’s the triad of Reiter syndrome

A

Conjunctivitis
Urethritis
Arthritis

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29
Q

Wghats group of patients and lab findings in sarcoidosis?

A 
Black females 
⬆️ACE
⬆️CD4/CD8 ratio
Hypercalcemia 
Bilateral adenopathy in CRX
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30
Q

Whats polymialgia rheumatica

A

Pain in shoulders and hips
Fever
No muscular weakness
Women >50 yrs

Tto low dose corticosteroids

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31
Q

Fibromyalgia presentation

A

Chronic widespread musculoskeletal pain

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32
Q

Lab findings in polymiositis (5)

A 
⬆️CK 
⊕ ANA
⊕ anti-Jo-1
⊕ anti-SRP
⊕ anti-Mi-2 antibodies
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33
Q

What’s adding in lab findings in dermatomyositis?

A

CD4 ✅

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34
Q

Difference between myasthenia gravis and lambert-Eaton myasthenia syndrome 4

A

myasthenia gravis antibody ACh receptor, worse with muscle use Thymoma,drug reversal symptom edrophonium

lambert-Eaton myasthenia syndrome antibody Ca canal, improve whit muscle use,oat cell cancer, drug do not reversal symptoms

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35
Q

Layers of the skin

A

Corneum (keratin)
ƒLucidum
ƒGranulosum
ƒSpinosum (desmosomes) ƒ
Basale (stem cell site)

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36
Q

What components are in adherents junction?

A

Cadherins
Ca dependent adhesion proteins
Looss of E-cadherin promotes metastasis

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37
Q

What’s parakeratosis?

A

Hyper keratosis whit retention of nuclei in stratum corneum

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38
Q

What’s espongiosis ?

A

Epidermal accumulation of edematous fluid in intercellular spaces

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39
Q

What’s acantolysis?

A

Separation of epidermal cells

Spinosum stratum

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40
Q

What stratum grow most inn achantosis?

A

Spinosum

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41
Q

What kind of allergic is neomycin allergic?

A

Contact dermatitis

Type IV hypersensitive

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42
Q

Cause of Rosacea?

A

Alcohol

Heat

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43
Q

Difference between staphylococcal scalded skin syndrome and toxic epidermal necrolysis?

A

staphylococcal scalded skin syndrome destruction of keratinocyte attachment in Granulosum

toxic epidermal necrolysis destruction of epidermal-dermal junction

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44
Q

What virus is responsible by moluscum contagiosum?

A

Poxvirus

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45
Q

What virus is associated whit hairy leukolakia?

A

EBV

HIV patients

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46
Q

How you see bullous pemphigoid immunofluorecense ?

A

Linear pattern in epidermal-dermal junction

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47
Q

What kind Of Ig and what associated disease are in dermatitis herpetiformis ?

A

Deposits of IgA at tips of dermal papillae.

Associated with celiac disease.

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48
Q

Infection association of erythema multiforme (2)

A

Mycoplasma pneumoniae

HSV

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49
Q

What’s actinic keratosis?

A

Pre malign lesion Leading to squamous cell carcinoma

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50
Q

6P’s of linchen Planus

A 
Pruritic
Purple
Polygonal
Planar 
Papules and Plaques
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51
Q

How lichen planus is seen in microscopi?

A

Sawtooth infiltrate of lymphocytes at dermal-epidermal junction. Associated with hepatitis C.

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52
Q

Clinical presentation of basal cell carcinoma

A

nonhealing ulcers

scaling plaque

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53
Q

Clinical presentation of squamous cell carcinoma

A

Ulcerative red lesions with frequent scale.

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54
Q

What’s the ABCDE of melanoma ?

A 
Asymmetry
Border irregularity
Color variation
Diameter > 6 mm
Evolution over time
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55
Q

What’s the mutation and the treatment for melanoma

A

BRAF mutation

Vemurafenib inhibitor or BRAF kinase

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56
Q

Which Drugs can ⬆️ Uterine tone?

A

Dinoprostone PGE2.

