Musculoskeletal, Skin, And Connective Tissue Flashcards
What parts of the body have pain and stiffness in polymyalgia rheumatica?
Shoulders and hips
What disorder is associated with polymyalgia rheumatica?
Temporal (giant cell) Arteritis
What are the differences in cellular response between…
Polymyositis:
Dermatomyositis:
Polymyositis: CD8+ T cell response
Dermatomyositis: CD4+ T cell response
What are the differences in location of inflammation between…
Polymyositis:
Dermatomyositis:
Polymyositis: Endomysial inflammation
Dermatomyositis: Perimysial inflammation
What does the acronym RASHORPAIN stand for in SLE?
Rash Arthritis Soft tissues/Serositis Hematologic disorders Oral/nasopharyngeal ulcers Renal disease Photosensitivity (Positive VDRL/RPR) Antinuclear antibodies Immunosuppressants Neurologic disorders (seizures, psychosis)
In Myasthenia gravis there are autoantibodies to…
The post synaptic ACh receptor
Myasthenia gravis is associated with what abnormality?
Thymoma; thymic hyperplasia
Lambert Eaton myasthenic syndrome is caused by antibodies to…
presynaptic calcium channels (leading to decreased ACh release)
What type of cancer is associated with Lambert Eaton myasthenic syndrome?
Small cell lung cancer
What type of scleroderma is associated with Scl-70 (DNA topoisomerase I) antibody?
Diffuse scleroderma
What is CREST involvement in limited scleroderma?
Calcinosis Raynaud phenomenon Esophageal dysmotility Sclerodactyly (tightening of skin) Telangiectasia
What antibody is associated with scleroderma (limited)?
Anticentromere antibody
What type of hypersensitivity is seen in allergic contact dermatitis?
Type IV hypersensitivity
What is the difference between atopic dermatitis and psoriasis in terms of location?
Atopic dermatitis - flexor surfaces (face and antecubital fossa)
Psoriasis - extensor surfaces
What changes to the cellular layers of the skin occurs in psoriasis?
Increased stratum spinosum
Decreased stratum granulosum
What is the Leser-Trelat sign
Associated with seborrheic keratosis - sudden appearance of multiple suborrheic keratoses indicating an underlying malignancy (GI or lymphoid)
What is the order from most superficial to most deep of the following infectious skin diseases?
Impetigo; Cellulitis; Necrotizing fasciitis
Impetigo (very superficial) > Cellulitis (dermis and subcutaneous tissues) > Necrotizing fasciitis(deeper tissue injury)
What disease is associated with Lichen Planus?
Hepatitis C
What are the 6 Ps of Lichen Planus?
Pruritic, Purple, Polygonal Planar Papules, Plaques
Which skin disorder is associated with a christmas tree distribution?
Pityriasis rosea (Herald patch)
What tumor marker is associated with melanoma?
S-100
What mutation is associated with melanoma?
Activating mutation in BRAF kinase
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 1?
Trigeminal nerve (V2 and V3) and Maxillary artery (portion)
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 2?
Facial nerve and stapedial artery (regresses)
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 3?
Glossopharyngeal nerve and common carotid artery + proximal internal carotid artery
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 4?
Superior laryngeal branch of vagus and true aortic arch + subclavian arteries
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 5?
All obliterated
What cranial nerve and aortic arch derivative is associated with pharyngeal arch 6?
Recurrent laryngeal branch of vagus and pulmonary arteries + ductus arteriosus
What is the “unhappy triad” associated with lateral force applied to a planted leg
Damage to ACL, MCL, and medial meniscus (attached to MCL)
Name the functions of the following muscles Supraspinatus: Infraspinatus: Teres minor: Subscapularis:
Supraspinatus: abducts arm initially (before deltoid)
Infraspinatus: laterally rotates arm; pitching injury
Teres minor: adducts and laterally rotates arm
Subscapularis: adducts and medially rotates arm
Traction or tear of upper trunk:
Traction or tear of lower trunk:
Upper trunk: Erb palsy (C5, C6 roots)
Lower trunk: Klumpke palsy (C8-T1) or Thoracic outlet syndrome (compression of lower trunk AND subclavian vessels)
What nerve is injured in the following scenarios…
Fractured surgical neck of humerus or anterior dislocation:
Crutches or midshaft fracture of humerus:
Supracondylar fraction of humerus:
Fracture of medial epicondyle of humerus:
Fractured surgical neck of humerus or anterior dislocation: Axillary nerve
Crutches or midshaft fracture of humerus: Radial nerve
Supracondylar fraction of humerus: Median nerve
Fracture of medial epicondyle of humerus: Ulnar nerve
What leg nerve is likely injured in the following scenarios?
