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Step1 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Erb palsy

A

Waiter’s tip

Traction or tear of upper trunk C5-C6

Lateral traction on neck during delivery and other trauma

Injury to deltoid, supraspinatus, infraspinatus

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2
Q

Klumpke palsy

A

Claw hand

Traction or tear of lower trunk C8-T1

Upward force on arm during delivery

Injury to intrinsic hand muscles, lumbricals, interossei

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3
Q

Thoracic outlet syndrome

A

Compression of lower trunk and subclavian vessels

Cervical rib injury, pancoast tumor

Injury to intrinsic hand muscles

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4
Q

Winged scapula

A

Lesion of long thoracic nerve

Axillary node dissection after mastectomy, stab wounds

Injury to serratus anterior

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5
Q

Axillary C5-C6 injury

A

Fractured surgical neck of humorous, anterior dislocation of humorous

Loss of abduction of shoulder

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6
Q

Musculocutaneous C5-C7 injury

A

Upper trunk compression

Loss of forearm flexion and supination

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7
Q

Radial C5-T1 injury

A

Midshaft fracture of humerus

Wrist drop (loss of elbow, wrist, and finger extension)

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8
Q

Median C5-T1 injury

A

Supracondylar fracture of humerus, carpal tunnel syndome

Pope’s blessing
Loss of wrist and later finger flexion, thumb opposition

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9
Q

Ulnar C8-T1 injury

A

Fracture of medial epicondyle of humerus (funny bone)

Loss of flexion of wrist and medial fingers

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10
Q

Recurrent branch of median C5-T1 injury

A

Superficial laceration of palm

Loss of thenar muscle group activity (Ape hand, cannot move thumb away from rest of fingers)

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11
Q

Obturator L2-L4 injury

A

Pelvic surgery

Decrease thigh adduction

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12
Q

Femoral L2-L4 injury

A

Pelvic fracture

Decreased thigh flexion and leg extension

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13
Q

Common peroneal L4-S2 injury

A

Trauma or compression of lateral aspect of leg

Foot drop (inverted and plantar flexed, loss of eversion and dorsiflexion)

PED (peroneal everts and drosiflexes)

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14
Q

Tibial L4-S1 injury

A

Knee trauma, tarsal tunnel syndrome

Inability to curl toes, foot evert w/ loss of inversion and plantar flexion

TIP (tibial inverts and plantar flexes)

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15
Q

Superior gluteal L4-S1 injury

A

Posterior hip dislocation

Trendelenburg sign (pelvis tilts because weight bearing leg cannot maintain alignment of pelvis through hip abduction w/ lesion contralateral to side that drops)

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16
Q

Inferior gluteal L5-S2 injury

A

Posterior hip dislocation

Difficulty climbing stairs or rising from seated position, loss of hip extension

17
Q

Paget disease

A

Ostetits deformans

Common localized disorder of bone remodeling caused by increase in both osteoblastic and osteoclastic activity

Mosaic pattern of woven and lamella bone

Hat size can be increased, hearing loss is common due to auditory foramen narrowing

18
Q

Osteosarcoma

A

Malignant, predisposed by paget disease

Usually involves metapysis of long bones
Sunburst pattern radiological

19
Q

Ewing sarcoma

A

Malignant

Usually involves diaphysis of long bones

Anaplastic small blue cell tumor

Onion skin apperance on radiographs

20
Q

Chondrosarcoma

A

Rare, malignant, cartilaginous

Usually involves pelvis, spine, or diaphysis of long bone

Can emerge from osteochondroma (benign)

21
Q

Giant cell tumor

A

Benign

Epiphyseal end of long bones

Soap bubble sign on X-ray

22
Q

Sjogren syndrome

A

Autoimmune disorder characterized by destruction of exocrine glands especially lacrimal and salivary glands

Xerophthalmia (no tears), xerostomia (no saliva)

Presence of anti-Ro and antiLa antibodies (SS-A, SS-B)

Bilateral parotid enlargement

23
Q

Reactive arthritis (Reiter syndrome)

A

Seronegative (without rheumatoid factor) spondylarthropathy (HLA-B27 gene) strong association

Can see (conjunctivitis), can pee (urethritis), can bend knees (arthritis)

Post GI (shigella, salmonella, campylobacter) or chlamydia

24
Q

Polymyositis

A

Progressive symmetric proximal muscle weakness

Most often involves shoulder

Inflammation w/ CD8+ T cells

Increased CK, positive ANA, positive anti-Jo

25
Q

Dermatomyositis

A

Progressive symmetric proximal muscle weakness w/ skin involvement (malar rash, heliotrope rash)

Increased risk of occult malignancy

Inflammation w/ CD4+ T cells

Increased CK, positive ANA, positive anti-Jo

26
Q

Polymyalgia rheumatica

A

Pain and stiffness in shoulders and hips often w/ weigh loss and fever

No muscle weakness, associated w/ temporal arthritis

Increased ESR, normal CK

27
Q

Scleroderma (systemic sclerosis)

A

Excessive fibrosis and collagen deposition throughout body

CREST syndrome (local, antiCentroere)
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasia

Diffuse (Scl-70 antibody, anti-DNA topoisomerase I)

28
Q

Pemphigus vulgaris

A

Potentially fatal autoimmune skin disorder w/ IgG antibody against desmosome protein (reticular/net pattern w/ immunofluorescence)

Flaccid intraepidermal bullae caused by acantholysis (separation of epidermal cells)

Positive Nikolsky sign (separation of epidermis upon manual stroking of skin)

29
Q

Bullos pemphigoid

A

Less severe than pemphigus vulgarism

IgG antibody against hemidesmosomes (linear immunoflurescence pattern)

Tense blisters containing eosinophils

Negative Nikolsky sign

30
Q

Erythema multiform

A

Associated w/ infections (HSV, m. pneumoniae), drugs (sulfa, beta-lactams), cancers, and autoimmune

Presents w/ multiple types of lesions (papules, macules, vesicles, target lesions)

31
Q

Erythema nodosum

A

Painful inflammatory lesion of subcutaneous fat, usually on anterior shins

Can be idiopathic or associated w/ sarcoidosis, TB, fungal, or strep infections, and leprosy

32
Q

Basal cell carcinoma

A

Most common skin cancer, found in sun exposed area

Locally invasive, but almost never metastasizes

Pink, pearly nodules, commonly w/ telangiectasis, roller borders, central clearing, or ulceration

33
Q

Squamous cell carcinoma

A

Second most common skin cancer

Associated w/ excessive exposure to light, immunosuppression, or arsenic exposure

Locally invasive, but may spread to lymph nodes, but rarely metastasizes

Ulcerative red lesions w/ frequent scale

34
Q

Melanoma

A

Common tumor w/ significant risk of metastasis

S-100 tumor marker (mesodermal origin)

ABCDE: asymmetry, border irregularity, color variation, diameter > 6 cm, evolution over time

35
Q

Alendronate

A

Biphosphonate

Bind hydroxyapatite in bone, inhibiting osteoclast activity

Treat osteoporosis, Paget disease of bone

36
Q

Colchicine

A

Binds and stabilizes tubulin to inhibit microtubule polymerization, imparing leukocyte chemotaxis and degranulation

Acute and prophylactic treatment for gout

37
Q

Etanercept

A

TNFalpha inhibitor (decoy receptor)

Fusion protein produced by recombinant DNA

Treat RA, psoriasis, ankylosing spondylitis

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