Carboprost PGF2

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57
Q

Which analog of prostacyclin can ⬇️vascular tone and platelet aggregation?

A

Epoprostenol PGI2

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58
Q

Function of PGE1

A

⬇️vascular tone

ALPROSTADIL

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59
Q

Difference between zileuton and montelukast

A

Zileuton inhibit lipooxigenase (⬇️ bronchial tone⬇️neutrophil chemotaxis)

Montelukast just ⬇️ bronchial tone

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60
Q

Doses of aspirin

A 
Low dose (< 300 mg/day):  platelet aggregation. 
Intermediate dose (300–2400 mg/day): antipyretic and analgesic. High dose (2400–4000 mg/day): anti-inflammatory.
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61
Q

Intoxication by aspirin

A

Tinnitus
Acute renal failure
Reye syndrome

First respiratory alkalosis
Then acidosis mixta

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62
Q

Toxicity by bisphosphonates

A

Corrosive esophagitis

Osteonecrosis of jaw

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63
Q

Mechanism of action of allopurinol and febuxotat

A

Inhibit xanthine oxidase
⬆️hypo xanthine
⬆️[ ] 6MP and azathioprine

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64
Q

Mechanism of action of probenecid

A

Inhibit reabsortion of Uris acid in proximal tubule

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65
Q

What are TNF-alpha inhibitors?

A

Etanerceb
Infliximab
Adalimumab

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66
Q

How chronic use of glucocorticoids drecrese bone density?

A

⬇️ GI absorption of calcium
⬇️ collagen synthesis
⬇️ GnRh
⬆️ urinary calcium loss

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67
Q

How ankylosing spondylitis can be monitored , same as complications (3)

A

Limited chest wall expansion
Ascending aortitis whit aortic insufficiency
Anterior Uveitis

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68
Q

Principal clinical features of fibromyalgia (3)

A

Widespread musculoskeletal pain
Fatigue
Neuropsychiatric disturbances

> 3 MONTHS!!!!!

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69
Q

What features of rheumatic fibromyalgia are characteristics (4)

A

> 50 yrs
Subacute pain and stiffness
Weigh loss
FEVER!!!

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70
Q

What antibodies are implied in Polymiositis?(2)

A 
Antinuclear antibodies (ANA)
Anti-histidil-tRNA (anti-Jo-1)
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71
Q

How UV rays can cause DNA damage?

A

PYRIMIDINE DIMERS!!!!!!!

72
Q

What’s caudal regression syndrome?

A

Risk factor: uncontrolled diabetes in pregnancy

Agency of sacrum , lumbar spine
Flaccid legs urinary incontinence

73
Q

What are the elements underlie in the pathophysiology of acne (4)

A

Follicular epidermal proliferation
Excessive sebum production
Inflammation
Propionibacterium acnes

74
Q

What type of muscle fibers there are?

A

Type I slow full of myoglibin poor in glycogen POSTURAL

Type II fast poor in myoglobin full off glycogen
IIa intermediated
IIb anaerobic

75
Q

What type of t helper cells and its cytokines are implied in Psoriasis?(2,5)

A 
Th1  Th17
TNF-alpha
IL-12
IFN-gamma
IL-23
IL-17

Leading to keratinocyte proliferation

76
Q

Treatment of psoriasis pharmacological group

A

Vit D analogs (inhibition of keratinocyte proliferation stimuli its differentiation)

Calcipotriol
Calcitriol
Tacalcitol

CICLOSPORINE Inhibit IL-2. T cell differentiation

77
Q

What drugs provide repaid relief of rheumatic symptoms?(2)

A

Glucocorticoids

NSAIDs

78
Q

What drugs are consider DMARDs (4)

A

Hydroxicloroquine
Methotrexate
Minocycline
Sulfasalazine

79
Q

How is the diagnosis of giant cell arteritis? (3)

A

⬆️ erythrocyte sedimentation rate
⬆️ C-reactive protein
Bx intimal thickening Elastic lamina fragmentation, multi-nucleated giant cells

Tto glucocorticoids

80
Q

What muscle disease is linked whit giant cell arteritis ?

