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Step 1 High Yield > Musculoskeletal, Skin, And Connective Tissue > Flashcards

Musculoskeletal, Skin, And Connective Tissue Flashcards

1
Q

What parts of the body have pain and stiffness in polymyalgia rheumatica?

A

Shoulders and hips

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2
Q

What disorder is associated with polymyalgia rheumatica?

A

Temporal (giant cell) Arteritis

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3
Q

What are the differences in cellular response between…
Polymyositis:
Dermatomyositis:

A

Polymyositis: CD8+ T cell response
Dermatomyositis: CD4+ T cell response

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4
Q

What are the differences in location of inflammation between…
Polymyositis:
Dermatomyositis:

A

Polymyositis: Endomysial inflammation
Dermatomyositis: Perimysial inflammation

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5
Q

What does the acronym RASHORPAIN stand for in SLE?

A 
Rash
Arthritis
Soft tissues/Serositis
Hematologic disorders
Oral/nasopharyngeal ulcers
Renal disease
Photosensitivity (Positive VDRL/RPR)
Antinuclear antibodies
Immunosuppressants
Neurologic disorders (seizures, psychosis)
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6
Q

In Myasthenia gravis there are autoantibodies to…

A

The post synaptic ACh receptor

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7
Q

Myasthenia gravis is associated with what abnormality?

A

Thymoma; thymic hyperplasia

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8
Q

Lambert Eaton myasthenic syndrome is caused by antibodies to…

A

presynaptic calcium channels (leading to decreased ACh release)

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9
Q

What type of cancer is associated with Lambert Eaton myasthenic syndrome?

A

Small cell lung cancer

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10
Q

What type of scleroderma is associated with Scl-70 (DNA topoisomerase I) antibody?

A

Diffuse scleroderma

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11
Q

What is CREST involvement in limited scleroderma?

A 
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly (tightening of skin)
Telangiectasia
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12
Q

What antibody is associated with scleroderma (limited)?

A

Anticentromere antibody

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13
Q

What type of hypersensitivity is seen in allergic contact dermatitis?

A

Type IV hypersensitivity

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14
Q

What is the difference between atopic dermatitis and psoriasis in terms of location?

A

Atopic dermatitis - flexor surfaces (face and antecubital fossa)
Psoriasis - extensor surfaces

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15
Q

What changes to the cellular layers of the skin occurs in psoriasis?

A

Increased stratum spinosum

Decreased stratum granulosum

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16
Q

What is the Leser-Trelat sign

A

Associated with seborrheic keratosis - sudden appearance of multiple suborrheic keratoses indicating an underlying malignancy (GI or lymphoid)

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17
Q

What is the order from most superficial to most deep of the following infectious skin diseases?
Impetigo; Cellulitis; Necrotizing fasciitis

A

Impetigo (very superficial) > Cellulitis (dermis and subcutaneous tissues) > Necrotizing fasciitis(deeper tissue injury)

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18
Q

What disease is associated with Lichen Planus?

A

Hepatitis C

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19
Q

What are the 6 Ps of Lichen Planus?

A

Pruritic, Purple, Polygonal Planar Papules, Plaques

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20
Q

Which skin disorder is associated with a christmas tree distribution?

A

Pityriasis rosea (Herald patch)

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21
Q

What tumor marker is associated with melanoma?

A

S-100

22
Q

What mutation is associated with melanoma?

A

Activating mutation in BRAF kinase

23
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 1?

A

Trigeminal nerve (V2 and V3) and Maxillary artery (portion)

24
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 2?

A

Facial nerve and stapedial artery (regresses)

25
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 3?

A

Glossopharyngeal nerve and common carotid artery + proximal internal carotid artery

26
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 4?

A

Superior laryngeal branch of vagus and true aortic arch + subclavian arteries

27
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 5?

A

All obliterated

28
Q

What cranial nerve and aortic arch derivative is associated with pharyngeal arch 6?

A

Recurrent laryngeal branch of vagus and pulmonary arteries + ductus arteriosus

29
Q

What is the “unhappy triad” associated with lateral force applied to a planted leg

A

Damage to ACL, MCL, and medial meniscus (attached to MCL)

30
Q 
Name the functions of the following muscles
Supraspinatus:
Infraspinatus:
Teres minor:
Subscapularis:
A

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

31
Q

Traction or tear of upper trunk:

Traction or tear of lower trunk:

A

Upper trunk: Erb palsy (C5, C6 roots)

Lower trunk: Klumpke palsy (C8-T1) or Thoracic outlet syndrome (compression of lower trunk AND subclavian vessels)

32
Q

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:

A

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

33
Q

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:

A

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)

34
Q 
What are the actions of the following nerves?
Obturator:
Femoral:
Common peroneal:
Tibial:
Superior gluteal:
Inferior gluteal:
A

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

35
Q

What nerve and artery are injured with damage to the following structures:
Distal humerus/cubital fossa:
Popliteal fossa:
Posterior to medial malleolus:

A

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

36
Q

What is released by myosin during the power stroke?

A

ADP and subsequently, inorganic phosphate

37
Q

Weight training results in hypertrophy of ______ muscle fibers

A

fast-twitch (type 2 muscle)

38
Q

How does “1 slow red ox” relate to type 1 muscle

A

Slow twitch; red fibers; increased mitochondria and myoglobin concentration (oxidative phosphorylation)

39
Q

What is membranous ossification?

A

Woven bone formed directly without cartilage (bones of calvarium and facial bones) that is later remodeled to lamellar bone - not affected in achondroplasia

40
Q

FGFR3 ______-activation decreases chondrocyte proliferation in an ________ ________ inherited condition

A

FGFR3 over-activation decreases chondrocyte proliferation

Autosomal dominant

41
Q

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:

A

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

42
Q

What mutation is associated with osteopetrosis?

A

Carbonic anhydrase II (impaired ability of osteoclast to generate acidic environment necessary for bone resorption)

43
Q

Which bone tumors occur in the…
Epiphysis:
Metaphysis:
Diaphysis:

A

Epiphysis: Giant cell tumor (soap bubble - benign)
Metaphysis: Osteosarcoma (codman triangle)
Diaphysis: Ewing sarcoma (early metastases); chondrosarcoma (glistening mass withing medullary cavity)

44
Q

Which glycogen storage disease can cause gout?

A

Von Gierke disease

45
Q

What are the seronegative spondyloarthropathies (HLA-B27)?

A 
Psoriatic arthritis (sausage fingers)
Ankylosing spondylitis (ankylosis, uveitis, and aortic regurgitation)
Inflammatory bowel disease
Reactive arthritis (Can't see, pee, or climb a tree)
46
Q

What bacteria can cause reactive arthritis?

A

Shigella, Salmonella, Yersinia, Campylobacter, Chlamydia

47
Q

What happens to ACE levels and vitamin D levels in sarcoidosis?

A

Both increase

48
Q

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:

A

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

49
Q

What is keratocanthoma?

A

Variant of squamous cell carcinoma (skin) that grows rapidly and may regress spontaneously over months

50
Q 
Aspirin dose and function...(NOT AN NSAID)
Low dose (
A

Low dose (

51
Q

What is derived from the 1st branchial pouch?

A

Mastoid air cells, middle ear cavity, eustachian tubes

52
Q

What is derived from the second branchial pouch?
Third pouch?
4th pouch?

A

2nd: Lining of palantine tonsil
3rd: Thymus, inferior parathyroids
4th: Superior parathyroids

Step 1 High Yield (21 decks)

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