Musculoskeletal DZ Flashcards by Michael Salgado

Function of supraspinatus muscle

Abducts arm initially

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Lumbar puncture is in line with what structure?

Iliac crest

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Most common rotator cuff injury?

Supraspinatus. Abducts arm initially

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Pitching injury - what muscle

Infraspinatus

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Dislocation of this bone may cause acute carpal tunnel syndrome

Lunate

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Patient with a fracture of supracondylar humerus. Motor defect?

Median nerve. Decreased Opposition of thumb, Lateral finger flexion, wrist flexion

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Patient with subluxation of radius. N affected?

Deep branch of radial nerve

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Dislocation of humeral head. What nerve is affected? (And roots)

Axillary nerve (C5-T1)

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Fracture and midshaft humerus. Muscles affected?

Brachioradialis, extensors wrist and fingers, supinator, triceps

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Fracture of medial epicondyles humorous?

Ulnar nerve C8, T1

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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

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Patient that can’t extend PIP and DIP. Muscles also control?

Lumbricals. Also control flexion at MCP

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Patient with achondroplasia. Mech?

Activating mutation of FGF3 - inhibits chondrocyte growth

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Treatment for mild versus severe osteoporosis

SERMs and calcitonin versus biphosphonate and pulsitile PTH

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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

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Patient with decreased calcium increased PTH and decreased phosphate. Other lab findings?

Osteomalacia. Increased Alk phos.

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Patient complains about difficulty hearing. Comes in later with cardiogenic shock. Cause of shock?

Paget’s disease of bone. AV shunts cause heart failure.

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X-ray of patient’s bone shows a lytic focus with surrounding sclerosis

Osteomyelitis

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Patient with decreased serum calcium and increased Alk phos. X-ray shows?

Osteopetrosis. X-ray shows thick dense bones

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Patient with decreased serum calcium and serum phosphate. Increased PTH and increased Alk phos

Osteomalacia

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Patient with increased serum calcium, decreased serum phosphate, increased parathyroid hormone, and increase Alk phos. Findings?

Osteitis fibrosa cystica. Brown tumors.

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Patient with precocious puberty, brown patches on skin. Changes to bone?

McCune Albright. Replacement of bone by fibroblasts and collagen. irregular bony trabeculae

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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

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Young male presents with Malignancy arising from bone that projects laterally from growth plate. Location?

Osteochondroma. Metaphysis.

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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)