A

Polymialgia rheumatica

81
Q

What are late symptoms of LYME disease?

A

Mono arthritis

KNEEE!!!!

82
Q

How hemorrhage cutaneous lesions are classified ?(3)

A

Petechia <5mm diameter
Purpura 5-10 mm diameter
Ecchymosis >1cm diameter

83
Q

What antiviral drugs require viral kinase

And what do not?

A

CLOVIR ends needs viral kinase

FOVIR ends DO NOT NEED VIRAL KINASE

84
Q

What’s the most common tendon muscle affected in rotator cuff syndrome?

A

Supraspinatus tendon

Evaluated whit “empty-can” test

85
Q

Why COX 2 selective are linked whit thrombosis and stroke?

A

Normally COX2 leads to ⬆️ prostacyclin (PGI2) vasodilate and ⬇️platelet aggregation

86
Q

Complications of psoriasis (3)

A

Psoriatic arthritis distal interphalgical joints
Nail changes
Inflammatory eyes

87
Q

Types of xanthomas (4)

A

Eruptive yellow papules
Tuberous and tendinous
Plane skin folds related whit primary biliary cirrhosis
Xanthelasma eyelid

88
Q

Whats the innervation and function of latissimus dorsi (ancho dorsal)

A

Thoracodorsal nerve c6-c8

Extension , addiction ,internal rotation of humerus

89
Q

What nerve an muscle are injured in whiplash lesson (latigazo)

A

XI cranial nerve
Trapezius
Elevate, rotate, stabilize the scapula

90
Q

Through what muscles via sciatic nerve pass

A

Piriformis

Superior gemellus

91
Q

What are the major flexor of the hip?

A

Iliacus and psoas

92
Q

Microscopic findings in celiac disease (3)

A

Atrophy of intestinal villus
Crypt hyperplasia
Intraepithelial lymphocytes

93
Q

Cutaneous associations of ulcerative colitis (2)

A

Erythema nodosum

Pyoderma gangrenosum

94
Q

Malignant capacity of lentigo melanoma

A

LOW

Melanoma in situ

95
Q

Which ligaments stabilizing the ankle (7)

A

LATERAL
Anterior Talofibular (most sprain)
Calcaneofibular
Posterior Talofibular

MEDIAL
Anterior Tibiotalar
Tibionavicular
Tibiocalcaneo
Posterior Tibiotalar
96
Q

How radial and median nerves are injured in elbow fractures?

A

RADIAL Anterolateral displacement of distal diaphysis humeral

MEDIAN Anteromedial displacement of distal diaphysis humeral

97
Q

Which later muscular changes are present un Duchenne disease?

A

Pseudohypertrofy of Calf

Fat connective tissue replacement of hypertrophic calf muscle

98
Q

Which is the cause of androgen in alopecia and which drugs can diminish the substance implied?

A

To much dihydrotestosterone

5alpha - reductase inhibitors FINASTERIDE

99
Q

Treatment for alopecia aerate

A

Topical corticoids

100
Q

What’s the hallmark of atopic dermatitis?

A

INTENSE PRURITUS!!!!!!!

101
Q

What’s the allergic triad?

A

Atopic disease
Allergic rhinitis
Asthma

102
Q

How osteocytes remain connected each other?

A

GAP JUNCTIONS!!!!

103
Q

What are the embryologic source of melanocytes?

A

NEURAL CREST!!!!!

104
Q

What are the complications associated to polymiositis ?(2)

A

Interstitial lung disease

Myocarditis

105
Q

What mediator is linked which giant cell arteritis? And what drug target this substance ?

A

IL-6!!!!

Tocilizumab Ac IL-6

106
Q

How osteoclastic activity can be messured?(3)

A

Tartrate-resistant acid phosphatase
Urinary hydroxiproline
✅Urinary deoxypyridinoline

107
Q

What is the consequence of miastenia gravis in the action potential?

