Musculoskeletal Flashcards
McMurray test
Popping on external rotation is medial meniscal tear
Popping on internal rotation is lateral meniscal tear
innervation of rotator cuff
C5-C6
innervation supraspinatus
suprascapular nerve
innervation infraspinatus
suprascapular nerve
innervation of teres minor
axillary nerve
innervation of subscapularis
upper and lower subscapular nerves
dislocation of which wrist bone can cause acute carpal tunnel
lunate
damage of which wrist bone can damage ulnar nerve
hamate
which wrist bones are directly distal to scaphoid
trapezium laterally
trapezoid
capitate most medially
lunate articulates with which bones
scaphoid, capitate, hamate, triquetrum (contains pisiform)
Guyon canal syndrome
compression of ulnar nerve at wrist or hand, seen in cyclists
what roots contribute to axillary nerve
C5-C6
what roots contribute to radial nerve
C5-T1
what roots contribute to musculocutaneous nerve
C5-C7
roots of median nerve
C5-T1
roots of ulnar nerve
C8-T1
lesion in Erb palsy (waiter’s tip deformity)
upper trunk
lesion causing (total) claw hand (Klumpke palsy)
lower trunk
lesion causing wrist drop
posterior cord or radial nerve
lesion in saturday night palsy
radial nerve
lesion winged scapula
long thoracic nerve
lesion difficulty flexing elbow + variable sensory loss
musculocutaneous
lesion Ape’s hand and Pope’s blessing
median nerve
lesion 4th and 5th claw
ulnar nerve
a distal ulnar nerve lesion causes
ulnar claw when extending
a proximal ulnar nerve lesion causes
OK gesture when making a fist
a distal median nerve lesion causes
median claw
a proximal median nerve lesion causes
Pope’s blessing when making a fist
thoracic outlet syndrome compresses which part of brachial plexus
lower trunk
roots of obturator nerve
L2-L4
roots of femoral nerve
L2-L4
roots of common peroneal nerve
L4-S2
roots of tibial nerve
L4-S3
roots of superior gluteal nerve
L5-S2
roots of sciatic nerve
L4-S3
roots of inferior gluteal nerve
L5-S2
roots of pudendal nerve
S2-S4
artery paired with long thoracic nerve
lateral thoracic A
artery paired with axillary nerve
posterior circumflex A
artery paired with radial nerve
deep brachial A
artery paired with median nerve in distal humerus
brachial A
artery paired with tibial nerve in popliteal fossa
popliteal A
artery paired with tibial nerve in leg
posterior tibial A
in muscle contraction, calcium binds to
troponin C
sarcomere Z line
the ends of each sarcomere, connects one sarcomere to the next
sarcomere M line
mid-sarcomere line, through myosin
sarcomere A band
myosin band, always stays the same length
sarcomere H band
space between actin filaments, overlies myosin, bisected by M line
sarcomere I band
actin that is not overlying myosin, bisected by Z line
which muscle fibers are slow
type 1 fibers
mutation achondroplasia
gof FGFR3, only affects endochondral ossification
osteoporosis DEXA score
T score less than -2.5
disease that can cause hat size increase and hearing loss
Paget disease of bone
lab values osteoporosis
normal
lab values osteopetrosis
possibly low calcium
lab values Paget disease of bone
high ALP
lab values osteofibrosa cystica
consistent with primary hyperthyroidism
high calcium, low phosphate, high ALP, high PTH
lab values secondary hyperthyroidism
low calcium, high phosphate, high ALP, high PTH
lab values osteomalacia/rickets
low calcium, low phosphate, high ALP, high PTH
lab values hypervitaminosis D
high calcium, high phosphate, low PTH
MC bone location Ewing
diaphysis
MC bone location osteosarcoma
metaphysis
MC bone location osteochondroma
metaphysis
MC bone location myeloma
diaphysis
MC bone location osteoid osteoma
diaphysis, periosteum
MC bone location fibrous dysplasia
diaphysis
MC bone location simple bone cyst
border of diaphysis and metaphysis
MC bone location giant cell tumor
epiphysis. the only tumor here
soap bubble sign on this bone tumor
