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Rapid Review Path > Musculoskeletal and Soft Tissue disorders > Flashcards

Musculoskeletal and Soft Tissue disorders Flashcards

1
Q

osteogenesis imperfecta (brittle bone)

A

AD

defect in type I collagen synthesis

blue sclera, deafness

treat with bisphosphonate

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2
Q

osteopetrosis (marble bone disease)

A

AR (severe), AD (less severe)

deficiency in osteoclasts, osteoblasts work fine–> too much bone

pancytopenia, anemia, pathologic fx and compression of CN

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3
Q

osteomyelitis in sickle cell

A

due to salmonella paratyphi

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4
Q

pseudomonoas aeroginosa

A

can cause osteomyelitis from puncture of foot through rubber footwear

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5
Q

sequestra

A

devitalized bone

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6
Q

involucrum

A

reactive bone formation in periosteum

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7
Q

draining sinus tracts to the skin surface from osteomyelitis often occur

A

danger of SCC developing at orifice of sinus tract

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8
Q

treat osteomyelitis with

A

S. aureus= vanco+ceftazidime

S. paratyphi(sickle cell)= ciprofloxacin

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9
Q

primary osteoporosis

A

ideopathis type in children and young adults

postmenopausal women

senile type in men and women

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10
Q

secondary osteoporosis

A

increased cortisol

heparin

hypogonadism (hypopituitarism)

malnutrition

space travel

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11
Q

role of estrogen in osteoporosis

A

it inhibits osteoclasts and increases activity of osteoblasts

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12
Q

clinical manifestations of osteoporosis

A

compression fractures of vertebral bodies (most common)

Colle’s fx of distal radius

Dowager’s hump

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13
Q

Dx and Rx of osteoporosis

A

dual photon absorptiometry

first line agent is bisphosphonate which inhibits bone resorption, then calcitonin

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14
Q

senile osteoporosis

A

decreased ability of osteoblasts to divide and produce osteoid

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15
Q

aseptic necrosis

A

femoral head is most common site (subcapital fx)

corticosteroids most common cause

scaphoid most common wrist bone fx

MRI most sensitive test for early detection of aseptic necrosis

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16
Q

Osteochondrosis

A

aseptic necrosis of ossification centers in children

Legg-Calve-Perthes disease= aseptic necrosis of femoral head ossification center in children 3-10

osteochondritis dissecans is a variant of osteochondrosis limited to articular epiphysis with the distal femur being the most common site

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17
Q

osgood-schlatter disease

A

painful swelling of tibial tuberosity in active boys

presents as permanent knobby-appearing knees

18
Q

fibrous dysplasia

A

defect is osteoblasts maturation and differentiation

medullary bone is replaced by fibrous tissue with cyst formation

ribs most common site

Albright’s syndrome= polyostotic bone involvement, cafe au lait spots, precocious puberty

19
Q

bone tumors

A

mets is most common (specifically from breast CA)

multiple myeloma–> osteogenic sarcoma–> chondrosarcoma–> Ewing’s sarcoma

most common benign tumor is osteochondroma

20
Q

MSU crystals and CPP

A

MSU crystals have negative birefringence–> yellow when parallel to slow ray

CPP have positive birefringence–> blue when parallel to slow ray

21
Q

mucin clot test of synovial fluid

A

to evaluate joint viscosity

acid added to synovial fluid clots hyalouronic acid

poor clot formation reflects decreased quantaity of HUA-> sign of inflammation

22
Q

morning stiffness of joints, think…

A

RA, SLE, polymyalgia rheumatica

23
Q

alkaptonuria

A

AR

deficiency in homogentisic acid oxidase–> accumulation of HGA in intervertebral discs–> OA and other systemic findings

urine turns black when oxidized

24
Q

Heberden’s nodes

A

DIP joint enlargement with pain

25
Q

Bouchard’s nodes

A

PIP joint enlargement with pain

26
Q

RA pathogenesis

A

HLA-DR4, trigger is EBV, parvovirus, HHV6,mycoplasma

synovial cells express antigen that triggers B cell–> RF which is IgM Ab aganst Fc receptor of IgG–> formation immunocomplexes–> activation of complement–> pannus formation–> release of cytokines that destroy articular cartilage–> ankylosing of joints