A

⬇️ the end plate potential under the threshold

108
Q

Mechanism of action of scopolamine ?

A

Selective muscarinic ACh receptor ANTAGONIST

109
Q

Mechanism of action of biphosphonate?

A

Inhibition of mature osteoclasts

110
Q

Mechanism of action Of estrogens in osteoporosis management?

A

Inhibition of osteoclastic differentiation.

Inhibition of RANKL

111
Q

How is the pain in bursitis?

A

Diminish the ACTIVE range of motion

No pain in PASIVE MOTION

112
Q

What are the side effects of colchicine?

A

Nausea
Vomit
Diarrhea

113
Q

Mechanism of action of probenecid ?

A

⬇️Proximal tubular Uric acid Reabsortion

114
Q

Drugs contraindicated in ACUTE gout crisis ?(2)

A

Allopurinol

Probenecid

115
Q

Dugs which inhibit DHF reductase? (4)

A

Methotrexate
Trimethoprim
Pirimetamine
Phenytoin

116
Q

Side effect of hidroxicloroquine?

A

Irreversible retinopathy

117
Q

Substance responsible for Keloid formation?

118
Q

Inflammatory cell and infections related with Erithema Multiforme? (1,2)

A

CD8 Lymphocytes

Herpes simplex
Mycoplasma

119
Q

Acute cardiac complications in rheumatic fever? (2)

A

Mitral regusrgitation

Pancarditis

120
Q

Common Hemangiomas in adult,children,pregnant patients?🍒🍓🕷

A

Adult. 🍒Cherry Hemangiomas
Children. 🍓Strawberry Hemangiomas first grow and then regress
Pregnant -OCPs- liver disease.🕷Spider Hemangiomas

121
Q

Which congenital diseases are related whit cystic hygroma? (2)

A

Turner syndrome

Down syndrome

122
Q

Fisopathology in Charcot-Mary-tooth disease?

A

Abnormal myelin synthesis

PIE DE ARCO

123
Q

What are the auto antibodies in dermatitis herpetiform?

A

Ac Transglutaminase

124
Q

What are the Drugs which cause Drug-induced Lupus? (4)

A

Procainamide
Hydralazine
Isoniazid
D-procainamide

125
Q

The vertebral artery go through what bone structures in the neck?

A

Through transversal foramina whiting the transverse process 6 to 1 at cervical vertebra

126
Q

Muscles inervated by Axiliary nerve ?(2)

A

Deltoid

Infraspinatus

127
Q

Tracks involved in sudacute combined degeneration by B12 deficiency? (3)

A

Dorsal columns
Corticospinal
Spinocerebellar

128
Q

What is the mos community bone cancer in middle age and older adults localized in pelvic bones and is radiolucent ?

A

CHONDROSARCOMA!!!!

129
Q

What tumor is related whit myasthenia gravis?

A

THYMOMA!!!!

130
Q

How is call the marked thickened of the epidermis presented in psoriasis?

A

ACANTHOSIS!!!!

131
Q

In what day after MI there is the point Maximus of ventricular wall weaknesses, and can occur a tamponade?

132
Q

Mechanism of action of alendronate ?

A

Bone resorption inhibitor
Stabilator hidroxyapatite bone structure
Induces secretion of osteoclast inhibitors

133
Q

Which cells have increase activity in PAGET DISEASE in each phase?

A
  1. Osteolitic OSTEOCLASTS!!!!
  2. MIXED
  3. Osteosclerotic OSTEOBLASTS!!!
134
Q

What symptoms persist in chronic use of opiods?

A

CONSTIPATION

MIOSIS

135
Q

Which muscle structures are anterior and posterior to the brachial plexus and can participate in thoracic outlet syndrome?

A

ANTERIOR SCALENE

MIDDLE SCALENE

136
Q

Microscopic finding in dermatitis herpetiform

A

Sub epithelial blister with neutrophils in dermal papilla

137
Q

Very specific autoantibody found in Rheumatoid Artritis?

