Musculoskeletal DZ Flashcards
Function of supraspinatus muscle
Abducts arm initially
Lumbar puncture is in line with what structure?
Iliac crest
Most common rotator cuff injury?
Supraspinatus. Abducts arm initially
Pitching injury - what muscle
Infraspinatus
Dislocation of this bone may cause acute carpal tunnel syndrome
Lunate
Patient with a fracture of supracondylar humerus. Motor defect?
Median nerve. Decreased Opposition of thumb, Lateral finger flexion, wrist flexion
Patient with subluxation of radius. N affected?
Deep branch of radial nerve
Dislocation of humeral head. What nerve is affected? (And roots)
Axillary nerve (C5-T1)
Fracture and midshaft humerus. Muscles affected?
Brachioradialis, extensors wrist and fingers, supinator, triceps
Fracture of medial epicondyles humorous?
Ulnar nerve C8, T1
Patient with the disappearance of the radial pulse upon moving ahead with the ipsilateral side. Other findings?
Atrophy of interosseus muscles
Atrophy of the thenar and hypothenar eminences
Sensory defects on the medial side of the forearm
Patient that can’t extend PIP and DIP. Muscles also control?
Lumbricals. Also control flexion at MCP
Patient with achondroplasia. Mech?
Activating mutation of FGF3 - inhibits chondrocyte growth
Treatment for mild versus severe osteoporosis
SERMs and calcitonin versus biphosphonate and pulsitile PTH
Patient with decreased visual acuity, trouble hearing, hydrocephalus, and renal tubular acidosis? Treatment?
Osteopetrosis. Smaller foramina for nerves and defect in carbonic anhydrase prevents bone resorption and causes Renal tubular necrosis. Tx is BM transplant
Patient with decreased calcium increased PTH and decreased phosphate. Other lab findings?
Osteomalacia. Increased Alk phos.
Patient complains about difficulty hearing. Comes in later with cardiogenic shock. Cause of shock?
Paget’s disease of bone. AV shunts cause heart failure.
X-ray of patient’s bone shows a lytic focus with surrounding sclerosis
Osteomyelitis
Patient with decreased serum calcium and increased Alk phos. X-ray shows?
Osteopetrosis. X-ray shows thick dense bones
Patient with decreased serum calcium and serum phosphate. Increased PTH and increased Alk phos
Osteomalacia
Patient with increased serum calcium, decreased serum phosphate, increased parathyroid hormone, and increase Alk phos. Findings?
Osteitis fibrosa cystica. Brown tumors.
Patient with precocious puberty, brown patches on skin. Changes to bone?
McCune Albright. Replacement of bone by fibroblasts and collagen. irregular bony trabeculae
Patient presents with tumor on the epiphyseal end of the distal femur. X-ray finding? Histo?
Giant cell tumor. Soap bubble sign on x-ray. Spindle-shaped cells with multinucleated giant cells
Young male presents with Malignancy arising from bone that projects laterally from growth plate. Location?
Osteochondroma. Metaphysis.
Patient with bone pain Around the distal femur. X-ray shows triangle and burst pattern on x-ray. RFs?
Osteosarcoma. Radiation, retinoblastoma, pagets disease of bone.
Boy under 15 presents with a bone tumor.
Ewing’s
T(11;22). Locations?
Ewings tumor. Pelvis, scapula, ribs, diaphysis of long bones.
45-year-old male presents with bone tumor in pelvis, spine, scapula, long bones? Part of bone?
Chondrosarcoma. Diaphysis
Patient with bone pain that resolves with aspirin. Tumor?
Osteoid osteoma
Patient with bone pain that is not relieved by aspirin. Tumor?
Osteoblastoma
Patient with bone tumor in the small bones of the hands and feet?
Chondroma
Rheumatoid arthritis. Type of hypersensitivity? Cells involved?
Type III hypersensitivity. Lymphocytes, macrophages, plasma cells.
Patient presents with nodes on the DIP and PIP joints. Bone findings?
