Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Boards > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

0
Q

What nerve is affected by this injury?

Fibular neck fracture

A

Trauma to the lateral leg can cause common peroneal damage. Sensory deficit would be anterolateral leg & dorsum of foot.

TIPPED:
Tibial inverts & plantar flexes, Peroneal everts & dorsiflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the muscles of the thenar & hypothenar eminences?

A 
Both are OAF
Thenar:
Opponens pollicis
Adbuctor pollicis brevis/Adductor pollicis
Flexor policis brevis

Hypothenar:
Opponens digiti minimi
Abductor digiti minimi brevis
Flexor digiti minimi brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What nerve is affected by this injury?

Knee trauma

A

Tibial nerve can be injured in knee trauma. Sensory deficit would be the sole of the foot. The most important thing to assess with knee dislocation or trauma is the popliteal artery. It is easily injured & can lead to amputation.

TIPPED:
Tibial inverts & plantar flexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerves could be affected by this injury?

Posterior hip dislocation

A

Superior gluteal –> Trendelenberg sign

Inferior gluteal –> Can’t rise from a seat or climb stairs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What nerve is affected by this injury?

Anterior hip dislocation

A

Obturator nerve

Motor: Thigh adduction deficit
Sensory: Medial thigh deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What nerve is affected by this injury?

Pelvic fracture

A

Femoral n. is common

Motor defcicit: Thigh flexion & leg extension
Sensory deficit: Anterior thigh & medial leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the types of fibers in skeletal muscle?

A

Type I & Type II

“1 slow red ox”

Type 1 are slow twitch
Red due to myoglobin & mitochondria
Oxidative phosphorylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does NO cause smooth muscle relaxation?

A

NO –> ^Guanylate cyclase activity –> ^cGMP –> myosin light chain phosphatase (MLCP) –> relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two types of bone formation & where do they occur?

A

Endochondral ossification:
Bones of axial & appendicular skeleton
Cartilaginous model made first by chondrocytes. Then osteoblasts/clasts –> woven bone –> lamellar bone

Membranous ossification:
Skullcap & facial bones
Woven bone –> lamellar bone (no cartilage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does estrogen affect bone metabolism?

A

Inhibits apoptosis in osteoblasts

Induces apoptosis in osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes achondroplasia?

A

Autosomal dominant activating mutation in FGFR3 –> inhibits chondrocyte proliferation –> impaired endochondral ossification

*** >80% of mutations are spontaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is seen in osteoporosis?

A

Trabecular (spongy) bone loses mass & interconnections
Normal lab values
Abnormal DEXA scan
Pathologic fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of fractures are seen in Osteoporosis?

A

Femoral neck fracture
Vertebral crush fracture
Distal radius fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the types of osteoporosis?

A

Type I = postmenopausal

Type II = senile (men & women >70y)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes osteopetrosis?

What is seen?

A

Mutations impair osteoclasts’ ability to form acidic environment required for resorption. Common cause is mutated carbonic anhydrase type 2.

Symptoms:
Pancytopenia
Extramedullary hematopoiesis
Dense bones on X-ray with no medulla
Cranial nerve impingement –> focal deficits
Type II renal tubular acidosis (if carbonic anhydrase def.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is seen histologically with osteomalacia/rickets?

A

Vit. D deficiency –> impaired mineralization of osteoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is seen with osteomalacia & rickets?

A

^PTH, ^Alk Phos, decreased Ca2+ & Phosphate
Osteomalacia - pathologic fractures

Rickets:
Pigeon-breast deformity
Rachitic rosary
Frontal bossing
Bowing of legs (if ambulatory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is seen with Osteitis fibrosa cystica?

A 
^Alkaline phosphatase (the only abnormal lab)
Hearing loss
Lion face
Mosaic/woven pattern of bone
Fractures
^ Hat size

Increased risk for osteosarcoma & high output CHF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is seen in McCune-Albright Syndrome?

A

Polyostotic fibrous dysplasia (bone replaced with fibrous tissue)
Precocious puberty
Cafe-au-lait spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where on the bone are the various primary cancers typically found?