A

Ac - Citrullinated peptides

138
Q

Types of exocrine glands?

A

Merocrine: exocytosis 🔹salivary and sweat glands

Apocrine: membrane bound vesicles 🔹Mammary glands

Holocrine: cell lysis 🔹Sebaceous glands

139
Q

Nerve and artery damaged in midshaft humerus fracture

A

Radial nerve

Deep bronchial artery

140
Q

Pathognomonic sign in myotonic dystrophy?

A

Abnormal slow relaxation of muscles
Inability to release the doorknob

Cataracts
Frontal balding
Gonadal atrophy
Type 1 muscle fibers atrophy

141
Q

Cause of congenital torticollis?(2)

A

Birth trauma

Malposition in Utero

142
Q

What type of clinical macroscopic findings can be seen in MEN2B?

A

Mucosal neuromas
Marfanoid habitus

Medullary thyroid cancer
Pheochromocytoma

143
Q

Best site to anesthetics femoral nerve?

A

Inguinal crease (pliegue)

144
Q

What are the features of actinic keratosis ?

A

Rough sandpaper-like texture

Hyper keratosis-cutaneous horns

145
Q

Structures that are compromised in acute compartment syndrome of the leg?(3)

A

ANTERIOR COMPARTMENT

Extensors muscles
Anterior tibial artery
Deep peroneal nerve

146
Q

Want autosomic dominant genetic disease has skin and mucosal telangectasias and recurrent severe nosebleeds?

A

Hereditary hemorrhagic telangectasias

OSLER-WEBER-RENDU

147
Q

What’s Pierre robin secuence?

A

Micrognatia
Glossoptosis (posterior displacement)
U shaped cleft palate

148
Q

Which vascular disease has impossibility to wrist extension (wrist drop)?

A

Hurt-Strauss =eosinophilic granulomatosis whit polyangiitis

Asthma history
ANTIBODIES NEUTROPHIL MYELOPEROXIDASE p-ANCA

149
Q

Action of osteoprotegerin in osteoporosis ?

A

🚫osteoporosis

Osteoprotegerin block RANK ( important to osteoclast formation)

150
Q

Explain peptides responsibles for localized amyloidosis in cardiac atria,thyroid gland, pancreas,cereebrum,pituitary gland.

A

cardiac atria : atrial natriuretic peptide
thyroid gland: calcitonin ( medullary carcinoma)
pancreas: amylin (associated with DM2)
cerebrum: beta-amyloid (Alzheimer)
pituitary gland : prolactine

151
Q

How is the presentation in train of four stimulation of depolarizing and non-depolarizing NMJ blockers ?

A

depolarizing EQUUAL REDUCTION THEN PROGRESSIVE REDUCTION

non-depolarizing PROGRESSIVE REDUCTION

152
Q

Difference between Duchenne and Becker talking about its protein issue?

A

🚫Duchenne lack of distrophin

⬇️ Becker decrease synthesis of dystrophin

153
Q

Management of restless leg syndrome?

A

PRAMIPEXOLE
dopamine agonist!!!

Iron supplement

154
Q

Injury in specific arteries in femoral neck fracture leads to femur head Osteonecrosis ..(2)

A

Ascending cervical and retina ulnar from MEDIAL CIRCUMFLEX ARTERY !!!

155
Q

Important artery that can be injured in femur neck fracture in the child?

A

Lifpamentus teres artery from OBTURADOR ARTERY

epiphyte all growth plate

156
Q

what are glomangioma ?

A

tumor of glomus
encapsulated neurovascular organs in dermis which act in thermoregulation

tipically seen under the nails.

156
Q

Femoral nerve pass through what important muscular structures?

A

ILIOPSOAS MAJOR !!!!

157
Q

What’s Dupuytren contracture?

A

Fibroproliferative disease of the palmar fascia leading to fingers flexion

159
Q

Blotchy every muscle fibers on glomori thrichrome stain are characteristic in ?,…..

A

MITOCHONDRIAL MYOPATHIES!!!