Subchondral bone cysts, sclerosis, osteophytes, eburnation
Patient with parotid enlargement arthritis, and dysphasia Histo? Increased risk for?
Sjogren’s syndrome. Lymphocytic infiltrate of exocrine glands. Increased risk for B cell lymphoma
Patient with Von Gierke’s disease may get development of these crystals. Tx?
Gout. Monosodium urate. Allopurinol and febuxostat
Patient with mass on Achilles tendon and external ear. Mass also typically found where?
Gout. Olecranon bursa.
Patient with swelling of joint space. Weakly positive birefringent crystals. Made up of?
Pseudogout. Calcium pyrophosphate crystals
Patient presents with synovitis, tenosynovitis, and dermatitis. Causal organisms?
Infectious arthritis. Staphylococcus aureus, Streptococcus, Neisseria gonorrhea
Causes of drug induced lupus?
Quinidine, chloromazepine, hydralazine, isoniazid, methyldopa, penicillamine, phenytoin, procainamide
Patient with erythema nodosum, Bell’s palsy and granulomas?
Sarcoidosis
Sixty-year-old female presents with difficulty standing up and increased ESR
Polymyalgia rheumatica
Patient comes in with shoulder pain. Endomysial inflammation. Histo?
Polymyositis. CD8 T cells
Patient comes in with a rash on eyes, rash on neck, and red lesions on fingers. Area inflamed? Type of infiltrate?
Dermatomyositis. Perimysial inflammation with CD4+ T cells
Patient with lung cancer comes in with proximal muscle weakness. Cause?
Lambert Eaton syndrome
Patient comes in with ptosis, diplopia, and weakness. Weakness worsens of muscle use. Associated with what underlying cancer?
Thymoma, thymus hyperplasia
Patient comes in months after trauma to the elbow. Presents with mass at site of trauma. Cause?
Myositis ossificans. Metaplasia of skeletal muscle to bone following muscle trauma.
Patient comes in with difficulty breathing. Has puffy, taut skin with absence of wrinkles
Scleroderma
Patient comes in with plaques of silvery scale. Layer of skin affected?
Stratum corneum. Hyperkeratosis parakeratosis (retention of nuclei)
Albinism vs vitiligo
Decrease melanin (Decreased tyrosinase activity. Vs Decreased melanocytes
Junctional versus intradermal nevi
Flat versus papular
Infant comes in with crusted lesions on face and flexors. Associated with?
Atopic dermatitis. Associated with asthma, allergic rhinitis
The sudden appearance of these “stuck on” skin lesions may signal an underlying malignancy
Seborrhic keratosis. Lesser Trelat sign.
Patient with eosinophils with intense blisters
Bullous pemphigoid
Deposits of IgA at the tips of dermal papillary. Also see what cells?
Dermatitis herpetiformis. See neutrophils and eosinophils
Drug-induced bullous pemphigoid caused by?
Penicillamine and furosemide
Microbes that cause erythema multiforme?
HSV, mycoplasma, chlamydia, histoplasmosis
Patients with red skin lesions, Mucositis, and sloughing off skin?
SJS
Lesions that may lead to squamous cell carcinoma
Actinic keratosis
Patient with nodules on anterior shins. Associated with sarcoidosis and microbes.
Erythema nodosum
Patient with hepatitis C may get this type of infiltration at epidermal dermal Junction?
Lichen planus. Lymphocytic infiltrate
Patient presents with rash on back. Trial of corticosteroids is ineffective.
Pityriasis rosea.
UVA versus UVB light?
Tanning and photoaging versus Sunburn
Patient with staph infection presents with sloughing skin. Which skin layer affected?
Stratum granulosum
Patient presents with pink pearly nodules on face. Also see telangiectasias and crusting. Histo?
Basal cell carcinoma. Palisading nuclei
Patient with chronic draining sinus gets this skin lesion?
Squamous cell carcinoma
Lesion that grows rapidly over perios pf Weeks and then regresses spontaneously over months
Keratoacanthoma
Patient with BRAF kinase mutation. Treatment?
Melanoma. vemuRAFenib (BRAF kinase inhibitor)