giant cell tumor
onion skin periosteal reaction in this bone tumor
Ewing
codman triangle or sunburst pattern in this bone tumor
osteosarcoma
Li-Fraumeni, Paget disease of bone, and familial retinoblastoma are risk factors for this bone tumor
osteosarcoma
anaplastic small blue cells in this bone tumor
Ewing
biomodal distribution in this bone tumor
osteosarcoma
Bouchard nodes are in
proximal IP
birefringence of gout
negative, yellow needles when under parallel light
Heberden’s nodes are in
distal IP
gout composition
monosodium urate
pseudogout composition
calcium pyrophosphate
heart finding associated with ankylosing spondylitis
aortic regurgitation
antibody that represents poor prognosis in SLE
anti-dsDNA means renal disease
antibody in MCTD
anti-U1 RNP
lupus pernio
skin lesions on face resembling lupus, seen in sarcoid
Schaumann bodies
calcium + protein in Langerhans cells. a finding in sarcoid
finding on bronchoalveolar lavage in sarcoid
elevated CD4+/CD8+ ratio
CK in PMR is [normal/elevated]
normal
antibodies polymyositis/dermatitis
anti-Jo-1, anti-SRP, anti-Mi-2
antibody diffuse scleroderma
anti-Scl-70
antibody limited scleroderma (CREST)
anti-centromere
name the skin layers from out to in
corneum, lucidum, granulosum, spinosum, basale
what are the proteins in tight junctions
claudins and occludins
proteins in adherens junction
cadherins
a disease with hypergranulosis
lichen planus
a disease with acanthosis
(epidermal hyperplasia, spinosum) acanthosis nigricans also psoriasis (spinosum gets larger, granulosum shrinks)
types of lesions in lesser-trelat
seborrheic keratosis
cause of bacillary angiomatosis
bartonella henselae
cause of kaposi sarcoma
HHV8
disease associated with cystic hygroma
Turner syndrome
MCC impetigo
s pyogenes or s aureus
MCC bullous impetigo
s aureus
MCC erysipelas
s pygones
area of skin lysed in staph scaled skin syndrome
stratum granulosum
area of skin lysed in TEN
epidermal-dermal junction
Wickham striae
reticular white lines in mucosa. seen with lichen planus
disease association with lichen planus
HCV
disease that has a herald patch followed by scaly erythematous plaques in christmas tree distribution
pityriasis rosea
acanthosis, sawtooth dermal-epidermal junction with band of lymphocytic infiltrate seen in
lichen planus
skin cancer with palisading nuclei
BCC
keratoacanthoma is a variant of which skin cancer
SCC. grows rapidly and can regress
4 types of melanoma
superficial, nodular, lentigo maligna, acral lentiginous
MOA denosumab
mAb vs. RANKL
what part of arachidonic pathway do steroids block
blocks phospholipase A2 and blocks NF-kappa-B (which is a COX2 activator)
MOA zileuton
blocks 5-lipoxyganse to prevent leukotriene formation
MOA montelukast, zafirlukast
block CysLT1 receptor
note: montelukast is singulair
celecoxib MOA
COX-2 blocker only
MOA leflunomide
reversibly inhibits dihydroorotate dehydrogenase to prevent pyrimidine syntehsis
MOA teriparatide
recombinant PTH, incudes formation in pulsatile administration for osteoporosis treatment
AE teriparatide
causes transient hypercalcemia
class of drugs: “-dronate”
bisphosphonates
MOA and use pegloticase
uricase to metabolize uric acid into allantoin. used for gout
why is aspirin not used in gout?
salicylates impair uric acid clearance
which drug is like allopurinol
febuxostat
class of drugs: adalimumab
TNF-alpha inhibitor similar to infliximab
MOA and use rasburicase
uricase simialr to pegloticase, but used to prevent tumor lysis syndrome
alprostdil: analog of, and use
PGE1, erectile dysfunction and to maintain PDA
misoprostol: analog of, and use
PGE1, prevention of NSAID-induced gastric ulcers, abortifacient
Latanoprost: analog of, and use
PGF2-alpha, treatment of chronic glaucoma
dinoprostone and carboprost: analogs of, and use
D: PGE2, C: PGF2-alpha
abortifacient, ripening of cervix for induction of labor