160
Q

How is the superficial lymphatic drainage of the lower extremity?

A

MEDIAL ⏩ inguinal lymphonodes

LATERAL⏩popliteal nodes ⏩ inguinal lymphonodes

161
Q

Pathophysiology of keloid formation

A

⬆️⬆️TGF-Beta to much collagen deposit
In the PROLIFERATIVE PHASE OF HEALIG
3 days to 3 weeks

162
Q

Principal features of Lambert-Eaton Myasthenic syndrome?(4)

A

Proximal muscle weakness (gait, climb stairs)
🚫 oculobulbar nerve (diplopia , ptosis)
Dysarthria disphagia
Disautonomic (Dry mouth , Impotency )

163
Q 
How osteoprotegerin (OPG) block the osteoclast maduration?
And wha drug can induce the same outcome?
A

OPG bind RANK-L
Block the interaction whit RANK

DENOSUMAB
monoclonal antibody

164
Q

Medications linked with osteoporotic factures?(8)

A

⬆️ Vit D catabolism :Anticonvulsants
⬇️ Estrogens: Aromatase inhibitors , Medroxiprogesterone
⬇️ Testosterone and estrogen: GnRH agonist
⬇️ Ca Absortion: omeprazol
⬇️ Bone formation: glucocorticoids, HBPM, thiazolidinediones

165
Q

What’s myasthenic crisis and Cholinergic crisis? And how is it tested?

A

Myasthenic crisis ⬇️ACh. Improve with edrophonium

Cholinergic crisis ⬆️⬆️ACh insensitivity Doesn’t improve with edrophonium

166
Q

Mutation related with amyotrophic lateral sclerosis ?

A

Mutation of the gene that codes for cooper-zinc superoxide dismutase SOD1

167
Q

Mechanism of action of pancuronium and tubocurarine?

A

Nicotinic receptor antagonist

168
Q

Mechanism by morphine induces allergies?

A

Ig-E Independent mast cell activation

169
Q

Pathognomonic skin lesions after lighting ?

A

Lichtenberg figures⚡️⚡️⚡️

170
Q

Cause of wrinkles in older people?

A

Decrease of collagen fibril production
⬆️up regulation of matrix metalloproteinases
Degradation of type I and type III collagen and elastin

171
Q

Different kind of nevi. (3)

A

Junctional Nevus NEVUS CELLS IN DERMOEPIDERMAL JUNCTION flat , darker center

Compound Nevus NEVUS CELLS EXTENDS FROM EPIDERMIS TO DERMIS papules

Intradermal Nevus NEVUS CELLS JUST AT DERMIS pedunculate

172
Q

What’s the triad of McCune-Albrigth syndrome? And it’s cause?

A 
Fibrous dysplasia (Osteolitic lesions at hip and pelvis)
Endocrine abnormalities (precocious puberty, hyperthyroidism)
Cafe-Au-lait spots

GNAS gene –constitutive activation of G protein

173
Q

Muscles of rotator cuff which inserts in greater and lesser tuberosity?

A

GREATER. Supraspinosum, infraspinosum, Teres minor

LESSER. Subscapularis

174
Q

In hyperparathyroidism what kind of Osseous reabsortion is seen?

A

Subperiosteal reasorption with cystic degeneration

175
Q

Histologic finding in contact dermatitis?

A

ACUTE ESPONGIOSIS
Eosinophilis and lymphocytes infiltrates

CRHONIC
achantosis (thickening of stratum Spinosum)
Hyperkeratosis (thickening of stratum corneum)

176
Q

Where is seen hypergranulosis?

A

Lincoln planus

177
Q

clinical complex of tuberous sclerosis? (5)

A 
renal angiomiolipomas
brain hemartomas
cardiac rhabdomiomas
facial angiofibromas
leaf-shaped patches  of skin
178
Q

which arteries conform kiesselbach plexus?(3)

A

anterior ethmoidal
sphenopalatine
superior labial (facial)

Step 1 (1) (16 decks)

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