Musculoskeletal

Question 1

Answer 1

Lead Lines:

White lines near epiphysis are an indicator of lead poisoning

Question 2

Answer 2

Osteoarthritis:

Progressive degeneration of articular cartilege

Affects the DIP (Heberden nodules) and PIP (Bouchard nodules)

joint stiffness in the morning that worsens during the day. Affects a limited number of joints (oligoarticular); hips, lower lumbar spine, knee

Disruption of the cartilage that lines the articular surface, Osteophyte formation

Question 3

Answer 3

Rheumatoid arthritis:

Chronic, systemic autoimmune disease

Rheumatoid nodules; central zone of necrosis surrounded by epithelioid histiocytes; arise in skin and visceral organs . SLE

Symmetric involvement of PIP joints of the fingers (swan-neck deformity), wrists (ulnar deviation), elbows, ankles, and knees is characteristic DIP is usually spared (unlike osteoarthritis).

Question 4

Answer 4

Polymysitis:

symmetrical muscle weakness

inflammation, necrosism and regenration of muscle fibers.

Over-expression of MHC-1 in Sacrlemma attracts CD8+ T lymphos and cause myocyte damage

Loss of muscle mass in proximal musculature, difficulty flexing neck and torso.

Question 5

Answer 5

Monosodium urate crystals:

Gout, crystals deposit in joints due to crystsallization of uric acid.

Sx; swollen, red, painful, metatarsal-phalangeal joint of big toe, Tophus formatio, uric acid in the joints

negatively birefringent

Question 6

Answer 6

Multiple Myeloma plasma cells:

Question 7

Answer 7

Paget’s Disease:

Excessive bone deposition in periphery of vertebrae producing picture frame apearance

assoc with isolated increase of Alk Phos.

Question 8

Answer 8

Duchenne Muscular dystrophy:

Fibrofatty muscle fiber replacement causes pseudohypertrophy of calf muscles