A

Giant cell tumor (osteoclastoma) - Epiphysis
Osteosarcoma & Osteochondroma - Metaphysis
Ewing’s & Chondrosarcoma - Diaphysis

Chondrosarcoma is typically intramedullary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does a giant cell tumor (osteoclastoma) present?

A

Soap bubble appearance on x-ray
Located at the epiphysis (knee)
Spindle cells with multinucleate giant cells
20-40y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does an Osteochondroma present?

A

Mature bone with cartilaginous cap (looks like little bone)
Found on metaphysis
Males under 25y
^Risk of chondrosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What risk factors are associated with osteosarcoma?

A

Familial retinoblastoma
Paget’s disease of the bone
Radiation
Bone infarcts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is seen with osteosarcoma?

A

Codman’s triangle (elevation of periosteum)
Sunburst x-ray
Found at metaphysis of long bones (knee)
Male teenagers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
What mutation is seen in Ewing's Sarcoma?
t(11;22) 11+22 = 33 (Patrick Ewing's number)
25
What is seen with Ewing's sarcoma?
Seen in males <15y Anaplastic small blue cell tumor (from neuroectoderm) Onion skin appearance Aggressive with early mets but responds well to chemo.
26
What is seen with chondrosarcoma?
Found in axial or proximal skeleton Men 30-60y Mass within the medullary cavity (diaphysis)
27
With bone tumors, what does the response to aspirin mean?
Responds to aspirin ---> osteoid osteoma | Does not respond --> osteoblastoma
28
What metastases are osteolytic? | Osteoblastic?
Osteoblastic = Prostate cancer Osteolytic = BLT w/ Ketchup & Mustard ``` Breast (lytic/blastic) Lung Thyroid Kidney Multiple myeloma ```
29
What joint findings are seen in osteoarthritis?
Subchondral cysts Osteophytes (bone spurs) Eburnation (polished bone) Heberden's nodes (DIP); Bouchard's nodes (PIP)
30
What intra-articular findings are seen in RA?
``` Pannus formation (granulation tissue) Rheumatoid nodules Ulnar deviation Fusion Baker's cyst (in popliteal fossa) ```
31
What Ig's are seen in RA?
``` Anti-cyclic citrullinated peptide Ab Rheumatoid factor (IgM against Fc portion of IgG) ```
32
What is seen in Sjögren's syndrome?
``` Dry eyes (Xerophthalmia) Dry mouth (Xerostomia) Arthritis Parotid enlargement (if occurring quickly or asymmetrically --> B cell lymphoma!!) ```
33
What Ab's are present in Sjögren's syndrome?
RoLa = AB ``` Anti-Ro = SS-A Anti-La = SS-B ```
34
What are risk factors for gout?
``` Thiazide diuretics von Gierke's disease ^ cell turnover (malignancy) Lesch-Nyhan Renal insufficiency ``` Vast majority is primary goud (idiopathic)
35
What type of crystals might be seen on a joint tap?
Needle shaped & negatively birefringent --> gout (Monosodium urate) Rhomboid & positively birefringent --> pseudogout (Calcium pyrophosphate)
36
What is the treatment for gout?
``` Acute = NSAID's; Steroids Chronic = Xanthine oxidase inhibitors (Allopurinol, Febuxostat) ```
37
What are the common bugs in septic arthritis?
S. aureus Streptococcus Gonorrhea
38
What are the risk factors for Osteonecrosis (avascular necrosis)?
``` Trauma High-dose corticosteroids Alcoholism Sickle cell anemia SLE ``` *Seen most commonly in the femoral head
39
What are the seronegative spondylarthropathies? | Who are they seen in?
``` PAIR: Psoriatic arthritis Ankylosing spondylitis Inflammatory bowel disease Reiter's syndrome (reactive arthritis) ``` They are more common in males & those with HLA-B27
40
What is seen with psoriatic arthritis?
Psoriasis Asymmetric joint pain Dactylitis --> "pencil in cup" deformity on x-ray
41
What is seen with ankylosing spondylitis?
``` Chronic inflammation of spine & sacroiliac joints Ankylosis = fusion of spine "bamboo spine" on x-ray Uveitis Aortitis --> aortic regurgitation ```
