Rheum and Derm Flashcards
most common malignant primary bone tumor of children
osteosarcoma
most common benign bone tumor
osteochondroma
11;22 translocation
Ewing sarcoma
“sunburst” pattern on x-ray
osteosarcoma
“soap-bubble” appearance on x-ray
giant cell (osteoclastoma)
“onion skin” appearance of bone
Ewing sarcoma
May be a hamartoma
osteochondroma
Codman’s triangle on x-ray
osteosarcoma
achondroplasia gene mutation
FGFR3
osteitis fibrosa cystica
von Recklinghausen dis of bone
hyperparathyroidism: high PTH -> high Ca and alk phos, low Phos
or psudeohypopaarathyroid: PTH resistance in renal tubules: low Ca and high phosphate
high PTH: excess osteoclasts -> Brown tumors in bone
excess osteoclast activity results in disorganized bony architecture
Paget’s
bone is replaced by fibroblasts, collagen, and irregular bony trabeculae
polyostotic fibrous dysplasia
defective mineralization of osteoid
rickets and osteomalacia
failure of bone resorption -> thickened and dense bone
osteopetrosis
genetic deficiency of carbonic anhydrase II
osteopetrosis
bone enlargement, bone pain, arthritis
Paget’s
vertebral compression fractures
osteoporosis
side effects of amiodarone
pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroid
check PFT, LFT, and TFT
also corneal deposits and photosensitivity
dislocated vs separated shoulder
dislocated: head of humerous out of glenoid cavity
separation: clavicle separates from the acromion and coracoid processes
anterior shoulder dislocation
axillary n, posterior circumflex a supraspinatous tendon Brankart lesion (anterior glenohumeral ligaments) Kill-Sachs lesion (posterolateral humeral head defect)
patellofemoral syndrome
most common cause of knee pain < 45 yo
anterior knee pain exacerbated by activity
Adhesive capsulitis
severe shoulder adhesions that lock the shoulder in place. commonly due to disuse of shoulder due to pain or prolonged immobilization
Tx: injections, PT, break under anesthesia
ligaments typically injured during an ankle sprain
anterior talofibullar (most common)
calcaneofibullar
posterior talofibullar
antibodies useful to diagnose rheumatoid arthritis
rheumatoid factor (IgM against Fc IgG) anti-cyclic citrullinated peptide (ACPA)
how do NSAIDs cause renal disease
renal ischemia: decreased production of prostaglandins causes afferent arteriole to vasoconstrict
acute interstitial nephritis
swollen, hard, painful joint finger
osteoarthritis
swollen, boggy, painful joint finger
rheumatoid arthritis
cartilage erosion with polished bone beneath
osteoarthritis
pencil and cup deformity
psoriatic arthritis
acute gout medications
NSAIDS
colchicine
steroids
chronic gout medications
allopurinol (inhibits xanthine oxidase)
probenacid (inhibits reabsorption of uric acid)
sexually active 19 yo male presents with pink eye, arthritis of the right knee, and dysuria. what is the most likely diagnosis?
reactive arthrtitis
“can’t see, can’t pee, can’t climb a tree”
swollen, red, acutely painful great toe joint
Gout
positively birefringent rhomboid-shaped crystals
pseudogout
negatively birefringent needle-shaped crystals
gout
bamboo spine on x-ray
ankylosing spondylitis
HLA-B27
seronegative spondyloarthropathies
PAIR
Psoriatic arthritis, ankylosing spondylitis, inflammatory bowel, Reactive arthritis
what bone disorder results from excess PTH
osteitis fibrosa cystica (von Recklinghausen)
systemic lupus diagnosis
4 of 11 of:
SOAP BRAIN MD
serositis, oral ulcers, arthritis, photosensitivity, blood disorder, renal disorder, ANA positive, Immunologic disorder, neurologic disorder, malar rash, discoid rash
drugs that cause drug-induced Lupus
SHIPP sulfonamides hydralazine isoniazid phenytoin procainamide
anti-smith and anti-dsDNA
SLE
anti-histone Ab
drug-induced lupus
antic-centromere Ab
CREST
CREST Scleroderma
Calcinosis Raynaud's phenomenon Esophageal dysmotility Sclerodactyly Telangiectasia
anti-topoisomerase Ab
diffuse scleroderma
anti-Jo-1 Ab
polymyositis
anti-Ro
Sjogren’s
facial rash and Raynaud phenomenon in a young woman
SLE
arthritis, dry mouth, and dry eyes
Sjogren’s
most common cause of death in SLE
renal failure
nephritis
atopic dermatitis
AKA eczema
pruritic eruption associated with asthma and allergies
Pathopysiology of acne
Hyperkeratosis (Tx vit A analogs, retinoids)
Sebum overproduction (isotretinoin, spironolactone, estrogens)
Propionibacterium acnes (erythromycin, benzoyl peroxide)
inflammtion (steroids)
hallmark of necrotizing fasciitis
crepitus, purple color, rapidly spreads, tenderness beyond borders
caused by anaerobes and s. pyogenes
pruritic, purple, polygonal papules
lichen planus
pruritus associated with asthma
eczema (atopic dermatitis)
pruritic vesicles associated with celiac disease
dermatitis herpetiformis
allergy to nickel
type IV hypersensitivity
antibodies against epidermal basement membrane
bullous pemphigoid
antibodies against cell-cell adhesions
pemphigous vulgaris
parakeratotic scaling
psoriasis
keratin-filled cysts
seborrheic keratosis
sand-paper; predisposition to squamous cell cancer
actinic keratosis
honey-crusting lesions common about nose and lips
impetigo
hyperkeratosis and koilocytosis
verrucae (warts)
histology showing palisading nuclei
basal cell carcinoma
keratin pearls on skin biopsy
squamous cell carcinoma
most common malignant skin tumor
basal cell carcinoma
skin rash and proximal muscle weakness
dermatomyositis
75 year old man presents with acute knee pain and swelling. An x-ray reveals absence of erosion of the joint space, but there are calcium deposits in the menisci. What is the diagnosis, and what would you find on aspiration of the joint?
pseudogout with calcium pyrophosphate crystals
what are the common locations for tophi in gout patients?
external ear
olecranon bursa
achilles tendon