Pelvic surgery:
Pelvic fracture:
Compression of lateral aspect of leg or fibular neck fracture:
Knee trauma, baker cyst, or tarsal tunnel syndrome:
Posterior hip dislocation, polio:
Posterior hip dislocation:
Pelvic surgery: Obturator (L2-L4)
Pelvic fracture: Femoral (L2-L4)
Compression of lateral aspect of leg or fibular neck fracture: Common peroneal (L4-S2)
Knee trauma, baker cyst, or tarsal tunnel syndrome: Tibial (L4-S3)
Posterior hip dislocation, polio: Superior gluteal (L4-S1)
Posterior hip dislocation: Inferior gluteal (L5-S2)
What are the actions of the following nerves? Obturator: Femoral: Common peroneal: Tibial: Superior gluteal: Inferior gluteal:
Obturator: Thigh sensation and adduction
Femoral: Thigh flexion and leg extension
Common peroneal (PED): Everts and dorsiflexes (foot drop if injured)
Tibial (TIP): Inverts and plantarflexes (also sensation on dorsum of foot)
Superior gluteal: medius and minimus - injury causes trendelenburg gait
Inferior gluteal: maximus - injury causes loss of hip extension
What nerve and artery are injured with damage to the following structures:
Distal humerus/cubital fossa:
Popliteal fossa:
Posterior to medial malleolus:
Distal humerus/cubital fossa: Median nerve and brachial artery
Popliteal fossa: Tibial nerve and popliteal artery
Posterior to medial malleolus: Tibial nerve and posterior tibial artery
What is released by myosin during the power stroke?
ADP and subsequently, inorganic phosphate
Weight training results in hypertrophy of ______ muscle fibers
fast-twitch (type 2 muscle)
How does “1 slow red ox” relate to type 1 muscle
Slow twitch; red fibers; increased mitochondria and myoglobin concentration (oxidative phosphorylation)
What is membranous ossification?
Woven bone formed directly without cartilage (bones of calvarium and facial bones) that is later remodeled to lamellar bone - not affected in achondroplasia
FGFR3 ______-activation decreases chondrocyte proliferation in an ________ ________ inherited condition
FGFR3 over-activation decreases chondrocyte proliferation
Autosomal dominant
What disorder is associated with the following descriptions?
Subperiosteal thinning:
Disorganized lamellar bone structure:
Osteoid matrix accumulation around trabeculae:
Trabecular thinning with fewer interconnections:
Persistence of primary spongiosa in the medullary cavity:
Subperiosteal thinning: Osteitis fibrosa cystica (primary or secondary hyperparathyroidism - fibrous replacement of bone)
Disorganized lamellar bone structure: Paget disease of the bone
Osteoid matrix accumulation around trabeculae: Osteomalacia
Trabecular thinning with fewer interconnections: Osteoporosis
Persistence of primary spongiosa in the medullary cavity: Osteopetrosis
What mutation is associated with osteopetrosis?
Carbonic anhydrase II (impaired ability of osteoclast to generate acidic environment necessary for bone resorption)
Which bone tumors occur in the…
Epiphysis:
Metaphysis:
Diaphysis:
Epiphysis: Giant cell tumor (soap bubble - benign)
Metaphysis: Osteosarcoma (codman triangle)
Diaphysis: Ewing sarcoma (early metastases); chondrosarcoma (glistening mass withing medullary cavity)
Which glycogen storage disease can cause gout?
Von Gierke disease
What are the seronegative spondyloarthropathies (HLA-B27)?
Psoriatic arthritis (sausage fingers) Ankylosing spondylitis (ankylosis, uveitis, and aortic regurgitation) Inflammatory bowel disease Reactive arthritis (Can't see, pee, or climb a tree)
What bacteria can cause reactive arthritis?
Shigella, Salmonella, Yersinia, Campylobacter, Chlamydia
What happens to ACE levels and vitamin D levels in sarcoidosis?
Both increase
Name the following skin lesions:
Small, rough, caused by excess sun exposure:
Depositions of IgA at tips of dermal papillae:
Painless plaques on tongue that cannot be scraped off:
Inflammatory lesions of subcutaneous fat:
Small, rough, caused by excess sun exposure: Actinic keratosis
Depositions of IgA at tips of dermal papillae: Dermatitis herpetiformis
Painless plaques on tongue that cannot be scraped off: Hairy leukoplakia (EBV mediated)
Inflammatory lesions of subcutaneous fat: Erythema nodosum
What is keratocanthoma?
Variant of squamous cell carcinoma (skin) that grows rapidly and may regress spontaneously over months
Aspirin dose and function...(NOT AN NSAID) Low dose (
Low dose (
What is derived from the 1st branchial pouch?
Mastoid air cells, middle ear cavity, eustachian tubes
What is derived from the second branchial pouch?
Third pouch?
4th pouch?
2nd: Lining of palantine tonsil
3rd: Thymus, inferior parathyroids
4th: Superior parathyroids