42
What is seen in Reiter's syndrome?
Reactive arthritis triad: Conjunctivitis Urethritis Arthritis "Can't see, can't pee, can't climb a tree"
43
What population gets SLE?
Females between 14-45 | Most common & most severe in black women
44
What are the features of SLE?
I'M DAMN SHARP ``` Immunoglobulins (autoAb's) Malar rash Discoid rash Antinuclear Ab Mucositis (oropharyngeal ulcers) Neurologic psychosis Serositis (pleuritis, pericarditis) Hematologic disorders Arthritis Renal disorders (DPGN = most common cause of death) Photosensitivity ``` Also Libman-Sacks endocarditis, Raynaud's, hilar LAD, fever, fatigue, weight loss.
45
What cardiac manifestations can be seen with SLE?
Libman-Sacks endocarditis: Sterile wart-like vegetations on both sides of the valve Myocarditis, pericarditis
46
What hematologic manifestations are seen in SLE?
Lupus anticoagulant --> hypercoagulable but ^PTT Any combination of anemia, thrombocytopenia, neutropenia Immunoglobulins against everything ever
47
What is seen with antiphospholipid antibody syndrome?
Lupus anticoagulant: - -Paradoxical ^PTT - -DVT's - -Bud-Chiari - -Placental thrombosis (recurrent pregnancy loss) - -Stroke Anticardiolipin --> false-positive VDRL
48
What diagnostic antibodies are seen in SLE?
Antinuclear Ab's (ANA) - sensitive, not specific for SLE Anti-dsDNA - Specific; poor prognosis Anti-Smith - Very specific Antihistone - Drug induced lupus
49
What drugs are associated with drug-induced lupus?
HIP: Hydralazine INH Procainamide
50
What is seen in diffuse systemic scleroderma?
Excessive fibrosis & collagen deposition of any organ (pulmonary, renal, CV, GI) Esophageal dysmotility Tight skin, especially hands & face Anti-DNA Topoisomerase I Ab (Anti-Scl-70) ANA's
51
What is seen in CREST syndrome?
``` Calcinosis cutis Raynaud's Esophageal dysmotility Sclerodactyly Telangiectasia ``` Anti-centromere Ab's
52
What is seen with sarcoidosis?
``` HULA BABIES Hypercalcemia (epithelioid macs express 1-alpha-hydroxylase) Uveitis Lymphadenopathy (bilateral hilar) ^ACE levels Black females Asteroid bodies Bell's palsy Interstitial lung fibrosis Erythema nodosum Schaumann bodies ```
53
What is seen histologically in polymyositis & dermatomyositis?
Polymyositis - Endomysial inflammation with CD8+ infiltration & necrotic muscle fibers. Dermatomyositis - Perimysial inflammation with CD4+ infiltration & perimysial atrophy. **The one that has skin manifestations is closer to the skin (perimysial)
54
What is seen clinically with dermatomyositis?
Proximal muscle weakness (like polymyositis) Malar rash Gottron's papules (knuckles, elbows, knees) Heliotrope rash (upper eyelids) ^risk of occult (often gastric) malignancy
55
What labs are abnormal in dermatomyositis/polymyositis?
^CK ANA's Anti-Jo-1 Ab's Tx = steroids
56
What is seen with Mysthenia gravis?
``` Ptosis, diplopia Weakness Worsens with muscle use (ACh gets depleted) AChE inhibitors reverse symptoms Thymic hyperplasia/Thymoma ```
57
What is seen with LEMS?
Proximal muscle weakness & autonomic symptoms Improves with muscle use Underlying small cell lung carcinoma AChE inhibitors have no effect
58
What causes MG and LEMS?
Myasthenia Gravis - AutoAb's against postsynaptic ACh receptor compete with ACh for it. LEMS - AutoAb's against presynaptic Ca2+ channel decrease ACh release
59
What causes myositis ossificans?
Muscular trauma --> metaplasia of muscle to bone at site Usually seen in arm or leg muscles. Can present as a mass following trauma or finding on radiography.
60
``` Define these terms: Hyperkeratosis Parakeratosis Orthokeratosis Acanthosis Acantholysis ```
Hyperkeratosis - ^stratum corneum (consists of para & ortho) Parakeratosis - ^stratum corneum with retention of nuclei Orthokeratosis - ^stratum corneum with no nuclei Acanthosis - ^stratum spinosum (epidermal hyperplasia) Acantholysis - separation of erpidermal cells