27
Q

systemic manifestation of RA

A

Lung= interstitial fibrosis, effusions

blood= anemia of chronic disease, autoimmune hemolytic anemia, Felty’s syndrome=autoimmune neutropenia, splenomegaly)

cervical spine=subluxation of atlantoaxial joint–> cord compression along with vertebral artery occlusion

Caplan syndrome= rheumatoid nodules in lung+ pneumoconiosis

CV= pericarditis, aortitis, vasculitis

Baker’s cyst= outpouching of posterior joint space in knee

Labs= +serum RF, ANA

28
Q

sjorgen syndrome

A

destruction of minor salivary and lacrimal glands

xerophalmia (sand in my eyes), xerostomia (can’t chew a cracker) and dental carries, arthritis

Labs: +serum ANA, serum RF, anti-SS-A Ab (Ro), anti-SS-B Ab (La)

confirm with lip biopsy and must show lymphoid destruction of minor salivary glands

Rx=artificial tears, pilocarpine eye drops

29
Q

gout associations

A

urate nephropathy, renal stones, HTN, artery disease and Pb poisoning

30
Q

Acute gout

A

must confirm with joint aspiration. Hyperuricemia does not define gout

31
Q

tophus

A

MSU deposits in soft tissue around joint

it destroys subadjacent joints causing erosive arthritis

32
Q

Rx for gout

A

prevent with low purine diet and low EToH intake

treat acute with NSAID or colchicine

treat chronic with uricosuric agents for underexcretors like probenecid

Allopurinol for over-producers

33
Q

CPP dihydrate induced gout

A

increased with hemochromatosis, hemosiderosis (due to increased pyrophosphate inhibitor in these 2 disorders) and primary HPTH (due to increased Ca)

CPPD OA variant presents with knee involvement–> chondrocalcinosis which presents as linear deposits of CPP in articular cartilage

34
Q

RF seronegative spondyloarthropathies

A

-RF, +HLA-B27, male, sacroiliitis, spondylitis

35
Q

Ankylosing spondylitis

A

bamboo spine over time, aortitis, uveitis with potential for blindness

36
Q

Reiter’s syndrome

A

C. trachomatis, urethritis, conjunctivitis, arthritis

Achillis tendon periostitis is diagnostic

37
Q

psoriatic arthritis

A

sausage-shaped DIP joint in finger or toe

pencil-in-cup deformity and extensive nail pitting

38
Q

Late lyme disease

A

disabling arthritis, bilateral Bell’s palsy, myocarditis and pericarditis

39
Q

babesiosis

A

tick-transmitted hemolytic anemia

due to babesia microti

treat with atovaquone and azithromycin

40
Q

septic arthritis due to cat or dog bite

A

by pasteurella multocida

most common infection secondary to animal bite

see cellulitis, septic arthritis/tendinitis, osteomyelitis, endocarditis, meningitis

treat with amoxicillin-calvulanate

41
Q

type I and II muscle fibers

A

type I= slow-twitching, red, rich in mitochondria, myoglobin and oxidative enzymes, weak ATPase enzymes (long muscles in back)

type II= fast-twitching, white, poor in mitochondria, myoglobin and oxidative enzymes, rich in ATPase enzymes (extra-ocular muscles and fine muscles of hands)

42
Q

myotonic dystrophy

A

AD, most common adult muscular dystrophy

CTG trinucleotide repeat

inability to relax muscles

see sagging face, frontal balding, cataracts, testicular atrophy, cardiac involvement

Rapid Review Path (2 decks)

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