musculoskeletal/derm Flashcards
Most common causes of primary hyperparathyroidism
parathyroid hyperplasia or adenoma
expected labs seen in primary hyperparathyroidism
elevated PTH, elevated ALP, elevated vit D, elevated Cal, decreased PO4, elevated cAMP, hyper calciuria
symptoms seen in primary hyperPTH
moans, groans, stones, and psychiatric overtones: constipation, bone pain, kidney stones, depression
bone syndrome associated with hyperPTH
osteofibrosis cystica, “brown tumor”, as a result of osteoportoic lesion
Osteofibrosis cystica morphology
brown tumor because of hemosiderin deposotion
common cause of 2ndary hyperPTH
hypocalcemia or increased PO4–> usually a result of kidney disease
lab values in 2ndary or tertiary hyperPTH
hypocalcemia, hyperphosphatemia, elevated PTH, decreased vitamin D (kidney dysfunction), increased ALP
Sequelae of 2ndary and 3iary hyperPTH
renal osteodystrophy
elhos danlos mutation and inheritance
autosomal dominant mutation in PLOD1
Ehlos danlos pathogenesis
defect in collagen (type v) synthesis: the enzyme lysyl hydroxylase is defective, cannot crosslink collagen
Clinical manifestations of Ehlos Danlos
hyperflexibility, kyphosis/scoliosis, joint dislocation or vertebral subluxation, aortic aneurysm, organ rupture, retinal detachment
mutation in achondroplasia
autosomal dominant mutation of FGF3 receptor; homozygous is lethal
FGF3 action
involved in the cartilage development of long bone during endochondral ossification
what type of hypersensitivity reaction is contact dermatitis
type IV
type of deformities seen in RA
ulnar deviation, boutinneir’s deformities, swan neck deformities
findings that distinguish RA from osteoarthritis
MCP join involvement, PIP involvement (DIP rarely involved), also rheumatoid nodules under skin, subluxation of vertebrae, ulnar deviation, join pain that improves with movement
RA HLA association
HLA DR4
findings that distinguish OA from RA
joint pain that worsens throughout the day, no MCP involvement, DIP and PIP, bouchards nodes(PIP), hebener nodes (DIP), synovitis
OA XR findings
osteophytes/bone spurs
gross pathology of OA
osteophytes, eburnation, subchondral cysts
histologic pattern of pagets
mosaic pattern
lab findings for pagets disease
normal calcium levels (distinguished from osteopetrosis) and elevated ALP
what are pts with pagets disease of the bone at increased risk for?
sarcomas
MC bug causing osteomyelitis in IVDU
pseudomonas