61
What causes melasma?
Melasma = blotchy hyperpigmentation of the face from pregnancy or OCP use
62
What causes vitiligo?
Autoimmune destruction of melanocytes
63
What are the two types of nevi?
Junctional - found in children; flat | Intradermal - found in adults; raised
64
``` What are the medical terms for the following? Wart Freckle Mole Hive ```
Wart - Verruca Freckle - Ephelis Mole - Melanocytic nevus Hive - Urticaria (presents as a wheal)
65
What type of hypersensitivity is eczema & contact dermatitis?
Atopic dermatitis (eczema) - Type I hypersensitivity Allergic contact dermatitis - Type IV hypersensitivity
66
What is seen clinically with psoriasis? | Histologically?
Scaling plaques on extensor surfaces Auspitz sign Histo - ^spinosum, thin granulosum, parakeratosis, long papillae Can see nail pitting (little dents in nails) or psoriatic arthritis
67
What causes Leser-Trelat sign?
Leser-Trelat sign = sudden appearance of dozens of seborrheic keratoses. Indicates underlying malignancy (often GI).
68
What causes pemphigus vulgaris? | What is seen?
AutoAb against Desmoglein 1 and/or 3 Flaccid blisters & crusts involving skin AND ORAL MUCOSA Reticular (fishnet) immunofluorescence Acantholysis with tombstoning Positive Nikolski's sign (separation upon stroking of skin)
69
What causes Bullous pemphigoid? | What is seen?
AutoAb's against Hemidesmosomes Tense blisters with eosinophils on skin (spares oral mucosa) Linear immunofluorescence along DEJ
70
What causes Dermatitis herpetiformis?
Anti-gliadin IgA Ab's cross react with Reticulin in skin Tiny blisters at the tips of papillae (elbows)
71
What can cause erythema multiforme? | What is seen?
HSV & other infections Drugs Cancers Autoimmune disease Targets with a red outside & dusky grey inside
72
What is seen with SJS/TEN?
Fever, bullae, sloughing of skin Mucous membranes involved If > 30% TBSA --> TEN Usually caused by adverse drug reaction.
73
What is seen with acanthosis nigricans? | What causes it?
Hyperpigmented, velvety thick skin Seen in neck, axilla, groin Associated with: Hyperinsulinemia Visceral malignancy
74
What is seen with erythema nodosum? | What is it associated with?
Inflammatory red lesions of subcutaneous fat. Usually seen on anterior shins. ``` Associated with: Sarcoidosis Histoplasmosis & Coccidiomycosis TB & Leprosy Crohn's disease Streptococcal infections ```
75
What is seen with lichen planus? | What is it associated with?
6 P's: Pruritic, purple, polygonal, planar papules & plaques Seen on wrists, elbows, oral mucosa Sawtooth infiltrate of lymphocytes at DEJ Associated with HepC
76
What causes Pityriasis rosea? | What is seen?
Viral illness causes it somehow Herald patch followed by Christmas tree distribution on torso Resolves on its own in 6-8 weeks
77
Where are lower extremity venous & arterial ulcers seen?
Venous ulcers - Medial malleolus. Venous stasis dermatitis seen. Arterial ulcers - Lateral malleolus
78
What is seen in Staphylococcal scalded skin syndrome?
Exfoliative toxins destroy keratinocyte attachments in the STRATUM GRANULOSUM (vs. SJS/TEN which is DEJ) Fever Rash with slouging Heals completely
79
What are the relative incidences of skin cancers?
BCC > SCC > Melanoma This also corresponds to their prognosis.
80
What are the risk factors for SCC of the skin?
``` Immunosuppression (most common malignancy) Arsenic exposure (think of the women who wanted light skin) ``` Common to all skin cancers: Sun exposure Albinism Xeroderma pigmentosum
81
What is Keratoacanthoma?
A variant of skin SCC that grows rapidly & regresses spontaneously. It is cup shaped with keratin debris in the center.
82
What is the tumor marker for melanoma? | What mutation is commonly seen?
