Musculoskeletal - Amboss

Question 1

Name the disease(s) associated with antibodies against the following:

Myeloperoxidase

Answer 1

Microscopic polyangiitis

Eosinophilic granulomatosis with polyangiitis

(p-ANCA is an anti-myeloperoxidase antibody)

Question 2

Name the disease(s) associated with antibodies against the following:

Centromeres

Answer 2

CREST syndrome

Question 3

Name the disease(s) associated with antibodies against the following:

Voltage-gated calcium channels

Answer 3

Lambert-Eaton syndrome

Question 4

Name the disease(s) associated with antibodies against the following:

La protein

Answer 4

Sjögren syndrome

Question 5

Name the disease(s) associated with antibodies against the following:

Ro protein

Answer 5

Sjögren syndrome

Question 6

Name the disease(s) associated with antibodies against the following:

SCL-70

Answer 6

Diffuse systemic sclerosis

Question 7

Name the disease(s) associated with antibodies against the following:

Mi-2

Answer 7

Dermatomyositis

Polymyositis

Question 8

Name the disease(s) associated with antibodies against the following:

Jo-1

Answer 8

Dermatomyositis

Polymyositis

Question 9

Name the disease(s) associated with antibodies against the following:

SRP

Answer 9

Dermatomyositis

Polymyositis

Question 10

Name the disease(s) associated with antibodies against the following:

Histones

Answer 10

Drug-induced lupus

Question 11

Dislocation of the lunate is most likely to disrupt which nerve?

What is another serious complication?

Answer 11

The median n.

Avascular necrosis

Question 12

Anesthesia of the dorsal aspect of digits 1, 2, and 3 is likely a result of what?

Answer 12

Radial nerve neuropathy

(often due to a tight watch or handcuffs, etc.)

Question 13

Tenderness of the anatomic snuffbox is most commonly due to what?

Answer 13

Scaphoid fracture

Question 14

Involuntary contraction of the interphalangeal joints in digits 1, 2, and 3 during attempted finger extension indicates compression of what?

Answer 14

Guyon’s canal

(ulner nerve injury)

Question 15

What are some of the S/Sy of muscle damage that can be seen in hypothyroidism (due to impaired carbohydrate metabolism)?

Answer 15

Elevated creatine kinase

+

Delayed muscle reaction

Question 16

What medication class can be used to treat acute flares of rheumatoid arthritis and bridge to DMARDs (e.g. methotrexate, azathiopine, sulfasalazine, etc.)?

Answer 16

Glucocorticoids

Question 17

Which muscle is responsible for flexion of the PIP joints?

Which muscle is responsible for flexion of the DIP joints?

Answer 17

Flexor digitorum superficialis

Flexor digitorum profundus

Question 18

What motions do both the flexor digitorum profundus and superficialis both perform?

Which is only accomplished by the profundus?

Which is only accomplished by the superficialis?

Answer 18

Flexion of the wrist and MCP joints

Flexion of the DIP joints

Flexion of the PIP joints

Question 19

A patient shows S/Sy of ulnar damage following a fall onto his medial hand.

What is the likely bone affected?

Answer 19

The hook of hamate

(pisiform fractures are very rare)

Question 20

What is the key feature of developmental dysplasia of the hip?

Answer 20

Abnormal development of the acetabulum

Question 21

Name the age range in which each of the following is typically seen:

Avascular necrosis of the femoral head

Developmental dysplasia of the hip

Femoral neck fracture

Answer 21

4 - 10 years

< 6 years

> 70 years

Question 22

How should you treat pain (e.g. from osteoarthritis) in a patient with peptic ulcer disease?

Answer 22

Acetaminophen

Celecoxib

Question 23

What repeated movement leads to medial epicondylitis (golf elbow)?

What repeated movement leads to lateral epicondylitis (tennis elbow)?

Answer 23

Wrist flexion

Wrist extension

Question 24

What nerve travels through the obturator foramen?

Where is it going?

Answer 24

The obturator nerve

The thigh adductors

Question 25

A pannus is a proliferation of what?

Answer 25

Granulation tissue

Question 26

Name a few major complications of bisphosphonate use.

Answer 26

Mandibular osteonecrosis;

hypocalcemia, renal impairment, esophagiitis

Question 27

Which bursa lies directly over the kneecap?

Which is superior?

Which is on the medial knee?

Answer 27

Prepatellar

Suprapatellar

Anserine

Question 28

Where are Spigelian hernias found?

Answer 28

The linea semilunaris

(lateral to the rectus abdominis)

Question 29

Osteosarcomas typically arise from what tissue?

Answer 29

The periosteum

(from mesenchymal stem cells)

Question 30

Describe the location of these components in the cycle in which homocysteine and methionine interact:

Methionine

Homocysteine

S-adenosylmethionine

Propionyl-CoA

S-adenosylhomocyteine

Answer 30

(Homocysteine is methionine without the methyl group.)

Question 31

What are a few causes of homocystinuria?

Answer 31

Methionine synthase deficiency

Cystathionine synthase deficiency

Question 32

Overuse of the quadriceps during adolescence can lead to what condition?

Answer 32

Osgood-Schlatter disease

(Inflammation and potential avascular necrosis at the tibial tuberosity.)

Question 33

A patient presents after being hit in the face with a baseball.

She shows periorbital swelling, her globe is posteriorly displaced, her infraorbital rim is tender to palpation, and there is limited upward gaze.

What would you be likely to see on X-ray?

Answer 33

Tear-drop sign

(Fracture into the maxillary sinus)

Question 34

Identify the respective nerve(s) innervating the following muscles:

Supraspinatus

Deltoid

Subscapularis

Teres minor

Teres major

Infraspinatus

Serratus anterior

Answer 34

Suprascapular n.

Axillary n.

Suprascapular n.

Axillary n.

Lower subscapular

Suprascapular n.

Long thoracic n.

Question 35

Where are the pain points of fibromyalgia found?

Answer 35

The entheses of certain sites like the back, neck, shoulders, and medial aspect of the knees

Question 36

Identify the labeled portions of this image:

A)

B)

C)

D)

E)

Answer 36

Identify the labeled portions of this image:

A) I band

B) A band

C) H zone

D) M line

E) Z line