S-100 is the tumor marker (neural crest origin) BRAF kinase activating mutation is common. If BRAF V600E --> treat with vemurafenib (BRAF kinase inhibitor).
83
What is the most important prognostic indicator of melanoma?
Depth of invasion
84
What are the subtypes of melanoma?
1) Superficial spreading (good prognosis) 2) Nodular (poor prognosis) 3) Lentigo maligna 4) Acrolentiginous (not related to UV; seen on palms & soles; seen in dark-skinned people)
85
What does the Lipoxygenase pathway produce? | What are their roles?
Lipoxygenase --> Leukotrienes (both start with L) LTB4 - Neutrophil chemotaxis (they get there B4 everyone else) LTC4,D4,E4 - vascular & bronchial SM contraction & vascular permeability
86
What is formed by the Cyclooxygenase pathway? | What are their functions?
TXA2 - platelet aggregation; constricts vascular & bronchial SM Prostaglandins (PGE2, PGF): ^Uterine tone Relaxes vascular & bronchial SM Prostacyclin (PGI2): Inhibits platelet aggregation Relaxes vascular & bronchial SM Relaxes uterine tone
87
What is used to close a PDA?
Indomethacin | It is an NSAID
88
What is Celecoxib used for? | What are its toxicities?
It is a reversible COX-2 inhibitor (NSAID). Spares the gastric mucosa & platelet function. It is used for RA. Toxicities: Thrombosis Sulfa reaction
89
What is the mechanism of Acetaminophen?
It is a reversible COX inhibitor. It is inactivater peripherally & thus exerts its effects largely in the CNS --> analgesic, antipyretic, but not anti-inflammatory.
90
What is the mechanism of bisphosphonates? What are they used for? What are their toxicities?
Bisphosphonates (end in -dronate) bind hydroxyapatite in bone --> inhibition of osteoclasts Used for osteoporosis, Paget's disease, hypercalcemia Toxicities: Pill esophagitis Osteonecrosis of the jaw
91
What are the drugs for chronic gout management? | What are their unique characteristics?
Febuxostat - XO inhibitor; less drug interactions & less renal toxicity than allopurinol Allopurinol - XO inhibitor; ^concentrations of azathioprine & 6-MP Probenecid - inhibits PCT reabsorption of urate; ^penicillin levels; avoid if Hx of kidney stones
92
What are the TNF inhibitors?
All TNF inhibitors ^risk of reactivation TB & Hepatitis Etanercept - fusion protein decoy receptor (fused w/ IgG Fc) Infliximab/Adalimumab - mAb against TNF Used for PAIR diseases & RA
93
``` What structures do these fetal structures give rise to? Truncus arteriosus Bulbus cordis Sinus venosus Right anterior & common cardinal veins ```
Truncus arteriosus --> ascending aorta & pulmonary trunk Bulbus cordis --> outflow tract of LV & RV Sinus venosus: -Left horn --> coronary sinus -Right horn --> smooth part of RA Right anterior & right common cardinal vein --> SVC
94
From where is the aorticopulmonary derived?
Neural crest migration
95
What muscles are involved in abduction of the arm?
1) Supraspinatus (0-15 degrees) 2) Deltoid (15-90 degrees) 3) Trapezius & Serratus anterior (90-180 degrees)
96
What is tennis elbow? | Golfers elbow?
Tennis elbow = lateral epicondylitis (common extensor tendon) Golfer's elbow = medial epicondylitis (common flexor tendon)
97
What roots are injured in Erb-Duchenne palsy? | What nerves?
C5 & C6 Axillary, suprascapular, musculocutaneous
98
What can be injured with a posterior hip dislocation? | What is seen?
Superior gluteal --> trendelenberg sign Inferior gluteal --> can't get up from chair/climb stairs
99
What ligament is injured in an ankle sprain?
Anterior talofibular (lateral) ligament
100
What is seen with forced eversion of the ankle joint?
Pott's fracture Medial malleolus avulsed (deltoid ligament) Fibula is fractured higher up
101
Where does the pain of costochondritis occur?
The left parasternal border Usually affects >1 rib Worsens with deep breathing

Boards (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions